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37 Cards in this Set
- Front
- Back
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What is the rule of thumb for treating epilepsy?
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generally try and use monotherapy since 70 of all epileptics only have symptoms of one form of epilepsy
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What are the partial seizures?
and DOC |
partial seizures start in one hemisphere of the brain
partial simple is no loss of conciousness partial complex is loss of psychomotor skills, visual, auditory, olfactory, confusion; loss of conciousness - DOC CARBAMAZEPINE |
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What are the generalized seizures?
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clonic - tonic (gran mal) - sterotypical seizure; with convulsions - DOC PHENYTOIN, CARBAMAZEPINE
absence (petite mal) - brief unconciousness - DOC ethosuxamide and valproic acid for pts > 2 infantile - happens to infants myoclonic - paroxysmal symmetrical jerking with loss of conciousness Status epilepticus - seizures lasting more than 5 minutes - DOC diazepam 5-10mg IV over 5mg/min |
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BLACK BOX WARNINGS?
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CAn VAL Find Love
Carbamazepine aplastic anemia, angranulocytosis Valproid Acid hepatotoxicity, teratogenicity, pancreatitis Felbamate aplastic anemia hepatotoxicity Lamotrigine rash --> SJS |
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what two are excreted in the kidneys?
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topiramate
gabapentin reduce dose!!! |
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Kidney stones and weight loss?
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topiramate
and zonisamide counsel pt drink lots of H2O |
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what two have no known drug interactions?
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gabapentin and levitiracetam
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What is the rule of thumb when stopping AEDs?
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when the pt has been on monotherapy for 2 years with no seizures, then slowly try to withdraw drug therapy
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Liver Enzymes
Inhibitor? |
Inhibitor
valproic acid Inducer To CP3 phenytoin carbamazepine phenobarbitol primidone topiramate |
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What meds can cause seizures?
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Merperidine - demerol
Tricyclic antidepressants esp. amitripyline CANA cocain alcohol narcotic amphetamine clozapine imipenem - primaxin theophylline akylating agents |
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What is spina bifida and why do you have to be worried about it with pregnant women?
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spina bifida is a neuronal tube defect disorder caused by folic acid deficiency and AEDs cause folic acid deficincy so they need folic acid supplements while pregnant
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Why should someone be concerned with PEG and AEDs?
Which two AEDs? |
PEG is sometime used as a solvent for IV medications and can cause cardiotoxicity and therefore must be given slowly.
Phenytoin < 50mg/min and diazepam < 5mg/min |
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Febrile epileptic episode risk factors and treatment?
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child (4 mo - 5 yr) with rectal temp 102 or greater
could be simple or complex does not predispose children to be epileptics later in life may use Pb since phenytoin and carbamazepine will not work |
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Carbamazepine
Indication dose labs |
tegretol, carbatrol
indication P T Dose 800-1200 mg/d Labs CBC, LFT, BUN, Eye exam, UA |
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Ethosuximide
Indication Dose |
Zarontin
Indication A Dose 750-1000mg/D |
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Phenytoin
Indication Dose Labs Not effective for what type seizure |
Dilantin
Indicaiton PC - G - E - F Dose 100-600mg/d Labs serum levels hyperglycemia not effective for A |
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fosphenytoin
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Cerebyx
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primidone
indication Dose labs |
mysoline
indication P - G - M Dose 250-750 mg/D MAX 2gm/D Labs CBC |
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Valproic acid
indication dose labs |
Depacon - IV
Depakene - oral solution Depakote - sprinkle caps, DR, ER Indication P - G - M |
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Pregabalin
indication dose |
Lyrica
indication P dose 150-600 mg/d |
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Lamotrigine
indication dose |
Lamictal
indication PC - PC - T - A - M |
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Felbamate
indication |
felbatol
indication M **NOT USED MUCH |
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gabapentin
Indication dose |
Neurontin
indication P Dose 900-1200 mg q d |
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Lamotrigine
indication dose |
lamictal
indication PC - PS - T - A - M bipolar dose 200-400mg/d |
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levetiracetam
indication dose |
keppra
indication PS - M - T |
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Oxcarbazine
indication dose |
trileptal
indication P dose 600-2400mg/d |
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tigabine
indication dose |
gabitril
dose 36-56mg/d |
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topiramate
indication dose |
topamax
indication PC - T - I |
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Zonisamide
indication dose |
zonegran
indication A - M - P |
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clonazepam
indication dose |
Klonipin
indication A - M dose 1.5mg/d MAX 20mg/d |
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Diazepam
indication for both dose for both |
Valium - E
> 12 max 90mg/d Diastat - F 2-5 yrs: 0.5mg/kg 6-11 yrs: 0.3 mg/kg 12 +: 0.2 mg/kg |
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What can carbemazepine do to weight?
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weight gain up to 15 lbs
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Phenytoin
limiting side effect? with or with out food? Phenytoin sodium capsules contain what percent phenytoin? Pharmacokinetics? effect on weight? |
ataxia is limiting side effect
take with food to increase absorption and decrease N/V phenytoin sodium caps are 92% phenytoin Michaelis-Menton pharmacokinetics first order until enzyme saturation and then zero order NO EFFECT ON WEIGHT |
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Valproic acid
DOC ADR effect on weight |
DOC - absence seizures pts > 2
ADR macrcytic anemia; hepatotox weight gain up to 15 pounds |
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Zonisamide
chemically similar to? common side effect? |
sulfonamides
oligohydrosis |
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topiramate
chemically similar to? rarely causes this? can cause this? DOC for? weight? |
sulfonamide
rarely causes oligohydrosis doc for migrane phroph weight loss |
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tiagabine is associated with?
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sudden unexpected death in epilepsy
and a higher incidence of status epilepticus |
