Pharm 2: Antiepileptic Drugs

Front 1

Carbamazepine (Tegretol)

Back 1

Partial and generalized Tonic-Clonic seizures
Blocks V-sens. Na Ch
(→ Fatal aplastic anemia; ataxia, drowsiness (CNS Depression))
Tx: 1st choice Tonic-Clonic (worsens absence) + bipolar manic phase

Front 2

Phenytoin (Dilantin)

Back 2

Partial and generalized Tonic-Clonic seizures
Blocks V-sens. Na Ch
(→ Cereballar sx; gingival hyperplasia; megaloblastic anemia and other blood cell deficiencies)
Tx: 1st choice for partial and tonic-clonic, 2nd choice for status epilepticus (worsens absence)

Front 3

Phenobarbital (Luminal)

Back 3

Partial and generalized Tonic-Clonic seizures
Enhance GABA-mediate Cl- flux
(respiratory depression; induce hepatic enzyme)
CAUTION in children

Front 4

Primidone (Mysoline)

Back 4

Partial and generalized Tonic-Clonic seizures
Enhance GABA-mediate Cl- influx
Tx: 2nd choice for partial and tonic-clonic
Converted to 2 active metabolites (Phenobarbital and PEMA)
vertigo, diplopia, nystagmus

Front 5

Valproate (Valproic acid, Depakene)

Back 5

Partial and generalized Tonic-Clonic seizures
Blocks V-sens. Na and T-type Ca2+ Ch
↑ GABA synth and ↓degradation
Tx: 1st choice for tonic-clonic, myoclonic, atonic;
2nd choice for partial and absence (in kids)
Use in absence seizures, espec. When other seizures present; myoclonic seizures, perhaps DOC; tonic-clonic = adjunct
rare fulminant fatal hepatitis (children)

Front 6

Clonazepam (Klonopin)

Back 6

Generalized Absence seizures
Enhance GABA-mediate Cl- flux
Tx: 1st choice Atonic, 2nd myoclonic, 3rd absence (worsen tonic-clonic)

Front 7

Ethosuximide (Zarontin)

Back 7

Generalized Absence seizures
Block T-type Ca2+ Rs
Tx: Absence seizures in kids

Front 8

Valproate (Valproic acid, Depakene)

Back 8

Generalized Absence seizures
Partial and generalized Tonic-Clonic seizures
Blocks V-sens. Na and T-type Ca2+ Ch
↑ GABA synth and ↓degradation
Tx: 1st choice for tonic-clonic, myoclonic, atonic;
2nd choice for partial and absence (in kids)
Use in absence seizures, espec. When other seizures present; myoclonic seizures, perhaps DOC; tonic-clonic = adjunct
rare fulminant fatal hepatitis (children)

Front 9

Valproate (Valproic acid, Depakene)

Back 9

Myoclonic Seizures
Partial and generalized Tonic-Clonic seizures
Blocks V-sens. Na and T-type Ca2+ Ch
↑ GABA synth and ↓degradation
Tx: 1st choice for tonic-clonic, myoclonic, atonic;
2nd choice for partial and absence (in kids)
Use in absence seizures, espec. When other seizures present; myoclonic seizures, perhaps DOC; tonic-clonic = adjunct
rare fulminant fatal hepatitis (children)

Front 10

Diazepam (Valium)

Back 10

Status Epilepticus
Enhance GABA-mediate Cl- flux
Tx: 1st choice for status epilepticus

Front 11

Lorazepam (Ativan)

Back 11

Status Epilepticus
Enhance GABA-mediate Cl- flux
Tx: 1st choice for status epilepticus

Front 12

Phenobarbital (Luminal)

Back 12

Status Epilepticus
Enhance GABA-mediate Cl- flux
Tx: 2nd choice for partial & tonic-clonic;
3rd for status epilepticus

Front 13

Fosphenytoin (Cerebyx)

Back 13

Status Epilepticus
Tx: 2nd choice for status epilepticus

Front 14

Felbamate (Felbatol)

Back 14

Adjunct
Block glycine activation of NMDA Rs and ↑ GABA response
Tx: adjunctive for partial
Fatal aplastic anemai-restricted

Front 15

Gabapentin (Neurontin)

Back 15

Adjunct
↑ GABA release
Tx: adjunctive for partial

Front 16

Lamotrigine (Lamictal)

Back 16

Adjunct
Blocks V-sens. Na Ch
Tx: adjunctive for partial

Front 17

Topiramate (Topomax)

Back 17

Adjunct
Blocks V-sens. Na Ch; ↑ GABA activation GABAa Rs; Block kainite and AMPA Rs
Tx: adjunctive for partial

Front 18

Tiagabine (Gabitril)

Back 18

Adjunct
Prevents reuptake of GABA by blocking GAT-1 transporter
Tx: adjunctive for partial

Front 19

Levetiracetam (Kepra)

Back 19

Adjunct
Causes release of GABA
Tx: adjunctive for partial

Front 20

Zonisamide (Zonegran)

Back 20

Adjunct
Increase Na Ch inactivation & blocks Ca2+ t-type Ch
Tx: adjunctive for partial