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17 Cards in this Set
- Front
- Back
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Phenytoin aka diphenylhydantoin |
- used for traumatic brain injury-type seizures - 90% mostly bound to albumin - Dose-dependent elimination (very low blood levels = metabolism follows 1st order kinetics) - non-linear pharmacokinetics - When used, if you add any other oral medication, it can affect how much phenytoin is absorbed |
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What is the first presenting sign/symptom of phenytoin toxicity? |
nystagmus |
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What are the adverse effects of phenytoin? |
- gingival hyperplasia - hirsutism (extra hair where you don't want it) - Steven's Johnson syndrome (severe idiosyncratic skin rxn to drug) - diplopia - nystagmus |
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Carbamazepine |
- tricyclic compound related to some older anti-depressants/also used in treating bipolar disorder - Eliminated via hepatic metabolism - Autoinduction (speeds up its own metabolism) |
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What are the adverse effects of carbamazepine? |
- diplopia - ataxia |
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Valproic acid |
- LiVVVVVVer = valproic acid - enteric coated tablets |
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What are the 2 main drugs used to treat mood disorders but also used for anti-seizure? |
- valproic acid - carbamazepine |
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What is the adverse effect of valproic acid? When is contraindicated? |
- hepatic necrosis - teratogenicity (spina bifida) - valproic acid contraindicated if there is hepatic dysfunction |
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Phenobarbital |
- horrifically sedating - anti-seizure drugs given to someone without seizures potentially cause seizures! - affects the CNS |
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Which benzos can be used for anti-seizures? |
- clonazepam - diazepam - lorazepam - corazepate - use benzos in acute seizures |
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Gabapentin |
- #1 choice to treat nerve pain - renal elimination, not metabolized |
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What are the adverse effects of gabapentin? |
- dizziness - weight gain - confusion |
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Pregabalin |
- If gabapentin doesn't work, give pregabalin. - also used to treat neuropathic pain |
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Lamotrigine |
- also used to treat neuropathic pain |
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What are the adverse effects of lamotrigine? |
- severe potentially life threatening rashes (Steven's Johnson syndrome, toxic epidermal necrolysis) |
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What is the biggest adverse effect of topiramate?
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- Since topiramate is a weak carbonic anhydrase inhibitor, it may increase the risk of kidney stones.
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Complete list of anti-seizure drugs |
- topiramate - lamotrigine - pregabalin - gabapentin - benzodiazepines (clonazepam, diazepam, lorazepam, clorazepate) - phenobarbital - valproic acid - carbamazepine - phenytoin |
