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medicatios and levels

Tue, 02/08/2005 - 15:53
Hi, I've posted several times and have yet another question. My son is 4, diagnosed with Epilepsy in Oct 2004. We've been on Lamictal ever since diagnosis and at 15mg 2x a day seizures stopped. He has been having speech problems, he had some even before the Epilepsy (I had a post about this and got so much help on the suject. Thanks everyone!!), however it was a little more severe and a little different this time, so I thought I would mention it to the Neurologist and he suggested increasing the Lamictal to 25mg 2x a day. I questioned him on this since a smaller dose has done fine so far and he added that he is on a dose that is just barely taking care of the seizures and that 25mg is still a very small dose and I shouldn't be overly concerned. He said he has seen some great results with learning dissabilities and speech problems by slightly raising the dose, so were going to give it a try. My question is that I have read many times about people talking about the levels in the blood and toxicity. What excatly is toxicity and what are the symptoms? I would like to know what I'm looking for should there be too much Lamictal in his system. The Neuro did take bloodwork before we increased his meds and he said it was to make sure his liver and other oragans are handeling it so far. I hear people taking about levels are there certain levels the Neuro is also looking for? I want to ask him about this, but not quite sure what I am even talking about. Can anyone just inform me a little on this subject? I would be so thankful!! Thanks, Wendy

Comments

RE: medicatios and levels

Submitted by blondie1 on Sun, 2005-02-06 - 07:42

Hi Wendy,

I am new here with a newly diagnosed daughter with epilepsy. Although I am not familiar with all the different anti seizure meds out there, I am a nurse and I think I can explain to you what your doctor is talking about.

Whenever you take a medicine, it is "metabolized," which means broken down or processed, by your body. Ususally the liver or kidneys are involoved in this process. The reason the doctors check the "level," which means the blood level of the drug itself, is to make sure the dosage is not too high or too low for the patient. There is a certain range that is considered "therapeutic," which means there is enough of the drug in your system to do the job it is supposed to. If the level is too low, you may need a higher dose. If it is too high, you may need a lower dose, or you may have problems metabolizing that drug and you may need to switch meds. With regards to your son, the doctor wanted to make sure his level was within the therapeutic range or maybe below it, so there is enough room to increase his doseage. For example, let's say the range for Lamictal is 5-20 (but I don't know the real range for this drug, this is just an example) and your son's level is 10. He has room to take a higher dose and stay withing the recommended range.

As for toxicity, the symptoms are different for every drug, and sometimes there are no symptoms. Toxicity means the level of drug in your body is much too high. Call your doctor or pharmacist and they can tell you what to look for with Lamictal. You may be able to search online too and find out. It is very important to know if there are any signs of toxicity, and what to do if he develops them.

I hope I made this easy to understand. I know that I am overwhelmed by my daughter's condition and meds, and I understand the medical lingo---so I cannot even imagine how hard it is for you!  But listen---if you don't understand what the doctor means when he is talking to you, tell him and ask him to explain it again. Don't be afraid of looking stupid! You're not, you have just never heard all these words before! Lots of times doctors forget how to explain all this medical stuff in a way for non-medical people to understand (that's where nurses come in :-). Remember that this is your son's life and health, and you keep asking questions until you are comfortable with the explanation, ok?

Good luck

Rachel

Hi Wendy,

I am new here with a newly diagnosed daughter with epilepsy. Although I am not familiar with all the different anti seizure meds out there, I am a nurse and I think I can explain to you what your doctor is talking about.

Whenever you take a medicine, it is "metabolized," which means broken down or processed, by your body. Ususally the liver or kidneys are involoved in this process. The reason the doctors check the "level," which means the blood level of the drug itself, is to make sure the dosage is not too high or too low for the patient. There is a certain range that is considered "therapeutic," which means there is enough of the drug in your system to do the job it is supposed to. If the level is too low, you may need a higher dose. If it is too high, you may need a lower dose, or you may have problems metabolizing that drug and you may need to switch meds. With regards to your son, the doctor wanted to make sure his level was within the therapeutic range or maybe below it, so there is enough room to increase his doseage. For example, let's say the range for Lamictal is 5-20 (but I don't know the real range for this drug, this is just an example) and your son's level is 10. He has room to take a higher dose and stay withing the recommended range.

As for toxicity, the symptoms are different for every drug, and sometimes there are no symptoms. Toxicity means the level of drug in your body is much too high. Call your doctor or pharmacist and they can tell you what to look for with Lamictal. You may be able to search online too and find out. It is very important to know if there are any signs of toxicity, and what to do if he develops them.

I hope I made this easy to understand. I know that I am overwhelmed by my daughter's condition and meds, and I understand the medical lingo---so I cannot even imagine how hard it is for you!  But listen---if you don't understand what the doctor means when he is talking to you, tell him and ask him to explain it again. Don't be afraid of looking stupid! You're not, you have just never heard all these words before! Lots of times doctors forget how to explain all this medical stuff in a way for non-medical people to understand (that's where nurses come in :-). Remember that this is your son's life and health, and you keep asking questions until you are comfortable with the explanation, ok?

Good luck

Rachel

RE: RE: medicatios and levels

Submitted by wendymartinez on Mon, 2005-02-07 - 10:08

Thanks Rachel,

That for your reply and help.  Best of luck to you too!!

God Bless,

Wendy

Thanks Rachel,

That for your reply and help.  Best of luck to you too!!

God Bless,

Wendy

RE: RE: RE: medicatios and levels

Submitted by AmyQ on Mon, 2005-02-07 - 20:04
Hi, Wendy! I believe (I'm not sure which is the correct number) that the maximum number you want your son to ever reach on Lamictal is 16 (it might be 15). So, if you call the doctor/nurse and ask what the levels were, they will probably be well below this number if the doctor is increasing Lamictal. What does your son weigh? We've been through what you're going through with Lamictal, so based on his weight, I can probably paint more of a picture. For instance, our son is three, but he is big for his age. He has weighed 42 pounds since he was two. Anyway - he takes 100 mg in the AM and 100 mg in the PM, and his levels are fine. However, everyone is different. As for the learning disabilities and speech. When our little boy was first put on Lamictal and had it slowly increased, it was as if a light bulb went on with each increase. It was truly unbelievable. To us, it was a miracle drug. Unfortunately, it only controlled the seizures for a little while. I responded to one of your earlier e-mails. Did you ever ask them to do a 24-hour eeg to rule out Landau Kleffner? I'm just curious...- AmyQ

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