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23 Cards in this Set
- Front
- Back
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this drug is used for most forms of epilepsy except absence seizures. what is its mechanism of action? significant side effects?
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phenytoin. inhibition of voltage gated Na channels. bone marrow and hepatic function are affected thus necessitating withdrawal
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this drug is used for all types of epilepsy except absence seizures, but it is particularly useful for GTC's, both simple and complex partial. side effects?
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carbamazepine. aplastic anemia and agranulocytosis.
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this drug treats partial and generalized seizures including absence. mechanism of action? side effects? drug interactions?
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valproic acid. unclear. fatal hepatotoxicity, teratogenic. inhibits its own metabolism, displaces phenytoin from plasma proteins.
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what are the three benzodiazepines and what are they used to treat?
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diazepam for status epilepticus. clonazepam and clorazepate for long term abscence, myoclonic, akinetic, and atonic seizures.
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what is the mechanism of action for benzodiazepams? side effects?
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potentiates GABAa receptor function. low incidence of toxicity, but additive or synergistic effects with other sedative hypnotics.
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this drug treats GTC's, partial, and febrile seizures. mechanism of action? drug interactions?
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phenobarbitol. potentiates GABAa receptor function. Due to P450 activation, additive or synergistic interaction with other CNS depressants, esp. alcohol.
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this is the drug of choice for absence seizures. mechanism of action? side effects? interactions?
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ethosuximide. inhibits voltage gated Ca channels. SLE, eosinophilia, thrombocytopenia, lekopenia, pancytopenia. metabolism is inhibited by valproate. note it does not bind plasma proteins
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this is used to treat infantile spasms. mechanism of action? route of administration?
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corticotropin or ACTH. glucocorticoid mediated decrease in the neuronal excitability of the hippocampus. IM.
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this drug is an add on for partial and secondarily generalized seizures in adults. mechanism? interactions?
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gabapentin. increases GABA release by an unknown mechanism. no known interactions probably due to the fact that it does not bind plasma protein
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this drug is an add-on therapy for partial seizures in adults. mechanism? interactions?
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lamotrigine. inhibits voltage gated Na channels. metabolism induced by phenytoin, carbamazepine, phenobarbitol, and primidone; it decrease valproate levels.
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why is early diagnosis of seizures important?
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seizures are autocatalytic
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when is polytherapy useful with AED's?
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when the drugs have different mechanisms of action, few side effects, low potential for drug interactions
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why must the use of AED's be tapered when ceasing use?
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withdrawal will occur due to addiction as well as tolerance to the drugs actions (thus a seizure may occur).
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should pregnant women be treated with AED's?
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depends upon the person. some drugs have teratogenic effects, but a seizure may be worse for the baby
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discuss the kinetics of phenytoin
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the initial dose follows first order kinetics, but will later switch to saturation (0 order kinetics) at a dose that is variable for each person.
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describe autoinduction, and what drug will do this?
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the half life of the drug decreases following continuous therapy. carbamazepine
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what is the main clinical limitation with benzodiazepines?
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tolerance to anticonvulsive action of the drug
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what does vigabatrin treat? mechanism? kinetics and interactions? side effects?
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partial seizures and secondary generalized seizures. irreversible inhibition of GABA transaminase. no metabolism and does not bind plasma protein, it decreases plasma concentrations. psychiatric symptoms including depression and psychosis.
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this medication is an add on for partial seizures in adults with multiple and poorly understood mechanisms.
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topiramate.
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this add on for partial generalized seizures in adults is a GABA uptake inhibitor.
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tiagabine
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this drug is used to treat partial seizures, has an unknown mechanism of action, and may have some behavioral side effects.
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levetiracetam
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this drug is used to treat partial seizures with an unknown mechanism and psychiatric side effects as well as many, many others.
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zonisamide
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this drug is used only for refractory partial seizures... mechanism? side effects?
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felbamate. NMDA receptor antagonist. fatal aplastic anemia and liver failure.
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