A patient with recent-onset primary generalized epilepsy develops drug reachtion and skin rash due to Phenytoin sodium. The most appropriate course of action is:
Ref: KDT 6/e p411 Hypersensitivity reaction to a drug mandates its discontinuation. Phenytoin is being used for control of GTCS. Valproate can be substituted for phenytoin because it is equally effective against GTCS. Ethosuximide is useful only against absence seizures whereas clonazepam is used to control acute attacks only. Therefore, best course is to change the drug from phenytoin to valproate.
Shift to clonazepam
Resta phenytoin sodium after 2 weeks
Shift to sodium valproate
Shift to Ethosuximide
Central Nervous system