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20 Cards in this Set
- Front
- Back
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What is the DOC for absence seizures?
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Ethosuximide
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If a patient with absence seizures cannot tolerate Ethosuximide, treat with ___________.
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Lamotrigine
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BZs work for all generalized seizures except _____________.
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tonic-clonic
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What two drugs have the broadest spectrum of anti seizure activity?
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Valproate & Lamotrigine
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What are good drugs for partial seizures?
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Carbamazepine & Phenytoin
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What are the signs & symptoms of Absence seizures?
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Brief loss of awareness
Sometimes: eye blinking or lip-smacking No loss of consciousness or body tone *this form of Epilepsy almost always seen in young children |
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What antiseizure meds have a MOA that ONLY involves prolonging the state of Na channel inactivation?
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Phenytoin
Fosphenytoin Ethotoin Carbamazepine Lamotrigine |
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What is the MOA of Ethosuximide?
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Reduces low threshold calcium currents (T currents)
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What are the mechanisms of action of Valproate?
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Prolongs state of Na channel inactivation
Reduces low threshold Ca currents (T currents) Increases GABA by stimulating the synthetic enzyme Glutamic Acid Decarboxylase Inhibits the degradation of GABA |
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What are the mechanisms of action of Topiramate?
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Prolongs state of Na channel inactivation
Blocks Glutamate receptors Promotes the release of GABA |
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What is the MOA of Phenobarbital?
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Enhances GABA-mediated increases in chloride conductance by increasing the duration of channel opening
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What is the MOA of Diazepam & Clonazepam?
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Enhances GABA-mediated increases in chloride conductance by increasing the frequency of channel opening
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What is the MOA of gabapentin?
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Unknown
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What are the DOC for generalized tonic-clonic seizures?
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Phenytoin & Ethotoin
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What is the DOC for treating partial seizures and trigeminal neuralgia?
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Carbamazepine
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What are the adverse effects of Phenytoin?
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Hirsutism (increased hair growth)
Gingival hyperplasia Osteomalacia Megaloblastic anemia (resp. to folate) |
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What are the adverse effects of Valproate?
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Hepatotoxicity--esp. when other antiseizure drugs are administered concurrently
It is a serious concern due to the formation of toxic intermediates of valproate metabolism |
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What are the adverse effects of Carbamazepine?
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Bone marrow depression (leukopenia)
Aplastic anemia Agranulocytosis Hyponatremia Water retention |
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What are the adverse effects of Phenobarbital associated with long-term use and high dosages?
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Osteomalacia (resp. to Vit D)
Megaloblastic anemia (resp. to Folate) Hemorrhage in newborn (if mother is on Phenobarbital; resp. to Vit K) Porphyria |
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What is the treatment for Status Epilepticus?
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i.v. Lorazepam or Diazepam
If not effective, treat patient w/ i.v. Fosphenytoin |
