Faculty Supervision: Rodrigo Canales and William Drentell

The case describes how the Mayo Clinic, one of the most prominent hospitals in the world, engaged designers and built a research institute, the Center for Innovation (CFI), to study the processes of healthcare provision. The case documents the many incremental innovations the designers were able to implement and the way designers learned to interact with physicians and vice-versa.

101 I'd like to know the possibility of giving these drugs in epileptics: vincamine (Oxicebral), cinnarizine, piribedil (Trivastal) and pentoxyphylline (Trental). I'd like to know if they are contraindicated.

102 If an epileptic patient, treated with oxcarbazepine, develops a rash, should this drug be withdrawn or the dosage decreased and then increased gradually again?

103 Does a patient with refractory epilepsy benefit from acetazolamide?

104 What anti-epileptic drug is recommended for a child with epilepsy and co-morbid attention deficit hyperactivity disorder (ADHD)? Can Ritalin safely be used for treatment?

105 What is the difference in efficacy and pharmacokinetics between sodium valproate and valproic acid?

106 Is it safe to give valproic acid to infants below 12 months of age?

107 How many times must the liver transaminases (SGOT and SGPT) rise to justify a discontinuation of valproic acid therapy in children? Which of these enzymes is more sensitive and reliable in this situation?

108 1. Does valproic acid block the photosensitivity phenomenon in reflex epilepsy? 2. Can a patient with this photosensitivity be safely exposed to computer games or other photic stimuli when receiving valproic acid treatment? 3. Does the photosensitivity phenomenon occur in partial seizures?

109 1. Can an epileptic fit be induced in idiopathic and symptomatic focal epilepsy syndromes by flickering lights? 2. Is valproate effective against the photosensitive phenomenon (seizure induction by flickering light)?

110 How much time should one give before a loading dose of phenytoin is judged to be ineffective in controlling seizures and an alternative should be instituted?