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39 Cards in this Set

  • Front
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Carbamazepine
Tegretol (PO)
-200mg BID
-2400mg
Gabapentin
Neurontin (PO)
-300mg TID
-4800mg
Lamotrigine
Lamictal (PO)
-25mg QOD if on VPA
(25-50mg if not)
-100-150mg if on VPA
(500mg if not)
Oxcarbazepine
Trileptal (PO)
-300mg BID
-3000mg
Phenobarbital
Dilantin (PO, IV, IM)
-1-3mg/kg/day
-300mg
Phenytoin
Dilantin (PO, IV)
-3-5mg/kg/day
(200-400mg)
-600mg
Topiramate
Topamax (PO)
-25-50mg/day
-1000mg
Valproic Acid
Depakote (PO, IV)
-15mg/kg
(500-1000mg)
-60mg/kg
(5000mg)
Lacosamide
Vimpat (PO, IV)
-50mg BID
-400mg
Felbamate
Felbatol (PO)
-1200mg
-3600mg
Pregabalin
Lyrica (PO)
-150mg
-600mg
Levatiracetam
Keppra (PO, IV)
-500mg BID
-4000mg
Tiagibine
Gabitril (PO)
-4-8mg/day
-80mg
Zonisamide
Zonegran (PO)
-100-200mg
-600mg
Traditional AEDs
Phenobarbital
Primidone
Phenytoin
Ethosuximide
Carbamazepine
Valproate
Common Dose Related Adverse Effects
Coordination Problems
Diplopia
Dizziness/lightheadedness
Sedation
Unsteady gait
Which AEDs may cause the life threatening adverse effect of CV issues including arrhythmia?
Carbamazpeine
Phenytoin
Which AEDs have the potential to cause aplastic anemia?
Felbamate
Zonisamide
Valproate
Carbamazepine
What AED has the potential to cause agranulocytosis?
Carbamazepine
Which AEDs have dermatological SEs including Stevens Johnson syndrome?
Valproate
Gabapentin
Pregabalin
Levetiracetam
Topiramate
AED general drug related adverse effects
Behavioral/Personality changes
Cognitive
Dermatological
Slowed movements
Weight gain
AEDs that have hepatic ADEs (fuliminant hepatitis and hepatic necrosis)
Valproate
Felbamate
Lamotrigine
Phenobarbital
AEDs that may lead to hyponatremia
Carbamazepine
Oxcarbazepine
AEDs that interfere with Vitamin D metabolism (older AEDs)
Carbamazepine
Phenytoin
Phenobarbital
Valproate
AEDs that may exacerbate absence and myoclonic seizures
Phenytoin
Carbamazepine
AED that may exacerbate myclonic seizures
Lamotrigine
1. Best evidence for monotherapy for absence seizures
2. Also shown to be effective
1. Ethosuximide
Valproate
2. Lamotrigine
Best evidence for myclonic seizures
Valproate
Levetiracetam (FDA adjunctive)
Clonazepam
Monotherapy for Lennox-Gastaut Syndrome
Topiramate
Felbamate
Clonazepam
Lamotrigine
Rufinimide
(FDA approval is for adjunctive treatment for all except clonazepam)
Why AED monotherapy?
-Simplifies treatment
-reduces adverse effects
-First drug monotherapy fails in about 50% of patients with epilepsy
(36% of patients will continue to have seizures regardless of regimen)
AEDs that may induce the metabolism of other drugs:
Carbamazepine
Phenytoin
Phenobarbital
Primidone
AEDs that cause ED:
Primidone
Phenobarbital
Clonazepam
Klonopin (PO)
-1.5mg
-20mg
Primidone
Mysoline (PO)
-100-125mg
-2000mg
Rufinamide
Banzel (PO)
-200-400 BID (start less <400 if pt is on VPA)
-3200
(Lennox-Gastaut)
AEDs that are highly protein bound
VPA
Phenytoin
Tiagibine
Carbamazepine
Oxcarbazepine
(Topiramate is moderately protein bound)
Other drugs that may alter metabolism or protein binding of AED
Antibiotics
Chemotherapeutic Agents
Antidepressants
Best evidence and FDA indication to treat tonic-clonic seizures
Valproate
Topiramate
Monotherapy for partial seizures
1. Best evidence and FDA indication:
2. Similar efficacy, likely better tolerated:
1. Carbamazepine
Oxcarbazepine
Phenytoin
Topiramate
2. Lamotrigine
Gabapentin
Levetiracetam