Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/40

Click to flip

40 Cards in this Set

  • Front
  • Back
MA of Phenytoin (Dilantin, Diphenylan)
Inhibits Na+ channels
Pharmacokinetics of Phenytoin
Nonlinear between dose and [plasma] due to saturable liver metabolism
Protein binding of Phenytoin
High protein binding (including thyroid hormone-binding globulin)
Adverse effects of phenytoin
OH MY GOD!!!
Lymphadenopathy, lupus, gigival hyperplasia, hirsutism, corsened facial features, endocrine abnormalities--osteomalacia, hyperglycemia, decrease ADH, tetratogen
Lab tests for Phenytoin
Monitor T.I. and thyroid fxn tests
Carbamazepine (Tegretol)MA
(-) Na+ channels and decreases synaptic transmission
Metabolism of Carbamazepine
Induction of own metabolism
Adverse effects of Carbamazepine
Liver damage, leukopenia-rarely aplastic anemia and agranulocytosis, hyponatremia, ostoeporosis, teratogen
Lab test for Carbamazepine
Liver fxn test- REQUIRED
Monitor T.I.
Hematology and serum Na+
Renal fxn
Oxcarbazepine (Trileptal) MA
(-) Na+ and high voltage Ca2+ channels, enhances K+ currents
Metabolism of Oxcarbazepine
Prodrug, 10 monohydroxycarbazepine is active, fewer drug interxns
Why does Oxcarbazepine have fewer adverse effects?
No epoxide intermediate
Adverse effects of Oxcarbazepine?
Hyponatremia
Lab tests for Oxcarbazepine
Monitor serum Na+
*Decreases T4
Barbituates used in partial or gen TC seizures
(there are 8)
Phenobarbital
Primidone
Gabapentin
Tiagabine
Zonisamide
Levetiracetam
Felbamate
Vigabatrin
Phenobarbital MA
Modulates GABA a receptors, (-) Ca2+ channels, and decreases glutamate transmission
Adverse effects of phenobarbital
Sedation and possibly coma leading to death
Primidone (2-desoxyphenobarbital) MA
Like phenytoin
Split into phenobarbital and phenylethylmalonamide (PEMA)
Pharmokinetics of Primidone
Primidone and PEMA high clearance

Phenobarbital high clearance
*during chronic treatment can be 2-3X higher than primidone levels
Adverse effects of Primidone
Acute intoxication
Sedation
Lupus like syndrome
Blood dyscrasias
Osteoporosis
Gabapentin (Neurontin) MA
Unknown
Gabapentin Pharmokinetics
Excreted unexchanged
Gabapentin Adverse Effects
Peripheral edema
Behavior and though disorders in kids 3-12
Tiagabine (Gabatril)MA
GABA uptake (GAT-1) inhibitor
Tiagabine pharmokinetics
Highly bound to plasma proteins
Side effects of Tiagabine
Nonconvulsive status epilepticus
Zonisamide (Zonegran)MA
(-) Na+ and T-type Ca2+
Weak carbonic anhydrase inhibitor
Side effects of Zonisamide
Allergic rxn to Sulfa
Hypohydrosis and hyperthermia in peds pts.
Renal caliculi
Photosensitivity
Teratogen
Irritability
Levetiracetam (Keppra) MA
Inhibits delayed rectifier K+ channel and N-type Ca2+ channels, (-) negative modulation of GABA a receptors by Zn2+ and beta-carboine
Side effects of Keppra
Irritability
Behavioral Changes
Felbamate (Felbatol) MA
(-) NMDA receptors and (+) GABA transmission
Felbamate side effects
Aplastic anemia and severe hepatitis--hepatic failure
Lab tests for Felbamate
REQUIRED LIVER FXN TESTS
Hematology
Vigabatrin (Sabril) MA
Irreversibly (-) of GABA degradation enzyme and GABA transaminase
Vigabatrin side effects
CONTRAINDICATION: preexisting mental illness, may cause psychosis

Long term visual field deficits in 1/3 of pts may be irreversible
FDA required liver fxn testing for these drugs
Carbamazepine
Felbamate
Valproic Acid/sodium valproate
Which antiseizure drugs do we have to know lab tests for?
(There are 5)
Phenytoin- monitor T.I.
Carbamazepine- liver fxn
Oxcarbazepine- Na+ and T4
Felbamate- liver fxn
Valproic acid- liver fxn
General use Anti-seizure drugs?
(3)
Valproate
Lamotrigine
Topiramate
Absence seizure drug
Ethosuximide
Non-barbituate partial and generalized TC drugs?
Phenytoin
Carbamazepine
Oxcarbazepine