|
|
Discussion on Use of potassium bromide
|
| Author |
Message |
|
Posted on Monday, Mar 26, 2001 - 8:11 am:
Hi Dr O,
In an effort to save a few pennies I asked my vet for suggestions about drugs which could compliment my mare's large intake of phenobarbitone for her seizures. He said that potassium bromide was a useful adjunct. Having done my sums a bit it will still cost me a packet (hey that's the nature of horses isn't it  )but in some ways I'd rather go down this path than continue raising the phenobarbitone quantities. She is currently on approx 50 tablets per day of 60mg tablets. She was blood tested a few weeks ago and the level in her blood came back as well up on the therapeutic level (seven point something as I remember) but I'm quite sure she is not far from a seizure again - in the last few days she has pawed the ground when being offered food (particularly when she wasn't fully awake) and I've seen her do this before a full seizure broke through previously so I'm on my guard with her. Incidentally I'm going to have a think again about the pattern of her seizures in relation to her seasons. I've always said there was no correlation but now I'm starting to wonder.
Any thoughts about the use of bromide Dr O? (My vet suspects his wife doses his cups of tea with it!!)
|
|
Posted on Tuesday, Mar 27, 2001 - 7:15 am:
Hello Helen,
I have found a potassium bromide (KBr) dose in a text but cannot find any information other than that. It appears to have been used by the author who has not published any work on the results.
KBr is a common seizure therapy adjunct in dogs and cats. I have started an article on seizures in adults, just for you, that has a table of recommended dosages of different seizure medication including KBr. See Diseases: Neurological. I will try and expand on it in the next month. Here is some information I have on KBr use in dogs and cats:
Uses/Indications - Bromides are used as adjunctive therapy to control seizures in dogs who are not adequately controlled by phenobarbital (or primidone) alone. In patients suffering from phe- nobarbital (or primidone) hepatotoxicity, bromides may be used alone (renally excreted). Early indications are that approximately 50% of dogs show improvement in seizure control after the addition of bromides.
Pharmacokinetics - Bromides are well absorbed after oral administration, primarily in the small intestine. Bromides enter maternal milk. Bromides are principally excreted by the kidneys. The half life in dogs has been reported to be about 25 days; in humans, 12 days.
Contraindications/Precautions/Reproductive Safety - Older animals and those with additional diseases, may be prone to intolerance (see side effects below) at blood levels that are easily tolerable by younger, more healthy dogs.
Reproductive safety has not been established. Human infants have suffered bromide intoxication and growth retardation after maternal ingestion of bromides during pregnancy. Bromide in- toxication has also been reported in human infants breast feeding from mothers taking bromides.
Adverse Effects/Warnings - A transient sedation (lasting up to 3 weeks) is commonly seen in dogs receiving bromides in addition to phenobarbital. Toxicity generally presents as profound sedation to stupor, ataxia, tremors, or other CNS manifestations. Pancreatitis has been reported in dogs receiving combination therapy of bromides with either primidone or phenobarbital. However, since this effect has been reported with both primidone and phenobarbital, its relationship with bromide is unknown. Additional potential adverse effects reported include, anorexia, vomiting, and constipation. Rashes have been reported in humans taking bromides. If administering an oral loading dose of potassium bromide, acute GI upset may occur if given too rapidly. Potentially, large loading doses could affect serum potassium levels in patients receiving potassium bromide.
Overdosage/Acute Toxicity - Toxicity is more likely with chronic overdoses, but acute overdoses are a possibility. In addition to the adverse effects noted above, animals who have developed bromism (whether acute or chronic) may develop signs of muscle pain, conscious proprioceptive deficits, anisocoria, and hyporeflexia.
I hope this helps.
DrO
|
|
Posted on Tuesday, Mar 27, 2001 - 7:46 am:
Thanks for that Dr O, wow a whole article just for me, I'm very honoured My vet has told me to use a dosage of 10 15mg per kilo body weight twice daily. The idea is that I make it up into a syrup for palatability and then dose at approx 20ml twice a day (@ 250mg per ml) I think 20ml would be a fraction high as Cara is lightly built and narrow through the girth and although we work on a 450 kilo weight for her she is probably a bit less than that. Does KBl have less bad effects on the liver? It is something I was warned about with phenobarbitone, although my vet says that as a horse's liver is so huge it would take a long time to become seriously compromised. Meanwhile I monitor what comes out of the rear end pretty carefully and at the moment I'm pleased to say the patient is the picture of health and feeling like a spring lamb. If I'm as crazy when I'm in my eighties I won't have much to complain about!
Thanks again,
Helen
|
|
|
