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\author{SmeNdlela}
\pdfinfo{
  /Title (pharmacology-anti-epileptic-drugs.pdf)
  /Creator (Cheatography)
  /Author (SmeNdlela)
  /Subject (Pharmacology: Anti-Epileptic Drugs Cheat Sheet)
}

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    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Pharmacology: Anti-Epileptic Drugs Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{SmeNdlela} via \textcolor{DarkBackground}{\uline{cheatography.com/192660/cs/40061/}}}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}SmeNdlela \\
  \uline{cheatography.com/smendlela} \\
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Not Yet Published.\\
   Updated 28th August, 2023.\\
   Page {\thepage} of \pageref{LastPage}.
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  Measure your website readability!\\
  www.readability-score.com
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\begin{multicols*}{3}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{{\bf{Anti-Epileptic Agents\{\{fa-bolt\}\}}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{{\bf{1. Carboxamide derivatives}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Cabamazepine} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{} \tn 
% Row Count 2 (+ 0)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{} \tn 
% Row Count 2 (+ 0)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{} \tn 
% Row Count 2 (+ 0)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.04057 cm} x{2.93643 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{1.Cabamazepine}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Trade names:}} & Tegretol, Degranol and Sandoz-Carbamazepine \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
{\bf{Oral dosage form tablet:}} & sustained release tablet and suspension \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Primary drug for partial and generalized tonic clonic seizures} \tn 
% Row Count 6 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Not effective in absence seizure} \tn 
% Row Count 7 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Mechanism of action\{\{fa-bolt\}\}}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{▪ In seizure dysfunctional sodium channels allow for too much influx of Sodium \newline % Row Count 2 (+ 2)
ion which prolongs neuronal excitability (depolarization) \newline % Row Count 4 (+ 2)
▪ Carbamazepine limits repetitive firing of action potential \newline % Row Count 6 (+ 2)
(limits too much influx of sodium ion) \newline % Row Count 7 (+ 1)
▪ This is due to prolonging the Sodium channel inactivation% Row Count 9 (+ 2)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{{\bf{Side effects and Toxicity}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Cardiac arrhythmias with or without hypertension} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Behaviroal change} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Gastroinstinal symptoms} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Hirudism} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Megaloblastic anemia} \tn 
% Row Count 5 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{{\bf{Pharmacokinetics}}\{\{fa-bolt\}\}}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{• Phenytoin distributes into the body tissues, including the brain, \newline % Row Count 2 (+ 2)
   within {\bf{30 to 60 minutes after reaching the systemic circulation}} \newline % Row Count 4 (+ 2)
{\bf{• Effective for up to 24 hours}} \newline % Row Count 5 (+ 1)
• Metabolized by hepatic cytochrome P450% Row Count 6 (+ 1)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.63781 cm} x{2.33919 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Drug interactions:}}  \tn
% Row 0
\SetRowColor{LightBackground}
Reduces the effect of {\bf{oral contraceptives}} & Reduces the effect of {\bf{warfarin}} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
Could result in unplanned pregnancy & Could result in deep vain thrombosis \tn 
% Row Count 5 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Cytochrome P450 inducer}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.33919 cm} x{2.63781 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{5.Valproate}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Trade Names:}} & Epilium liquid, Epilium CR, Epilium IV, Epilium crushable, Convulox, Navalpro, Eprolep \tn 
% Row Count 5 (+ 5)
% Row 1
\SetRowColor{white}
{\bf{Oral and parantral dosage form:}} & Tablet, capsule, suspension, IV \tn 
% Row Count 7 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Effective against absence, myoclonic partial and tonic clonic seizures, suitable for {\bf{HIV positive children with epilepsy}}} \tn 
% Row Count 10 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Mechanism of action\{\{fa-bolt\}\}}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{▪ Mechanism of action is not fully understood \newline % Row Count 1 (+ 1)
▪ It is believed that valproic acid leads to increased production of GABA \newline % Row Count 3 (+ 2)
▪ In addition to this, valproate is also thought to enhance the effect of GABA that already exists in the area on the receptors. \newline % Row Count 6 (+ 3)
▪ Valproate mimics the action of GABA% Row Count 7 (+ 1)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Pharmacokinetics}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{• Absorbed rapidly and completely after oral administration with 81-89\% bioavailability. Active for around 9-16 hours \newline % Row Count 3 (+ 3)
• Metabolized by hepatic cytochrome P450% Row Count 4 (+ 1)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Side Effects and Toxicity\{\{fa-bolt\}\}}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Anorexia} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Vomiting} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Nausea} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Sedation atexia} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Tremor} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Rash} \tn 
% Row Count 6 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Alopecia} \tn 
% Row Count 7 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Increased appetite} \tn 
% Row Count 8 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Drug interactions}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{All benzodiazepines cause excessive sedation when combined with other medications that slow the brain's processes. (i.e, alcohol, barbiturates narcotics, and tranquilizers)% Row Count 4 (+ 4)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{For Benzodiazepines}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{0.9154 cm} x{2.56312 cm} x{1.09848 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{5.377cm}}{\bf\textcolor{white}{2. BENZODIAZEPINES\{\{fa-bolt\}\}}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Drug type:}} & {\bf{Trade names:}} & {\bf{Indication:}} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\seqsplit{Clonazepam} & Rivotril, Clonam & Drops, tablet, IV \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\seqsplit{Diazepam} & Pax, Valium, A-Lenon, Transjet, Betapam, Doval & Tablet, IV \tn 
% Row Count 7 (+ 3)
% Row 3
\SetRowColor{white}
\seqsplit{Lorazepam} & Ativan, Tranqipam & Tablet, IV \tn 
% Row Count 9 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\seqsplit{Midazolam} & Accord, Sabax, Midaium, Dormicum, Midazoject & IV, tablet, INF \tn 
% Row Count 11 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Mechanism of action\{\{fa-bolt\}\}}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{5.377cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/smendlela_1693216654_OIP.jpeg}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Indication of Benzodiazepines}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{▪ Prolonged seizure activity, less than {\bf{5 minutes between seizures}} \newline % Row Count 2 (+ 2)
▪ Can last up to {\bf{20 minutes or more}} \newline % Row Count 3 (+ 1)
▪ EML recommends which drug to stop status epilepticus% Row Count 5 (+ 2)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{{\bf{In Status Epilepticus}}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Mechanism of action\{\{fa-bolt\}\}}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{▪ Benzodiazepines cause activation of the GABAa receptor and opening of the \newline % Row Count 2 (+ 2)
Chlorine channels associated with the receptor \newline % Row Count 3 (+ 1)
▪ The neuronal membrane is hyperpolarized and is less likely to fire \newline % Row Count 5 (+ 2)
▪ Also inhibit excitatory glutamate receptors% Row Count 6 (+ 1)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{1.04425 cm} x{1.04425 cm} x{1.04425 cm} x{1.04425 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{4}{x{5.377cm}}{\bf\textcolor{white}{Benzodiazepines}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Clonazepam}} & {\bf{Diazepam}} & {\bf{Lorazepam}} & {\bf{Midazolam}} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Used for broad spectrum of seizures & First line treatment in Status \seqsplit{Epilepticus} & First line treatment in Status \seqsplit{Epilepticus} & First line treatment in Status \seqsplit{Epilepticus} \tn 
% Row Count 7 (+ 5)
% Row 2
\SetRowColor{LightBackground}
Effective in Status \seqsplit{Epilepticus} & Rarely used for long term & Rarely used for long term & Rarely used for long term \tn 
% Row Count 11 (+ 4)
% Row 3
\SetRowColor{white}
Absence seizure & Good oral \seqsplit{absorption} & Better than Diazepam & Effective in Status \seqsplit{Epilepticus} that has not improved following other \seqsplit{treatments} or when \seqsplit{intravenous} access can not be obtained \tn 
% Row Count 24 (+ 13)
% Row 4
\SetRowColor{LightBackground}
Given in \seqsplit{combination} & \seqsplit{Completely} \seqsplit{metabolized} in liver and excreted in urine & Good oral \seqsplit{absorption} & Good oral \seqsplit{absorption} \tn 
% Row Count 30 (+ 6)
\end{tabularx}
\par\addvspace{1.3em}

\vfill
\columnbreak
\begin{tabularx}{5.377cm}{x{1.04425 cm} x{1.04425 cm} x{1.04425 cm} x{1.04425 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{4}{x{5.377cm}}{\bf\textcolor{white}{Benzodiazepines (cont)}}  \tn
% Row 5
\SetRowColor{LightBackground}
Good oral \seqsplit{absorption} &  & \seqsplit{Completely} \seqsplit{metabolized} in liver and excreted in urine & . \tn 
% Row Count 6 (+ 6)
% Row 6
\SetRowColor{white}
Not for long term use - develops tolerance & . &  &  \tn 
% Row Count 11 (+ 5)
% Row 7
\SetRowColor{LightBackground}
\seqsplit{Completely} \seqsplit{metabolized} in liver and excreted in urine & . &  &  \tn 
% Row Count 17 (+ 6)
\hhline{>{\arrayrulecolor{DarkBackground}}----}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Side Effects and Toxicity\{\{fa-bolt\}\}}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Drowsiness and confusion} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Blurred vision} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Slurred speech} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Lack of coordination and weakness} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Difficulty breathing} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Coma} \tn 
% Row Count 6 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{For Benzodiazepines}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{1.89126 cm} x{3.08574 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{3.Phenobarbital}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Trade names}} & Phenobarb Vital, Propain Forte, Donatal Elexir, Lethyl Sedabarb \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
{\bf{Only oral dosage form}} & Tablet, syrup \tn 
% Row Count 5 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Low toxicity, inexpensive, widely used for young children} \tn 
% Row Count 7 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Non-selective to the type of seizure. {\bf{Mainly used for generalized tonic clonic and partial seizures and status epilepticus 20mg/kg, crushed and given by nasogastric tube}} (if one dose of midazolam or two doses of diazepam fail to show response)} \tn 
% Row Count 12 (+ 5)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Mechanism of action\{\{fa-bolt\}\}}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{❑Through its action on GABA receptors, phenobarbital increases flux of chlorine \newline % Row Count 2 (+ 2)
ions into the neuron which decreases excitability. \newline % Row Count 4 (+ 2)
❑ Direct blockade of excitatory glutamate signaling is also believed to contribute \newline % Row Count 6 (+ 2)
to the hypnotic/anticonvulsant effect% Row Count 7 (+ 1)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Pharmacokinetics}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{• Oral absorption is complete but slow \newline % Row Count 1 (+ 1)
• Peak concentration in plasma is seen after several hours (8-12 hours) after oral administration \newline % Row Count 3 (+ 2)
• Remains in the body for a long time (2-7 days) \newline % Row Count 5 (+ 2)
• Metabolized by liver (cytochrome p450)% Row Count 6 (+ 1)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{{\bf{Side effects and Toxicity}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Sedation (tolerance develops after continues use)} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Driving and use of heavy machinery must be avoided} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Irritability and hyperactivity in children} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Agitation and confusion in the elderly} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Some skin allergies in rare cases} \tn 
% Row Count 5 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.63781 cm} x{2.33919 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Drug interactions:}}  \tn
% Row 0
\SetRowColor{LightBackground}
Reduces the effect of {\bf{oral contraceptives}} & Reduces the effect of {\bf{warfarin}} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
Could result in unplanned pregnancy & Could result in deep vain thrombosis \tn 
% Row Count 5 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Cytochrome P450 inducer}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.33919 cm} x{2.63781 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{4. Phenytoin}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Trade Names:}} & Epanutin Forte suspension, Epanutin Infatabs, Epanutin Ready Mixed Parantral \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
{\bf{Oral and parantral dosage form:}} & Tablet, capsule, suspension, IV \tn 
% Row Count 6 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Active against {\bf{all types of partial and tonic clonic seizures but not absence seizures}}} \tn 
% Row Count 8 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Causes {\bf{antiseizure activity without causing general CNS depression}}} \tn 
% Row Count 10 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Mechanism of action\{\{fa-bolt\}\}}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{▪ In seizure dysfunctional sodium channels allow for too much influx of Sodium ion which prolongs neuronal excitability (depolarization) \newline % Row Count 3 (+ 3)
▪ Phenytoin Limits repetitive firing of action potential (too much influx of sodium ion) \newline % Row Count 5 (+ 2)
▪ This is due to slowing the rate of recovery of Sodium channels from inactivation.% Row Count 7 (+ 2)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{{\bf{Pharmacokinetics}}\{\{fa-bolt\}\}}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{• Phenytoin distributes into the body tissues, including the brain, \newline % Row Count 2 (+ 2)
   within {\bf{30 to 60 minutes after reaching the systemic circulation}} \newline % Row Count 4 (+ 2)
{\bf{• Effective for up to 24 hours}} \newline % Row Count 5 (+ 1)
• Metabolized by hepatic cytochrome P450% Row Count 6 (+ 1)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{{\bf{Side effects and Toxicity}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Cardiac arrhythmias with or without hypertension} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Behaviroal change} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Gastroinstinal symptoms} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Hirudism} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Megaloblastic anemia} \tn 
% Row Count 5 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

\end{document}