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