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

1/78

Click to flip

78 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)
Name the 5 traditional AEDs.
Phenytoin
Carbamazepine
Valproate
Phenobarbital
Ethosuximide
Name 8 2nd generation AEDs.
Gabapentin
Leviracetam
Lamotrigine
Oxcarbazepine
Tiagabine
Topiramate
Zonisamide
Felbamate
Which AEDs work by affecting Na channels?
Carbamazepine
Oxcarbazepine
Phenytoin
Lamotrigine
Zonisamide
Which AED works by affecting Ca currents?
Ethosuximide
Which AEd's affect GABA metabolism
Phenobarbital
Tiagabine
What is carbamazepine indicated for other than seizures?
bipolar disorder
chronic pain (e.g. trigeminal neuralgia)
What are the cytochrome interactions of carbamazepine?
3A4 substrate
2C9, 2C19, and 3A4 inducer
Which antiepileptics are autoinducers?
carbamazepine
Which antiepileptics can cause SJS and TEN?
Carbamazepine
Oxcarbazepine
Phenytoin
Lamotrigine
Zonisamide
Phenobarbital
Valproic acid
Felbamate

(all the traditionals plus oxcarb, zonisamide, and felbamate)
When is SJS or TEN most common in the course of carbamazepine treatment?
within the 1st 8weeks
What are 2 serious side effects of carbamazepine? (reason you need a baseline and follow up CBC)
Leukopenia

Aplastic anemia (dose related)

both usually w/in 1st 3 mo
What are the indications for the use of oxcarbazepine? what is it used off label for?
mono or adjunct therapy for tx of partial seizures; off label for peripheral neuropathies
What side effects are shared by both carbamazepine and oxcarbazepine?
N/V, drowsiness, dizziness, blurred/double vision, sedation, HA
SJS
TEN
SIADH
What is the difference between phenytoin and fosphenytoin?
fosphenytoin is a prodrug of phenytoin -

fosphenytoin can be administered by IV faster with fewer complications and without a filter
Which AED is used most often for prevention of seizures following head trauma and neurosurgery?
phenytoin
What are the cytochrome interactions of phenytoin?
2C9 and 2C19 substrate

Inducer of 2C9, 2C19, and 3A4
Will you need a higher or lower dose of warfarin if taking phenytoin?
higher
Which AED can cause a lupus like reaction?
phenytoin
Which AED can cause werewolf syndrome? What does that mean?
phenytoin; hypertrichosis
What two drugs cause hypertrichosis?
minoxidil and phenytoin
Which AED can cause drug fever?
phenytoin
What are some drugs that can cause drug fever?
H2 blockers
beta lactams
phenytoin
(there are others)
What are the side effects of phenytoin?
osteomalacia
hepatotoxicity
SJS/TEN
hypertrichosis
drug fever
peripheral neuropathy
gingival hyperplasia
nystagmus
blurred/double vision
ataxia
slurred speech
sedation
bone marrow suppression
What are the side effects of IV phenytoin?
hypotension
bradycardia
CV collapse
venous irritation
thrombophlebitis
Which AED is a class Ib antiarrhythmic when given IV?
phenytoin
Which Na channel AED can be used for absence seizures?
Lamotrigine
What is the interaction between lamotrigine and valproate?
valproate inhibits glucuronidation which will increase lamotrigine
What can lamotrigine be used for other than epilepsy?
bipolar disorder
Which AED should not be used in pts <16 b/c inc risk of SJS/TEN?
lamotrigine
which AED is a sulfonamide derivative?
zonisamide
Which AED has is chemically/structurally unrelated to other AEDs?
zonisamide
What are the clinical indications for zonisamide?
adjunctive for partial and generalized seizures
WHat are the cytochrome interactions of zonisamide?
3A4 substrate
What are the side effects of zonisamide?
ataxia, abnormal thinking, somnolence, confusion, dizziness, SJS/TEN
What are the cytochrome interactions of ethosuximide?
3A4 substrate
What are the most common adverse rxns of ethosuximide?
N/V, drowsiness, and hyperactivity
What AED extends GABA-mediated chloride channel openings?
phenobarbital
What is the limiting side effect of phenobarbital for seizures?
sedation
What are the cytochrome interactions of phenobarbital?
2C19 substrate
2C9 and 3A4 inducer
What ADR is unique to phenobarbital?
bone marrow suppression
what AED works by inhibiting GABA reuptake into presynaptic neurons?
tiagabine
What is tiagabine used for?
adjunctive tx for partial seizures
What are the cytochrome interactions of tiagabine?
3A4 substrate
Which AED has been associated with new-onset seizures and status when taken off-label?
tiagabine
What are the ADRs of tiagabine?
dizziness, somnolence, nausea, nervousness, tremor, difficulty concentrating
What two forms of valproate are available?
valproic acid and divalproex
What two things is valproate indicated for beside seizures?
mania associated w/bipolar disorder
migraine prophylaxis
What three AEDs are indicated for absence seizures?
ethosuximide
lamotrigine
valproate
What 3 AEDs can cause bone marrow suppression?
phenytoin
phenobarbital
valproate
What are the ADRs of valproate?
SIADH (like carbamazepine/ox)
somnolence
dizziness
insomnia
tremor
ataxia
pancreatitis
weight gain
N/V/D
alopecia
bone marrow suppression
dysmenorrhea
SJS/TEN
Which AED may cause neural tube defects?
valproate
With which AED must you monitor LFTs b/c potential for hepatotoxicity/hepatic failure?
valproate
Which AED for partial seizures should really NOT be used?
felbamate
Why is there almost never an indication to use felbamate?
associated w/fatal aplastic anemia and hepatic failure
What are the three mechanisms of action of topiramate?
blocks Na channels
enhances activity of GABA
NMDA antagonist
What side effect is unique to topiramate?
dec sweating --> heat intolerance/hyperthermia

also. . . metabolic acidosis
careful when using with anticholinergic drugs
How can topiramate cause metabolic acidosis?
dose-related renal bicarb loss b/c it has an inhibitory effect on carbonic anhydrase
what are the most likely clinical manifestations of topiramate induced acidosis?
tachypnea and calcium phosphate nephrolithiasis
what are the monitoring requirements for topiramate?
measure bicarb at baseline and again every 2-4mo.
How does pregabalin work?
modulates calcium currents and the release of glutamate, norepinephrine, and substance P
what is pregabalin indicated for?
adjunct for partial seizures
neuropathic pain (not DM neuropathy)
What are the side effects of pregabalin?
dizziness, somnolence, ataxia, weight gain, blurred or double vision, euphoria
which AED is a schedule V controlled substance?
pregabalin
Which AED crosses the BBB and mimics the physiologic effects of GABA?
gabapentin
What are the clinical indications for use of levetiracetam?
add-on for refractory partial seizures
What are the interactions of gabapentin and levetiracetam?
fairly clean
What are the side effects of levetiracetam?
fatigue, somnolence, dizziness, behavioral changes
Which AED is associated with diarrhea, hyponatremia, a rash, and pruritis?
carbamazepine
which AEDs may cause weight loss?
felbamate, topiramate

zonisamide causes anorexia
which AEDs may cause weight gain
pregabalin, valproate
which AED may cause lymphadenopathy?
phenytoin
which AED may cause renal stones?
topiramate
which AED is associated with easy bruising, hair loss, and weight gain?
valproate
Which AED is associated with tremor?
valproate, and topiramate
which AEDs may cause hyperactivity?
ethosuximide
which AED can cause aplastic anemia?
felbamate

(and zonisimide, and valproate and phenytoin and ethosuximide, and carbamazepine. . .but mostly felbamate)
which AEDs can cause agranulocytosis?
carbamazepine
ethosuximide
phenytoin
primidone/phenobarbital
valproate
zonisamide

(all the "traditionals" plus zonisamide)
which AEDs are rarely associated w/serum sickness?
carbamazepine
ethosuximide
phenytoin
valproate
phenobarbital