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52 Cards in this Set

  • Front
  • Back
which anti-seizure medications are for ABSENCE
Ethosuxamide
Lamotrigine
Valproate
what is the range for Carbamazepine
4-12
what is the range for phenytoin
10-20
which drug has the indication of alcohol prophylaxis
carbamazepine
name the anti-seizure medications that work by ehancing FAST sodium channel inactivation
Carbamazepine
Oxcarbazepine
Phenytoin
Fosphenytoin
Rufinamide
Lamotrigine
Topiramate
Valproic Acid
MOA of inhibition of glutamate release by binding the synaptic vesicles in SV2A
Levetiracetam
which drug binds to the collapsing-response mediator PRO 2 (CRMP-2)
Lacosamide
what is the potential benefit of binds to the collapsing-response mediator PRO 2 (CRMP-2)
prevents neuronal rewiring
which is a weak carbonic anhydrase inhibitor
Topiramate & Zonisamide
what drug decreases glutamate and aspartate release
Lamotrigine
what drug increases GABA mediated chloride influs
phenobarbital
what drug blocks GABA reuptake in the presynaptic neuron
Tiagabine
what drug antagonizes AMPA/kianite activity
Topiramate
which increases brain levels of GABA
gabapentin
pregabalin
which drug has the indication of status epilepticus
fosphenytoin
used for lennos-gastaut
Rufinamide
what is used for adjunct therapy for partial-onset seizures
Lacosamide
other than seizure prophylaxis (for both parital and absence) what are the other indications
bipolar
prevention of migraine HA
this drug is commonly used for postherpatic neuralgia & diabetic neuropathy
pregabalin
which drug causes rash in HLA-B*1502 (Asians)
carbamazepine
hyponatremia is more common in
oxcarbomazepine
what does the carbamazepine rash look like
red maculopapular
what is the cross reactivity of oxcarbamazepine and carbamazepine
30%
the use of any anti-epileptic increases the risk of what?
suidiality behavor and ideation- doubles
which USDA pregnancy category says "Controlled studies in women fail to demonstrate a risk to the fetus"
A- human trials say A-OK no risk
which USDA pregnancy category says"Risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant."
X- no way no how
which USDA pregnancy category says "Animal studies have not demonstrated a risk but no controlled studies in pregnant women OR animal studies have shown adverse effect that was not confirmed in controlled studies in women
"
B- no ADR in animals and no human trials
which USDA pregnancy category says "Studies in animals show adverse effects and no controlled studies in women OR studies in women and animals are not available"
C- ADR in animals and no human trials
USDA category "There is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk "
D-human risk, but benefits may outweigh the risk
name 4 D class anti-seizure meds
carbamazepine
phenobarbital
phenytoin
valproic acid
which drug has major risk of deformities including spina bifida
valproic acid
which drug causes fetal hydantoin syndrome
phenytoin
which drug is known to cause sedation, respiratory depression in breastfeeding
phenabarb
which 2 drugs casue hemorrhagic disease in the newborn
Phenobarb
Phenytoin
which class C has the most data and shows ~3% cleft problems
Lamotrigine
which class C shows urogenital problems in 1% of newborns
Oxcarbazine
polytherapy increase risk by
~2%
KEY CONCEPT: which is the bigger risk potentially teragoenicty of seizures
seizures- seizure control is the primary goal
Valproic acid is the worst for teratogenicity and so should be avoided in
child-bearing age women
what supplement should be given to childbearing age women on anti-seizure meds
at least 1mg/d Folic Acid
at what freqency is the dose adjusted based on serum conc
q1-3 mo
q2-4 wk for lamotrigine and oxcarbazepine
when can medication discontinuation be considered?
seizure free for at least 2 years and normal neurological exam and EEG
Generic is considered bioequivalent when 90% of AUC, Cmax fall within
80% and 125% of brandeded drug
what's the problem with bioequivalence
may not equate with clinical equivalence due to narrow therapeutic windows and patient variability
higher risk with AED include
multiple AED use and generic switching
which AEDs are associated with poor bone health
Carbamazepine
Clonazepam
Phenobarbital
Valproic acid
is there a dose response with fractures and AED
Yes
what's the increased RR of verterbral fractures when using AED
6x
what are other risk factors for vetebral fractures
Smoking
Alcohol use
Low free androgen index
Corticosteroid use
what is the suggested dose of Vitamin D for AED users
4000 IU/day for adults; 2000 IU/day for children
do you use Estrogen for Bone health in AED
no recommended increased seizure risk, only for women, and CV risks
what are some other options for bone health
bisphosphonates
SERMs
parathyroid hormone- but only for 2 years