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37 Cards in this Set

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Which drug works by blocking T-type channels?
Ethosuximide, zonisamide
What is ethosuximide good for?
absence sz
What drug should you not give in absence sz?
carbamazepine, tiagabine
Contraindications tiagabine?
NOT generalzied b/c leads to status and absence. NOT absence (partial sz only)
Which epilepsy drugs, despite having short half lives, are dosed BID?
tiagibine (selective GABA reuptake inhibitor), levetiracetam (binds SV2A)
Which AEDs are 90%protein bound? Significance
phenytoin and valproate (other highly bound drugs, altered albumin conditions like preg, malnutrition)
How are most AEDs metabolized? Exceptions?
most in liver (gabapentin and levetiracetam are ex intact by kidney…topiramate is 2/3 renal)
Which AEDs are hepatic inducers?
carbamazepine, phenytoin, phenobarb, primodone
Which AED inhibits hepatic enzymes?
valproate
Which AED has non-linear kinetics (saturates…don't know when)?
phenytoin
Which AEDs are available IV?
benzos, barbs, phenytoin, valproic acid, levetiracetam
Tx of choice for acute szs?
lorazepam or diazepam
Benzo MOA?
increased Cl- channel open freq
Major contraindication for Benzos?
Chronic use
What is flumazenil?
benzo OD drug
Barb MOA?
increased open time of Cl- channels
Indications for Barb use?
status epi, babies, poor (primodone for Ess Tremor)
None
Tiagabine MOA?
GABA reuptake inhibitor
Indications for tiagabine (contra)?
partial epilepsy (generalized leads to absence status epi)
Drugs that work by preventing high frequency Na channel firing?
phenytoin and carbamazepine
Indications for Carbamazepine and Phenytoin?
partial and GTC
Which AED is ass w/ purple glove syndrome and IV precipitation in dextrose?
phenytoin
What should you mix IV phenytoin w/? ADRs?
ethanol and propylene glycol can cause hypotenion and arrhythmias
Which AED has chroinc ADR of gingival hyperplasia, hirsutism, acne and coarsening of facial features?
phenytoin
How is carbamazepine different from phenytoin?
no cosmetic long term ADRs, can produce hyponatremia
How is oxcarbazepine different from carbamazepine?
hyponatremia is more common/worse, no hepatic/heme toxicity
Indications for lamotrigine?
pregnant women w/any epilepsy or BP d/o
Which AED has a slight stimulating effect?
lamotrigine
What are the broad spectrum AEDs?
valproate, topiramate, zonisamide, lamotrigine (benzos acutely)
What is the triad of ADRs for valproate?
weight gain, hair loss, tremor
Which AED is most firmly linked to teratogenicity?
valproate?
Dangerous ADRs for valproate?
thrombocytopenia, pancreatitis, hepatic failure, polycystic ovary syndrome
Which AED inhibits carbonic anhydrase?
topirimate (acetazolamide can be used as an AED)
ADRs for topiramate?
nephrolithiasis (closed angle glaucoma, cognitive impairment, wt loss)
What is the major benefit of levetiracetam?
starting dose is effective w/in a few days
Which drugs work on the alpha 2 delta subunit of voltage gated calcium channels?
gabapentin and pregabalin
Indications for gabapentin?
neuropathic pain, partial sz