Drugs For Epilepsy

Front 1

Phenytoin

Back 1

antiepileptic drugs (AED)
-oral and IV
-partial and tonic-clonic seizures (not petit mal, atonic, myoclonic)
-mechanism-selective inhibition of sodium channels
-variable oral absorption (not predictable)
-saturable enzyme metabolism in liver
-at some point, small dosage increments result in big increase in serum level
-LOTS of drug interactions

Front 2

Carbamazepine

Back 2

antiepileptic drug (AED)
- preffered by most to phenytoin
-lower incidence of compliance limiting side effects
-mechanism same as phenytoin
-metabolized by liver
-Half life decreases w/ chronic use due to "auto-induction" of metabolizing enzymes
-some drug interactions (grapefruit juice)
USES:
-epilepsy
-bipolar disorders
-trigeminal and glossopharyngeal neuraglias
ADVERSE EFFECTS:
-CNS symptoms- nystagmus, ataxia (less common than phenytoin)
-anemia, leukopenia=low WBC, thrombocytopenia= decreased platelets (rare bone marrow suppression
-birth defects

Front 3

Valproic acid (VPA)

Back 3

Anti-epileptic drug
-broadest spectrum AED
-used for virtually all types of seizures
-Mechs: suppresses both sodium and calcium channels, and augments GABA
-3 oral dose forms and IV
-extensively metabolized
-some interactions
USES:
-seizure disorder
-bipolar disorder
-migraine
ADVERSE EFFECTS:
-GI effects-usually transient (will usually go away)
-hepatotoxicity-liver failure (relatively unusual)(dark urine, liver swells)
-pancreatitis
-teratogenic effects

Front 4

Ethosuximide

Back 4

AED
-DOC for absence=petit mal
-inactive for other types...usually just in children
-Mech-inhibits calcium-channels in hypothalamus
-partially metabolized, partially excreted unchanged

S/E: mostly CNS and some GI, rarely cause serious side effects
-relatively well tolerated

Front 5

Phenobarbital + Primidone

Back 5

AED
-rarely used because of side effects (sedative s/e)
-primidone metabolized to phenobarb

Front 6

Lamotrigine

Back 6

AED
-used more than others
-usually "add on"

Front 7

Topiramate

Back 7

AED
-used more than others
-usually "add on"