Antiepileptics

Front 1

Na+ channel inhibitors for Epilepsy (4)

Back 1

Phenytion
Carbamazepine
Iamotrigine
Valproic Acid

Front 2

GABA enhancers for Epilepsy (6)

Back 2

Phenobarbitol
Clonazepam
Diazepam
Lorazepam
Tiagabine
Vigabatrin

Front 3

T-type Ca+ channel inhibitor for Epilepsy (absence)

Back 3

Ethosuximide

Front 4

Other drugs for Epilepsy (3)

Back 4

Topiramate
Levetiracetam
Gabapentin

Front 5

Cell physiological manifestations of SZ

Back 5

SZ activity is ass'd w/ high-frequency, rhythmic & coordinated firing of central neurons

Front 6

Strategy for pharmacological management of SZ

Back 6

1. High frequency APs (Na+ ch)
2. Enhancement of inhibitory GABA activity
3. Inhibition of T-type Ca+ ch (involved in mediating rhythmic electrical activity)

Front 7

CP & management of Status epilepticus

Back 7

CP: >5 minutes of continued SZ activity or 2+ SZs w/out regaining consciousness; can be life-threatening
Management:
1. ABCs
2. Lorazepam
3. Phenytoin
4. If + signs of systemic distress, induce complete anesthesia. If - , Phenobarbital
5. More Phenobarbitol
6. Induce complete anesthesia

Front 8

Acute triggers for status epilepticus

Back 8

electrolyte imbalances, renal failure, sepsis, CNS infection, head trauma, stroke, & drug OD. These are ass'd w/ higher mortality

Front 9

Chronic triggers for status epilepticus

Back 9

pre-existing epilepsy, SZs due to chronic use of EtOH, & CNS neoplasms. These are ass'd w/ a better prognosis

Front 10

Phenytoin, Carbamazepine, & Lamotrignine

Back 10

MoA: suppression of recovery from inactivation of voltage-gated Na+ channels
Ind: partial & general tonic clonic sz
S/E: double vision, ataxia, rashes, & gingival hyperplasia (Phenytoin-saturation kinetics), alpastic anemia & granulocytosis (carbemazapine-must be monitored)
Lamotrigine -for refractory partial sz

Front 11

Phenobarbitol

Back 11

MoA: Increased duration of GABA(A) channel opening, thereby potentiating the GABA inhibitory activity

Front 12

Valproic acid

Back 12

MoA: Suppression of recovery from inactivation of voltage-gated Na+ channels, & at [higher] blocks ion conduction through the T-type Ca+ channels
Ind: absence sz (in a pt who also has other types of sz), & myoclonic sz
Cont: Pregnancy-developmental abnormalities

Front 13

Clonazepam, Diazepam, & Lorazepam

Back 13

MoA: Enhances ion conduction through the GABA(A) receptor channel by direct binding to the gamma subunit & increasing the frequency of channel opening, thus potentiating the GABA response
Ind: Diazepam & Lorazepam-for status epilepticus
Pearl: development of tolerance

Front 14

Tiagabine

Back 14

MoA: Blockade of GABA reuptake in neurons & glia

Front 15

Vigabatrin

Back 15

MoA: Enhances GABA activity by inhibition of the GABA degradative enzyme GABA transaminase

Front 16

Ethosuximide

Back 16

MoA: Blocks ion conduction through the T-type Ca+ channels
Ind: absence sz

Front 17

Topiramate

Back 17

MoA: Na+ & Ca+ channel blockade, GABA potentiation, glutamate receptor antagonism

Front 18

Levetiracetam

Back 18

MoA: Unknown mech of action, but is known to bind to the presynaptic vesicle protein, SV2A (also binds Botox)
Ind: sz & pn

Front 19

Gabapentin

Back 19

MoA: Enhances release of GABA at inhibitory synapses through as yet unknown mechanism. Reduces release of excitatory amino acids by binding to Ca+ channels
Ind: neuropathic pn

Front 20

Lamotrigine

Back 20

Ind: for refractory partial sz
A/E: rashes, SJ syndrome