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