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7 Cards in this Set
- Front
- Back
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Carbamazepine (Tegretol) |
tricyclic antidepressant derivative - Indication: partial (focal) seizures, secondary tonic-clonic seizures. - DONT USE: in myoclonic - can worsen condition - other use: alt. of lithium in prophylaxis bipolar disorder + tx acute mania - Mechanism : Voltage gated Na+ channel blocker - t ½= 20-40 hours - strong hepatic enzyme inducer - many interactions - caution in cardiac disease as this affects na+ channels - s/e: sedation, ataxia, rash (stevens-johnson), red cardiac output, inc vit D/ folic acid metabolism |
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Oxcarbazepine |
analogue if carbamazepine - Indication: alt 1st line or add on for partial (focal seizures) - Mechanism: Voltage gate Na+ channel blocker - t ½= 2 hours --> metabolit eslicarbazepine also has therapeutic effect - lower s/e profile - s/e: dizziness, headache, cytochrome enzyme induction --> failure of estrogen contraception
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Eslicarbazepine |
metabolite of oxcarbazepine - indication: add-on therapy for partial (focal) seizures - Mechanism of action: voltage-gated Na+ channel blocker - t ½= 11 hours - lower frequency of s/e |
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Phenytoin (Epanutin, Dilantin) |
- Indication: Tonic-clonic, partial (focal) seizure - Mechanism: Voltage-gated Na+ channel blocker - low dose => 1st order, eventually disproportional rise in steady state plasma dose conc. - potent hepatic enzyme inducer --> metabolism of other drugs e.g. carbamazepine, folic acid and Vitamin D - s/e: confusion, gum hyperplasia, skin rashes, anemia and teratogenesis - NOT FOR LONG TERM |
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Lamotrigine (lamictal) |
- Indication: 1st line & adjunct for absence and tonic clonic seizures, adjuct for partial seizures, indicated for bipolar disorder - Mechanism: Voltage gated Na+ channel blocker, red glutamate release -t ½ = 24 hours (Single daily dose ) s/e: Rash in 10% of patients |
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Lacosamide (Vimpat) |
- Indication: Refractory partial (focal) seizures - mechanism: Voltage gated Na+ channel blocker - t ½= 13 hours - s/e: dizziness, nausea, headache, prolongation of PR intervals detected by ECG |
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