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38 Cards in this Set
- Front
- Back
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phenytoin use and side effect
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na channel inhibitor; used for partial and generalized tonic-clonic seizures; side effect gingival hyperplasia
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carbamazepine
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na channel inhibitor; used for complex partial and generalized tonic clonic
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oxcarbazepine
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na channel inhibitor; used for complex partial and tonic clonic; fewer adverse effects than phenytoin and carbemazepine
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valproic acid and 3 MOA's
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"valve pro" na channel inihb, VG Ca channel blocker; increases GABA prod and decreases GABA metabolism; used for photsensitive epilepsy and juvenille myoclonic epilepsy
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lamotrigine
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na channel blocker, may inhibit glutamate release
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topiramate
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na channel inhib; enhances post-syn GABA currents; Kainate receptor antagonist (blocks glutamate)
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zonisamide
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na channel inhib, binds to GABA receptor, inihbits Ca channels, facilitates DA and 5HT transmission
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lidocaine
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used only in refractory cases
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phenobarbitol
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increase duration of GABA activated opening of Cl channels
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primidone
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increase duration of GABA activated opening of Cl channels
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-zepam
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increase freq of GABA Cl channel opening
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tiagabine
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reduces re-uptake of GABA by blocking GAT-1
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ethosuximide
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reduces Ca currents in the thalamic neurons; used for absence seizures
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pregabalin
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block Ca channels on post syn neurons
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levetiracetam
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binds to synaptic vessicle protein to inhib NT release; blocks Ca channels to increase intracellular Ca levels
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What are the only 2 benzos that are approved for long term anti-convulsant use?
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clonazepam and chlorazepate
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Which drug is contraindicated by porphryia?
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primidone (a barbiturate); primidone gets converted to phenobarbital
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What are the 2 drugs used to treat status epilepticus? Which is more common in acute settings?
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diazepam and lorazepam ; lorazepam is more common in acute settings and diazepam is used for long term control of seizures
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DOC for absence seizure
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ethosuximide which blocks Ca channels
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What are 3 Ca channel blockers that are used as anti-convulsants?
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ethosuximide; gabapentin; pregabalin
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What is photosensitive epilepsy?
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epilepsy brought on by light
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valproate side effects
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"VALPROATE"- vomiting, increased Appetite, Liver toxicity
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Which drug should be used for photosensitive epilepsy?
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valproate
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Which drug should be used for juvenile myoclonic epilepsy?
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valproate
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phenytoin interactions and S/E; chem panel abnormalities
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PHENyTOin makes the little P450 excited and alters metabolism of drugs; acne, hirsutism; decreased folate, Vit K, and thyroxine
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What is the 1st choice for complex partial or generalized tonic clonic seizures?
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carbamazepine (Na channel blocker)
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What chem panel and CBC abnormalities are seen with carbamazepine use?
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decreased Na, WBC, and T4
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What is the advantage of using oxcarbazepine vs carbazepine?
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oxcar doesn't induce absence or myoclonic seizures and can be used for the same things: complex partial and generalized tonic clonic seizures
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What is the MC complaint of people on valproic acid?
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weight gain
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When is topiramate contraindicated and why?
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it can exacerbate renal stones b/c it inhibits carbonic anhydrase so you lose HCO3 which causes a metabolic acidosis and increase risk of stone formation; "you not only have seizures, but to TOP it all off, you have stones!!!"
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What is the one Na channel blocker that causes weight gain? All the others cause weight loss really.
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valproate
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What are 2 bad effects of the barbiturates?
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sexual dysfxn and hyperactivity in kids
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DOC for status epilepticus
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lorazepam
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Which drug shouldn't be given if pt has narrow angle glaucoma?
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a benzodiazepine
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What is the problem with ethosuximide
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it's half life is 60 hrs
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What's the difference in MOA of ethosuximide and gabapentin?
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ethosuximide inhibits T currents in thalamic neurons while gabapentin blocks v-g Ca channels
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What is paraldehyde used for?
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alcohol w/d seizures
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levetiracetam
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blocks fusion of synaptic vessicles so NTs are released into the synaptic cleft
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