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80 Cards in this Set
- Front
- Back
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> 90% protein bound
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PHT
VPA PRM |
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P450 inducers
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PHT
CBZ, OXC PB, PRM |
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P450 inhibitors
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VPA
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Cross reactivity
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PHT
PB ESX LTG CBZ |
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Renal excretion
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GBP
PGB FBM (hepatic too) OXC (metabolite only; pro-drug = hepatic) TPM (hepatic too) ZPS (hepatic too) |
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Rash
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LEV (lowest)
ZPS (sulfa) LTG (more in kids) also--PHT, ESX, OXC, PB |
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Neural Tube Defect
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CBZ (P450 inducer)
PHT (P450 inducer) VPA |
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Weight Loss
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TPM (nephrolithiasis)
ZPS (nephrolithiasis) ESX FBM |
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Weight gain
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GBP
PGB VPA |
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Kidney Stones (Nephrolithiasis)
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TPM
ZPS |
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Gingival Hyperplasia
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PHT
FBM |
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Migraine prophylaxis
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VPA
TPM |
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Mood stabilizers
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LTG
OXC GBP VPA CBZ |
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Broad spectrum
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LTG
VPA |
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Last line of AED tx (and possible reasons why)
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FBM--aplastic anemia, hepatic failure
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All AEDs cause sedation except?
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FBM
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All AEDs follow this type of pharmacokinetics (a-which is?) except this drug (b-which drug & follows which type?)
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a-most follow 1st order
b-PHT: 0-order |
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This drug can follow non-linear first order kinetics
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CBZ
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Aplastic Anemia
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FBM**
(CBZ) |
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SJS
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LTG**
(all 1st generation AEDs--CBZ, PHT, VPA, PB/PRM,ESX) |
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AED but more effective for neuropathic pain
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GBP
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an AED that is a controlled substance
a) what drug? b) what class? |
a) PGB
b) Schedule V |
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Causes severe HYPO-Na-emia but less severe rash
a) what drug? b) what drug is similar to it and the difference? |
a) OXC
b) similar to CBZ, which causes less severe HPYO-Na-emia but more severe rash |
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diplopia
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CBZ
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blurred vision
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CBZ
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ataxia
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CBZ
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Leukopenia, agranulocytosis,
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CBZ
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acne
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PHT
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hirsutism
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PHT
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facial coarsening
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PHT
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effective for absence seizures only
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ESX
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Treatment of absence seizures
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T-type Ca2+ channel blockers:
VPA ESX LTG ZPS |
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Behavioral problems
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PB--in children
GBP--children |
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Sleep disturbance
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ESX
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alopecia
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VPA
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Cognition problems (e.g. anomia--word naming problem)
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TPM
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Metabolic acidosis
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TPM
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Psychosis & hallucinations
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LEV
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Causes hiccups
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ESX
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Glaucoma
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TPM
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severe gout
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TPM
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causes cleft palate, lip hair, congenital heart defects
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all 1st generation AEDs--
CBZ PHT VPA PB/PRM ESX |
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Except for FBM, what are the 5 prominent AE caused by AED use?
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1) Sedation
2) GI upset 3) Dizziness 4) Nystagmus 5) Disturbances of cognition & behavior |
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Metallic taste
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TPM
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not very effective for AED (other indications are better)
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GBP
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increase ammonia levels in blood ("hyper-ammoninemia")
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VPA
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thrombocytopenia
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CBZ
VPA |
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acute pancreatitis & acute hepatitis
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VPA
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Folate/Vit D deficiency
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PHT
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causes Peripheral Neuropathy
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PHT
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Blood dyscrasias
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PHT
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Hepatitis
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CBZ
PHT (less) (VPA--acute hep & acute pancreatitis) |
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Treatment of Essential tremor
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PRM
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Poorly soluble
a) what is the soluble form called? |
PHT
a) Fosphenytoin |
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CBZ--MOA
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X Na+ channel
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PHT--MOA
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X Na+ channel
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VPA--MOA
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X Na+ channel
X T-type Ca2+ channel |
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PB/PRM--MOA
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increase GABA-ergic transmission
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ESX--MOA
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X T-type Ca2+ channel
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GBP--MOA
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increase GABA-ergic transmission
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LMG--MOA
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X Na+ channels
*****X glutamatergic transmission***** X T-type Ca2+ channels |
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TPM--MOA
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X Na+ channels
enhances GABAergic transmission |
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OXC--MOA
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X Na+ channels
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LEV--MOA
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?
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ZNS--MOA
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X Na+ channels
X T-type Ca2+ channels |
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FBM--MOA
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X Na+ channels
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PGB--MOA
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?
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Drugs that work by X Na+ channels
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VPA
FBM CBZ OXC LMG PHT TPM ZPS |
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Drugs that work by X glutaminergic transmission
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LTG
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Drugs that work by X T-type Ca2+ channels
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VPA
ESX LMT ZPS |
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Drugs that work by increase GABA-ergic response
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PB
GBP TPM |
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Drugs w/ unknown mechanisms
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LEV
PGB |
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Diverse manifestations determined by the region of the cortex activated by the seizure, lasting ≈ 20 to 60 sec.
Key feature is preservation of consciousness |
Simple partial seizure
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Impaired consciousness lasting ≈ 30 sec to 2 min, often associated with purposeless movements (e.g., lip smacking and wringing).
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Complex partial seizure
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Simple or complex partial seizure evolves into a tonic-clonic seizure with loss of consciousness and sustained contractions of muscles (tonic) throughout the body followed by periods of muscle contraction alternating with period of relaxation (clonic), typically lasting ≈ 1 to 2 min.
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Partial seizure with secondarily generalized tonic-clonic seizure
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Abrupt onset of impaired consciousness associated with staring and cessation of ongoing activities, typically lasting < 30 sec (aka petit mal); the only seizure type that does not cause brain damage.
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Absence seizure
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A brief (≈ 1 sec), shock-like contraction of muscles that may be restricted to part of one extremity or may be generalized.
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Myoclonic seizure
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Sustained contractions of muscles, typically lasting ≈ 1 to 3 min.
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Tonic seizure
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As described above for partial seizure with secondarily generalized tonic-clonic seizures except that it is not preceded by a partial seizure (aka grand mal).
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Tonic-clonic seizure
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A sudden loss of muscle tone, resulting in falling (“drop attack”), typically lasting ≈ secs
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Atonic seizure
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