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27 Cards in this Set

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Drug for Absence seizures
Ethosuximide
Ethosuximide (Zarontin) MA
(-) T-type Ca2+ channels
Side effects of Zarontin
Blood dyscrasias
Abnormal liver or renal fxn
General use Anti-seizure drugs
Valproic acid/Sodium valproate
Lamotrigine
Topiramate
Valproic Acid/Sodium Valproate (Depakene, Depakote) MA
(-) Na+ channels, T-type Ca2+ channels and GABA transaminase
(+) GABA synthetic enzyme and glutamic acid decarboxylase
HYPERPOLARIZATIONS MEMBRANES
Pharm of Valproic Acid
Highly bound to plama protein
Side effects of Valproic Acid
Idiosyncratic hepatotoxicity
*risk greatest in pts < 2 y.o. taking multiple meds--most fatalities during first 6 mo of therapy
Pancreatitis, idio thrombocytopenia, hyperammonemia, teratogen, osteoporosis
Lab tests for Valproic Acid
REQUIRED LIVER FXN TESTS
Lamotrigine (Lamictal) MA
(-) Na+ channels and (-) Glutamate release
Clinical use of Lamotrigine
Lennox-Gastaut syndrome for pts under 16
Side effects of Lamotrigine
Stevens-Johnson syndrome (immune mediated skin dz)
(.3% adults, 1% kids)
Arthritis, hypersensitivity, multi-organ failure, intravascular coagulation
Topiramate (Topamax)MA
(-) Na + channels, enhances GABA transmission
AMPA/KA receptor antagonist [carbonic anhydrase (-)]
Topiramate side effects
Metabolic acidosis
Severe myopia and secondary glaucoma
Hypohidrosis and hyperthermia
renal caliculi, wt. loss, language dysfxn
Other types of seizures
Status epilepticus
Infantile spasms
Febrile seizures
Status Epilepticus Characteristics
Continuous prolonged seizures, 5-10 min, or multiple in rapid succesion
Most common SE seizure
Generalized TC SE-- life threatening
*metabolic, CV, and Resp managment
Characteristics of Infantile Spasms
Myoclonic spasms, first attack before 1 yr. (90%), refractory to usual anti-seizure drugs
Febrile seizures characteristics
Not a form of epilepsy, brought on by fevers in infants and small children
Drugs of Choice for SE seizures
I.v. lorazepam
i.v. rectal diazepam
Front line SE drugs
I.v. lorazepam
i.v. rectal diazepam
i.v. fosphenytoin
(sometimes phenobarbital)
SE refractory cases
Iatrogenic coma
continuous i.v. pentobarbital or cont. iv midazolam
SE off label use
Absence SE: no barbiturates, use valproate for fosphenytoin
IS drug of choice
Corticotropin
Prednisone
IS frontline drugs
Vigabatrin
IS other drugs
Clonazepam
Nitrazepam
IS off-label drug
Topiramate
Febrile Seizure drugs
NONE
Rectal diazepam during fever