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38 Cards in this Set

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Phenytoin:

- Used for what?
- Mechanism
Most forms of epilepsy except for absence seizures

Inhibition of voltage gated Na+ channels
Phenytoin:

- Pharmacokinetics
- Serious side effects x5
Oral: slow and erratic

Bone marrow effects
Withdrawals
Hepatic function
Arrhythmias
Teratogenic
Phenytoin:

- Drug interaction
- Fosphenytoin?
Many at level of liver metabolism

For short-term administration for status epilepticus and seizure associated neurosurgery.
Carbamazepine:

- Used for?
- Mechanism
All seizures except absence

Inhibition of voltage gated Na+ channels
Carbamazepine:

- Pharmacokinetics
- Serious side effects x2
Oral: slow and erratic
Autoinduction

Aplastic Anemia
Agranulocytosis
Carbamazepine:

- Drug interactions
Many related to hepatic enzyme inducing properties
Which drug has the pharmacokinetic property of autoinduction?
Carbamazepine
Valproic Acid:

- Used for?
- Mechanism
Partial and generalized seizures
including Absence

Unclear
Valproic Acid:

- Pharmacokinetics
- Serious side effects x2
Oral: well absorbed

Fatal hepatotoxicity
Teratogenic
Valproic Acid:

- Drug interaction
Inhibits metabolism of other drugs including its own.
What does valproic acid do to phenytoin?
It will displace it from plasma proteins
Benzodiazepines:

- Types
- What is each good for?
Clonazepam
Diazepam
Clorazepate

Clonazepam and Cloarazepate used for long term treatment of most seizures.

Diazepam is drug of choice for status epilepticus.
Benzodiazepines:

- Mechanism
- Pharmacokinetics
Potentiates GABA

Very high protein binding
High therapeutic index
Benzodiazepines:

- Serious side effects
- Drug interaction
Low toxicity, but hyperactivity and irritability in kids

Additive or synergistic effects
Phenobarbital:

- Used for?
- Mechanism
Used for most seizures except absence (GTC, partial, FEBRILE)

Potentiates GABA
Phenobarbital:

- Pharmacokinetics
- Serious side effects
long half life (100 hrs)

Respiratory depression
Phenobarbital:

- Drug interaction
Many due to induction of P450 enzymes in liver
What is Primidone?
Anticonvulsant which is metabolized to phenobarbital.
Which drug has additive or synergistic interaction with CNS depressants (esp EtOH), and is a P450 inducer?
Phenobarbital
Ethosuximide:

- Used for?
- Mechanism
Drug of choice for absence seizures

Inhibits voltage gated calcium channels
Ethosuximide:

- Pharmacokinetics
- Serious side effects x5
Oral: Complete absorption

SLE
Leukopenia
Eosinophilia
Pancytopenia
Thrombocytopenia
Ethosuximide metabolism can be inhibited by what drug?
Valproic acid
ACTH/Corticotropin:

- Used for?
- Mechanism
Infantile spasms

Glucocorticoid decreases in hippocampal neuronal excitability
ACTH/Corticotropin:

- Pharmacokinetics
- Serious side effects x3
IM due to proteolysis in gut

HTN
Immunosuppresion
Osteoporosis
ACTH/Corticotropin:

- Drug interaction
Drugs that can stimulate or inhibit hepatic enzymes can directly affect ACTH therapy.
Gabapentin:

- Used for?
- Mechanism
Add-on for partial and secondary generalized seizures in adults.

Increase GABA by unknown mechanism
Gabapentin:

- side effects
- Drug interactions
Somnolence
Ataxia
Dizziness

No known interactions
Lamotrigine:

- Used for?
- Mechanism
Add on therapy for partial seizures in adults

Inhibits voltage gated sodium channels
Lamotrigine:

- Pharmacokinetics
- Side effects
Oral: complete absorption

Tremor
Ataxia
Dizziness
Vigabatrin:

- Used for?
- Mechanism
Partial and secondary generalized seizures

Irreversible inhibition of GABA transaminase
Vigabatrin:

- pharmacokinetics
- Serious side effects
Not metabolized
No plasma protein binding

Psychiatric symptoms (depression and psychosis)
T/F - Vigabatrin should be used with Phenytoin.
False - b/c vigabatrin decreases phenytoin plasma concentrations
Topiramate

- Used for
- mechanism
- Serious side effects
Add on for partial seizures

Unknown

Speech problems
Psychomotor problems
Concentration problems
Tiagabine:

- Used for
- Mechanism
- Serious side effects
Add on for partial generalized seizures

GABA uptake inhibitor

Tremor
Asthenia
Nervousness
Levetiracetam:

- Used for?
- Mechanism
- Serious side effects
Partial seizures

Unknown

Behavioral symptoms
Zonisamide

- Used for?
- Mechanism
- Side effects x2
Partial seizures

Unknown

Psychiatric symptoms
Kidney Stones
Felbamate

- Used for?
- Mechanism
Refractory partial seizures

NMDA receptor antagonist
Felbamate

- Serious side effects
Fatal aplastic anemia
Liver failure