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Potassium Bromide acts at the cellular level to decrease seizure activity by depressing neuronal activity and excitability. Potassium bromide is well absorbed orally and is principally excreted by the kidneys.
Potassium Bromide is an antiepileptic drug (AED) used in dogs to control seizures that are not adequately controlled by Phenobarbital alone. Potassium Bromide is almost always used initially in conjunction with Phenobarbital and is rarely considered as a first line drug because it may take as long as 4 months to reach a steady state concentration of bromide in the brain.
The management of animals with seizure disorders requires measurement of serum trough concentrations of AED at regular intervals in order to tailor a therapeutic dose for the individual patient and minimize the occurrence of toxicity. Once a steady state serum concentration of Potassium Bromide has been reached some clinicians may attempt to reduce the dose or even eliminate Phenobarbital in those patients whose seizures are well controlled. Dogs that are suffering from hepatotoxicity due to Phenobarbital may be treated with Potassium Bromide alone because of its renal excretion.
Cats are only rarely treated with Potassium Bromide because of the relatively high incidence of side effects in this species.
Client commitment and compliance are essential for the
management of the animals with seizure disorders. Because both Phenobarbital
and Potassium Bromide can be sedating, clients need to understand that their
pets may have a less active life style. The client will need to administer
medication at prescribed regular intervals, and the animal will need regular
blood work to monitor serum drug levels.
• Transient sedation, lethargy, anorexia, vomiting, polydipsia, polyuria, pancreatitis, constipation.
• Chloride ion levels affect Bromide levels because
they compete for uptake across the cellular membrane. Bromide toxicity can
occur in animals that are placed on restricted sodium intake such as a low
salt diet. On the other hand, increased sodium intake will decrease Bromide
levels placing the animal at risk for a seizure.
• The reproductive safety of Bromide use in dogs has not been established.
Bromide both crosses the placenta and is found in milk of lactating humans.
• Older animals may have a higher incidence of adverse side effects.
• Diuretics such as furosemide will increase the excretion of Potassium
Bromide.
• Other CNS sedating drugs may cause additional sedation when used with
Potassium Bromide.
• Bromism or toxicity due to chronic overdose presents as profound
sedation, muscle pain, CNS signs, ataxia, stupor, and tremors.
• Acute overdose occurs less frequently, but may present similarly to
chronic overdose with profound sedation, ataxia and other CNS signs. Treatment
may include GI emptying, supportive use of IV fluids and diuretics.
Dr.
Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania.
She has a master's degree in animal science from the University of Delaware
and graduated from the University of Pennsylvania School of Veterinary Medicine
in 1982.
She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com
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