Home Drug Guide Phenacemide

Drug Guide

Generic Name

Phenacemide

Brand Names Phenurone

Classification

Therapeutic: Anticonvulsant

Pharmacological: Carboxylic acid derivative anticonvulsant

FDA Approved Indications

  • Partial seizures
  • Generalized seizures

Mechanism of Action

Phenacemide depresses the motor cortex, raising the threshold for neuronal excitability. Its exact mechanism is not fully understood but is believed to involve the modulation of neuronal sodium channels and inhibition of excitatory synaptic transmission.

Dosage and Administration

Adult: Initial dose: 250 mg 2-3 times daily, gradually increased based on response and tolerability. Typical maintenance dose ranges from 1 to 3 grams daily in divided doses.

Pediatric: Dosage varies; typically initiated at 10-20 mg/kg/day divided into 2-3 doses, titrated upward as needed.

Geriatric: Start with lower doses due to increased sensitivity and potential liver or kidney impairment. Monitor closely.

Renal Impairment: Adjust dose based on degree of impairment, careful monitoring recommended.

Hepatic Impairment: Use with caution; monitor liver function; dose adjustments may be necessary.

Pharmacokinetics

Absorption: Well absorbed from gastrointestinal tract.

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Partially metabolized in the liver via conjugation and oxidation.

Excretion: Primarily excreted in urine, mainly as conjugates.

Half Life: Approximately 3-4 hours, but may be prolonged in hepatic or renal impairment.

Contraindications

  • Hypersensitivity to phenacemide or related compounds.
  • History of hepatic disease.

Precautions

  • Use cautiously in patients with liver or kidney impairment, hematologic disorders, or during pregnancy. Regular monitoring of blood counts and liver function is advised.

Adverse Reactions - Common

  • Drowsiness (Frequent)
  • Nausea or vomiting (Frequent)
  • Gastrointestinal disturbances (Common)

Adverse Reactions - Serious

  • Aplastic anemia (Rare)
  • Hepatotoxicity (Rare)
  • Blood dyscrasias including leukopenia, thrombocytopenia (Rare)

Drug-Drug Interactions

  • Other anticonvulsants (e.g., phenytoin, phenobarbital) may have additive sedative effects.
  • CNS depressants may enhance sedation.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor seizure frequency, neurological status, blood counts, and liver function tests.

Diagnoses:

  • Risk for ineffective tissue perfusion related to hematologic or hepatic adverse effects.
  • Impaired cognitive or motor function related to CNS effects.

Implementation: Administer medication as prescribed, monitor for effectiveness and adverse effects, educate patient on side effects.

Evaluation: Assess seizure control and monitor for adverse reactions regularly.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report any signs of blood dyscrasias (e.g., unusual bleeding, unexplained sore throat) or jaundice.
  • Avoid alcohol and CNS depressants unless directed.
  • Regular blood tests are necessary to monitor side effects.

Special Considerations

Black Box Warnings:

  • Hepatic failure, aplastic anemia, and blood dyscrasias have been reported. Use with caution and monitor blood counts and liver function.

Genetic Factors: None established.

Lab Test Interference: May interfere with liver function tests; monitor accordingly.

Overdose Management

Signs/Symptoms: Drowsiness, dizziness, nystagmus, ataxia, potentially coma in severe cases.

Treatment: Supportive care, activated charcoal if ingestion was recent, and symptomatic treatment. Dialysis may be considered in severe toxicity.

Storage and Handling

Storage: Store at room temperature away from moisture and light.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.