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28 Cards in this Set
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- Back
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carbamazepine (Tegretol)
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anticonvulsant: inhibit voltage gated Na+ channels, prolonging refractory period, reducing sustained firing. USE: partial simple, partial complex, tonic-clonic siezures. Also trigeminal neuralgia, bipolar. Oral admin, slowly absorbed. High lipid soluble, rapid penetration into brain. metabolized by P450, INDUCES P450, increasing its own metabolism and other antiepileptics over time. hepatotoxicity
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ethosuximide (Zarontin)
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anticonvulsant: inhibit voltage gated Ttype Ca++ channels, thus inhibiting rhythmic activity. USE: absence seizures. Oral. Doesn't bind plasma proteins. 1/2life 30-60hrs. 3/4 metabolized P450, 1/4 excreted unchanged in urine.
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gabapentin (Neurontin)
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anticonvulsant: enhances GABA transmission. USE: partial simple, partial complex, tonic-clonic. Not bound to plasma protiens, or metabolized by hepatic enzymes. Short 1/2 life(5-8hrs) eliminated by kidneys. Few drug interactions. Not usually used alone.
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lamotrigine (Lamictal)
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anticonvulsant: inhibit voltage gated Na+ channels, prolonging refractory period, reducing sustained firing. (-) release of glutamate. USE: simple/complex partial, tonic-clonic seizures. Metabolized by liver. 1/2 life reduced by enzyme inducing drugs (carbamazepine, phenytoin) increased by valproic acid
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phenobarbital (Luminal)
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anticonvulsant: barbiturate, enhances GABA transmission. USE: simple partial, recurrent tonic-clonic seizures, febrile seizures in kids (Primidone prodrug metabolized to phenobarbital)
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phenytoin (Dilantin)
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anticonvulsant: inhibit voltage gated Na+ channels (and Ca channels), prolonging refractory period, reducing sustained firing. Initial drug of choice for partial simple, partial complex and tonic-clonic seizures. Given IV for emergency tx of status-epilepticus. Also used to tx arrhythmias. not for absence seizures - can worsen them. metabolized by P450 system, can be saturated at high doses. SE: gingival hyperplasia, megaloblastic anemia, teratogenic effects
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valproic acid (Depakene)
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anticonvulsant: inhibit both voltage gated Ca++ and Na+ channels, thus inhibiting rhythmic activity and reducing sustained firing. Also inhibits GABA transmission. USE: myoclonic seizures. Hepatotoxicity makes it second line drug. Combined with Na-valproate to imprive GI tolerance. SE: therombocytopenia, teratogenic effects
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pregabalin (Lyrica)
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anticonvulsant: blocks Ca++ channels, decreases release of glutamate. USE: simple/complex partial. SE: thrombocytopenia
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topiramate (Topamax)
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anticonvulsant: blocks Na+ channels, increases activity of postsynaptic GABA receptors. USE: simple/complex partial, tonic-clonic seizurse
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zonisamide (Zonegran)
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anticonvulsant: blocks Na+ channels, blocks T-type Ca++ channels. USE: simple/complex partial, tonic-clonic seizures
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clonazepam (Klonopin)
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anticonvulsant: benzo, enhanced GABA transmission. USE: myoclonic and absence seizures. Tolerance develops after 1-6 months
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diazepam (Valium)
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anticonvulsant: benzo, enhanced GABA transmission. USE: emergency tx of status epilepticus IV
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lorazepam (Ativan)
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anticonvulsant: benzo, enhanced GABA transmission. USE: emergency tx of status epilepticus IV
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chlorpromazine (Thorazine)
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antipsychotic: phenothiazine. SE: muscarinic block, alpha-adrenergic receptor block(hypotension, reflex tachy, sexual dsfxn), hictamine receptor block (sedation, weight gain)
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fluphenazine (Permitil)
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antipsychotic: phenothiazine. IM option
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thioridazine (Mellaril)
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antipsychotic: phenothiazine. SE: muscarinic block
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thiothixene (Navane)
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antipsychotic: thiothixene
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haloperidol (Haldol)
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antipsychotic: butyrophenone. IM option. Pituitary D2 receptor block most prominent (increase prolactin release->infertility and impotenenc)
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clozapine (Clozaril)
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antipsychotic: atypical. SE: histamine receptor block (sedation weight gain)
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olanzapine (Zyprexa)
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antipsychotic: atypical
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risperidone (Risperdal)
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antipsychotic: atypical. IM option
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promethazine (Phenerganl)
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antipsychotic: antiemetic. Antihistamine
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prochlorperazine (Compazine)
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antipsychotic: antiemetic. D1 (and D2) receptor blocker
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fosphenytoin
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prodrug rapidly converted to phenytoin - used IM and IV
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antiepileptic drug side effects
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drowsiness/sedation, ataxia, nausea/vomiting, skin rash, weight gain/loss
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teratogenic effects
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phenytoin, carbamazepine, valproic acid, phenobarbital
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antipsychotic efficacy and metabolism
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relief in 70% of pts. Takes 4-8 weeks to work. Metabolized by P450. can be given via deep gluteal IM injections in oral non-compliant pts
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neuroleptic malignant syndrome
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collapse of autonomic nervous system. Fever, diaphoresis, CV intstability. 1-2% of pts, fatal in 10% of those who get it. Immediate TX: bromocriptine (dopamine agonist)
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