Use: Treat tonic-clonic, complex-partial and mixed seizures. Trigeminal neuralgia, bipolar and other affective disorders and resistant schizophrenia.
Alcohol withdrawal, neurogenic pain, restless leg syndrome and psychosis associated with dementia.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Dry mouth, oral and throat ulcers, glossitis, headache, blood dyscrasias, tinnitus and Stevens-Johnson syndrome.
Dental Drug Interactions: Decreases effects of barbiturates, corticosteroids, benzodiazepines, doxycycline and coumadin. Increase in carbamazepine toxicity with erythromycin, clarithromycin, propoxyphene and antifungals.
Action: Inhibits spread of seizure activity in motor cortex by increasing efflux or decreasing influx of sodium ions across cell membranes. In heart prolongs refractory period and suppresses ventricular pacemaker automaticity, shortens action potential.
Use: Manage generalized tonic-clonic (grand mal), simple partial and complex partial seizures, prevention of seizures following head trauma/neurosurgery. Treat ventricular arrhythmias, including those secondary to digitalis toxicity, surgical repair of congenital heart disease in children and prolonged Q-T interval. Also to treat epidermolysis bullosa.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Gingival hyperplasia, oral ulceration, taste loss, paresthesia and headache.
Blood dyscrasias, fever, Stevens Johnson syndrome and lupus
Dental Drug Interactions: Decreases effects of corticosteroids, oral anticoagulants and doxycycline. Barbiturates and chloral hydrate decrease phenytoin effects.
Use: Adjunct treatment of drug refractory partial and generalized seizures in adults with epilepsy, neuropathic pain.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Dry mouth, glossitis, gingivitis, stomatitis, pharyngitis, blood dyscrasias and myalgia.
Dental Drug Interactions: None
Use: Alone or as adjunct in partial seizures. Also for partial seizures in children with Lennox-Gastaut syndrome.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Gingival bleeding and hyperplasia (not with monotherapy), dry mouth, facial edema, buccal mucosa swelling, blood dyscrasias and headache.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Dry mouth, taste alteration, gingival hyperplasia, gingivitis, sinusitis, blood dyscrasias, photophobia, myalgia, paresthesia, hypoesthesia.
Action: Interferes with transmission of impulses from the thalamus to the cerebral cortex resulting in an imbalance in central inhibitory and facilitatory mechanisms. A CNS depressant.
Use: All forms of epilepsy, status epilepticus, febrile seizures in children, sedation, insomnia, hyperbilirubinemia and chronic cholestasis.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Headache, fever, laryngospasm, Stevens-Johnson syndrome and blood dyscrasias.
Dental Drug Interactions: Decreases effects of corticosteroids, oral anticoagulants and doxycycline. Enhances sedative properties of propoxyphene, benzodiazepines and CNS depressants.
Mephobarbital (Mebaral) Tinnitus
Use: Adjunctive therapy for treatment of partial onset adult seizures.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Headache,
paresthesia, sinusitis, arthralgia, and gingivitis.
Dental Drug Interactions: None.
Action: Increases seizure threshold, decreases neuron excitability, broken down into phenobarbital.
Use: Treat grand mal, complex partial and focal seizures.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Headache, blood dyscrasias, lupus-like syndrome.
Dental Drug Interactions: Additive CNS depression with other CNS depressants, liver damage with halogenated inhalation general anesthetics, decreases effects of acetaminophen, corticosteroids, Doxycycline and NSAIDs.
Dental Considerations: Local anesthesia with vasoconstrictors ok. Headache, fever, postural hypotension, Dysphagia, gingival hyperplasia and bleeding, dry mouth, stomatitis, blood dyscrasias, photosensitivity, photophobia, altered taste, TMJ-tinnitus.
Dental Drug Interactions: None.
Levodopa and Carbidopa (Sinemet)
Action: Parkinson’s symptoms are due to lack of dopamine in brain. Levodopa crosses blood brain barrier where it is converted to dopamine. Carbidopa inhibits the peripheral plasma breakdown of levodopa.