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22 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What are the GABAnergic AEDs?
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Phenobarbitol
Benzodiazepines Vigabatrin Tiagabine |
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What are some side effects of GABAnergic AEDs?
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headache
dizziness confusion sedation fatigue ataxia diplopia rash |
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What are the voltage gated sodium channel blockers?
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Phenytoin (dilantin)
Carbamazepine (tegretol) |
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Indications for benzodiazeprine?
Mechanism of action? |
Indications:
refractory epilepsy, status epilepticus, alcohol withdrawal seizures Mechanism: Allosteric potentiation of GABAa receptor function |
Examples: diazepam, clonazepam
Causes sedation, tolerance limits chronic use |
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Indications for phenobarbitol?
Mechanism of action? |
Indications:
simple partial, complex partial, secondary generalized Not effective for: absence seizures Mechanism: binds to GABAa receptors and potentiates activity |
Adverse side effects, thus not used anymore
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Indications for vigabatrin?
Mechanism of action? |
Indications:
Adjunct Rx for partial, secondary generalized Mechanism: irreversible inhibitor of GABA-T --> raises level of of GABA |
Better tolerated than most GABAergic AEDs
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Indications for tiagabine?
Mechanism of action? |
Indications:
Adjunct Rx for partial, secondary generalized Mechanism: inhibits re-uptake of GABA --> prolongs activity at synapse |
Better tolerated than most GABAergic AEDs
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Indications for phenytoin
Mechanism of action? (see side effects) |
Indications:
partial, secondary generalized Mechanism: Use dependent blocker of VG-Na channel |
side effects: gingival hyperplasia, hirsuitism, acne
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Indications for carbamazepine?
Mechanism of action? (see side effects) |
Indications:
partial, secondary generalized Mechanism: Use dependent blocker of VG-Na channel |
side effects: hyponatremia, benign neutropenia
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Multiple mechanism AEDs
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Valproate
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New generation AEDs
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Felbamate
Gabapentin Pregabalin Lamotrigine Topiramate Tiagabine Levetiracetam Oxycarbazine Zonisamide |
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Calcium channel blocker
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Ethosuximide
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Indications for valproate?
Mechanism of action? |
Indication:
Broad spectrum - partial (w and w/o 2ndary general.), Prim general. (absence) Mechanism: unclear, may act by boosting GABA and inhbiting VG-Na channels |
Side effects - weight gain, hair loss, hepatic toxicity, pacreatitis
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Indications for ethosuximide?
Mechanism of action? |
Indications: 1st line Rx for primary generalized (absence seizures)
Mechanism: reduces low-threshold Ca2+ currents, disrupts low rhythmic firing of thalamic neurons |
Side effects - GI intolerance, blood dyscrasias, hepatic toxicity
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Indications for felbamate?
Mechanism of action? |
Indication:
Broad spectrum - partial and generalized Mechanism: complex, inhibition of VG-Na, Ca channels and NDMA receptors |
Side effects - less sedating that classical AEDs, anorexia, nausea, vomiting, potentially fatal aplastic anemia
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Indications for gabapentin, pregabalin?
Mechanism of action? |
Indications: partial and secondary generalized seizures
Off-label for neuropathic pain and psychiatric illnesses Mechanism: GABA analog, but does not interact with GABA receptors, instead interacts with VG-Ca channel |
Very safe and well tolerated
No pharmacokinetic interactions |
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Indications for lamotrigine?
Mechanism of action? |
Indications: broad spectrum - partial and generalized in children and adults
Mechanism: inhibits both Na and Ca channels |
Well tolerated, rash (Stevens-Johnson syndrome)
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Indications for topiramate
Mechanism of action? |
Indications:
Broad spectrum - adjunct Rx in adults and children with refractory partial seizures Mechanism - inhibits Na channels by prolonging inactivation, potentiates GABA function, inhibits NMDA receptor |
Well tolerated
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Indications for tiagabine
Mechanism of action? |
Indication:
Adjunct therapy for partial seizures Mechanism: inhibits GABA reuptake |
Well tolerated, somnolence, nervousness, dizziness
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Indication for levetiracetam?
Mechanism of action? |
Indications:
Broad spectrum: partial, secondary generalized, primary generalized *initially adjunct for refractive partial Devoid of activity on conventional screening models Mechanism: unknown(?) |
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Indication for oxycarbazine?
Mechanism of action? |
Indication:
Partial seizures (same as carbamazepine) Mechanism: Inhibition of Na channels |
Might be better tolerated than carba
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Indication for zonisamide
Mechanism of action |
Indication:
Newest broad spectrum - partial and generalized in adults and children Mechanism: inhibits both Na and Ca channels |
Relatively well tolerated
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