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38 Cards in this Set
- Front
- Back
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phenytoin echanism of action
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blocks na channels zero order |
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phenytoin use
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partial seizures tonic clonic seizures al seiqures but abscece first line prophylactus for status epilepticus |
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phenytoid side effects
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nystagmus, diplopia, ataxia, sedation gingival hyperplasia hirsutism megaloblastic anemia, teratogenesis, sle like syndrome, induction of p four fifty , lymphadenopathy and steven Johnson syndrome, osteopenia |
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methphenytoid,ehtotoin phenacemide use
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replace ment for phenytoin... meptheytoin break to niranol and has effect
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carbamazepine
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blocks na channels
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carbamazepine use
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first line:partial seizures generalized tonic clonic seizure, trigeminal neuralgia bioplar |
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toxicity carbamazepine:
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most common does related is diplopia and ataxia, aplastic anemia agranulocytosis teratogenesis, induce cytochrome pfour fifty Steven Johnson SIADH, |
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Skip oxcarbazepine use
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less toxic and less effect on induce hepatic enzymes than carbamazepine
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skip elicarbazine use |
used as pro drug once a day replace carbazepine
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phenobarbital use
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simple, clomple tonic clonic first line use for neonates but not infantisle spasm |
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pehobarbital mechanism
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Increase gaba actions
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phenobarbital toxicity
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sedation, tolerance, dependence inuce p four fifty and cardiorespiratory depression |
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skip :primidone mechanism of action
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similar to phenytoin but convert to phenobarbital. block high frequency firing of neurons through action on vg NA channels...decrease synaptic release glutamate |
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phenytoin clinical use
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is effect against partial seizures and generalized tonic clonic seizures.
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phenytoin toxicity
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like phenobarital... drowsiness early in treatment sedation, cognitive issues, ataxia hyperactivity |
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gabapentin and Pregabalin: mechanism of action
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decrease CA entry.. predominant effect on N type Channels transported by l amino acid transporter gaba analog |
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Gabapentin clinical use toxicity
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partial seizures and tonic clonic seizures impt: for neuropathic pain,herpes tox: somnolence dizziness, ataxia , headache |
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Lamotrigine mechanism of action
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suppresses NA channels.. may inhibit CA channels
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Clinical uses lamotrigine and toxicity
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monotherapy for partial seizures and absence. steven Johnson skip bipolar disorder, lennox gastaut< seizures childhood type> dizziness, headache, diplopia nausea, somnolence and skin rash |
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Levetiracetam mechanism of action
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Bind selectively to SVA, modifies release of glutamate and gaba
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Levetiracetam use
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tonic clonic,
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Rufinamide all
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prolong inactivate na and interact with gaba clinical use: effective against all seizure types .. use with lennox gastaut syndrome |
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skip :Stiripentol special and mech
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refractory generalized tonic clonic seizures with sever myoclonic epilepsy of infancy enchance gaba transmission |
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Tiagbine mechanism and use
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increase gaba by inhibiting reuptake in neurons and glia< gat-one in hippocampus and forebrain
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tiagibine: clinical uses
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can cause seizures in some pts somnolence ataxia nervousness |
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Topiramate: mech
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block na channels and l type ca channels topiramate blocks repetitive firing of cultured spinal cords neurons |
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topiramate clinical uses and toxicity
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partial and generalized tonic clonic toxic: acute myopia and glaucoma. Uroliathiasis |
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vigabatrin action use
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simple and complex: partial.. infantile spasm Increase gaba by irreversibly inhibiting gaba transaminase< responsible for its degradation> toxicity |
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viabatrin special
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don't use with psychotic patients... cause psychosis periphera visual field defects |
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Zonisamide general
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act on NA channel, also act on t type voltage gated CA channel
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Ethosuxamide mechanism
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Effect on Ca currents reducing the low threshold t type current
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Ethosuxamide: clinical uses
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special: administrate with valporic reults in clearance and high steady state concentration. tox: steven Johnson, GI, headache, itching, fatigue |
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valproate mechanism< high yield>
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increa na channel inactivate and inhibit gaba transaminase =increase gaba |
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valproic acid use and toxicity
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all but status epilpeticus... myoclonic tox: gi distress, hepatotoxicity, tremor weight gain..contraindicted in pregnancy |
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Oxazolidinediond special
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activet against phentylenetertrazol induced seizures. not use for pregnancy
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Benzodiazepines: list
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diazepam: oral lorazapam: longer than diazepam Nitrazepam : infantile spasms Clonazepam: also absence |
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benzodiazepine mechaism
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increase gaba tox: sedation tolerance dependent respiratory depression for first line use mgso |
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acetazolamide mech
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inhibit carbonic anhydrase and mild acidosis in brain useful all seizure but rapid tolerance |
