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For patients with recurrent seizures, drug treatment is prescribed with the goal of preventing further attacks and is usually continued until there have been no seizures for at least 3 years Epileptic patients should be advised to avoid situations that could be dangerous or life-threatening if further seizures should occur State legislation may require clinicians to report to the state department of public health any patients with seizures or other episodic disturbances of consciousness 1 Choice of medication The drug with which treatment is best initiated depends on the type of seizures to be treated (Table 24 3) The dose of the selected drug is gradually increased until seizures are controlled or side effects prevent further increases If seizures continue despite treatment at the maximal tolerated dose, a second drug is added and the dose increased depending on tolerance; the first drug is then gradually withdrawn In treatment of partial and secondarily generalized tonic-clonic seizures, the success rate is higher with carbamazepine, phenytoin, or valproic acid than with phenobarbital or primidone Gabapentin, topiramate, lamotrigine, oxcarbazepine, levetiracetam, and zonisamide are newer antiepileptic drugs that are effective for partial or secondarily generalized seizures Felbamate is also effective for such seizures but, because it may

Now you ll need two buttons: btnSubmit, and btnClear. Set the Text properties for each of these as you see in the figure. We ll come back to the event handlers in a minute. The last control you need is a Label to show the output. Place it below the buttons, call it lblResult, and delete its Text property for the moment. Now you need event handlers for the two buttons. The handler for btnClear is simple. You just want to clear the TextBox, so simply call txtAmount.Clear( ). The handler for btnSubmit is where you ll do the work. The only tricky bit here is that the text entered in txtAmount is a string, so you ll need to convert it to a double if you want to work with it. Fortunately, Convert.ToDouble( ) works just fine there. The numericUpDown control doesn t have a Text property because it can hold only numeric values, it has a Value property instead. The first thing to do is calculate the amount of the tax:

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1 Syncope Syncopal episodes usually occur in relation to postural change, emotional stress, instrumentation, pain, or straining They are typically preceded by pallor, sweating, nausea, and malaise and lead to loss of consciousness accompanied by flaccidity; recovery occurs rapidly with recumbency, and there is no postictal headache or confusion In some instances, however, motor accompaniments may simulate a seizure Serum creatine kinase measured about 3 hours after the event is generally normal after syncopal episodes but markedly elevated after tonic-clonic seizures 2 Cardiac dysrhythmias Cerebral hypoperfusion due to a disturbance of cardiac rhythm should be suspected in patients with known cardiac or vascular disease or in elderly patients who present with episodic loss of consciousness Prodromal symptoms are typically absent A relationship of attacks to physical activity and the finding of a systolic murmur is suggestive of aortic stenosis Repeated Holter monitoring may be necessary to establish the diagnosis; monitoring

Usual Adult Daily Dose Minimum No of Daily Doses Time to Steady State Drug Levels Optimal Drug Level Selected Side Effects and Idiosyncratic Reactions

Figure 7.5 An example of the log command, which is used to perform printf style debugging of a script

Generalized tonic-clonic (grand mal) or partial (focal) seizures Phenytoin 200 400 mg 1 5 10 days 10 20 mcg/mL Nystagmus, ataxia, dysarthria, sedation, confusion, gingival hyperplasia, hirsutism, megaloblastic anemia, blood dyscrasias, skin rashes, fever, systemic lupus erythematosus, lymphadenopathy, peripheral neuropathy, dyskinesias Nystagmus, dysarthria, diplopia, ataxia, drowsiness, nausea, blood dyscrasias, hepatotoxicity, hyponatremia May exacerbate myoclonic seizures Nausea, vomiting, diarrhea, drowsiness, alopecia, weight gain, hepatotoxicity, thrombocytopenia, tremor, pancreatitis Drowsiness, nystagmus, ataxia, skin rashes, learning difficulties, hyperactivity Sedation, nystagmus, ataxia, vertigo, nausea, skin rashes, megaloblastic anemia, irritability Sedation, skin rash, visual disturbances, dyspepsia, ataxia Somnolence, nausea, dyspepsia, irritability, dizziness, ataxia, nystagmus, diplopia, glaucoma, renal calculi, weight loss, hypohidrosis, hyperthermia As for carbamazepine Somnolence, ataxia, headache, behavioral changes Somnolence, ataxia, anorexia, nausea, vomiting, rash, confusion, renal calculi Do not use in patients with sulfonamide allergy Somnolence, anxiety, dizziness, poor concentration, tremor, diarrhea Somnolence, dizziness, poor concentration, weight gain, thrombocytopenia, skin rashes, anaphylactoid reactions Sedation, fatigue, ataxia, nystagmus, weight loss Anorexia, nausea, vomiting, headache, insomnia, weight loss, dizziness, hepatotoxicity, aplastic anemia Nausea, vomiting, anorexia, headache, lethargy, unsteadiness, blood dyscrasias, systemic lupus erythematosus, urticaria, pruritus See above Drowsiness, ataxia, irritability, behavioral changes, exacerbation of tonic-clonic seizures See above See above

double tax = Convert.ToDouble(txtAmount.Text) * (Convert.ToDouble(nudTax.Value) * 0.01);

2 3 (2)

1 3 2 2

2 2 1 2

Then add the tax to the amount:

1,3,6

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