A patient with recent-onset primary generalized epilepsy develops drugs reaction and skin rash due to Phenytoin sodium. The most appropriate course of action is:: (A) Shift to clonazepam, (B) Resta phenytoin sodium after 2 weeks, (C) Shift to sodium Valproate, (D) Shift to Ethosuximide
Answer is C. 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. ref: KD Tripathi 8th ed.