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35 Cards in this Set
- Front
- Back
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SEIZURE MEDS
- which one is "state" dependent? |
- Phenytoin
(blocks VG Na+ channel in INACTIVATED state) |
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SEIZURE MEDS
- which one is associated with birth defects such as cleft palate and digital abnormalities? |
- Phenytoin
(Hydrantoin Syndrome if Rx taken at 1st trimester) |
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SEIZURE MEDS
- which one treats seizures associated with T-calcium channels at the Thalamus |
Ethosuximide
(2nd line is valproic acid) |
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SEIZURE MEDS
- which one is also used for Bipolar, Schizophrenia, and Migraines? |
- Valproic acid
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SEIZURE MEDS
- which one has zero order kinetics? |
- Phenytoin
(Zero order = Phenytoin, EtOH, ASA) |
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SEIZURE MEDS
- associated with a HIGH rate of derm reactions (Stevens-Johnsons Syndrome) |
- Lamotrigine
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SEIZURE MEDS
- has the best safety record in pregnancy? |
- Lamotrigine
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SEIZURE MEDS
- associated with teratogenic Spina Bifida |
- valproic acid
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SEIZURE MEDS
- only indication for use is WEST syndrome |
- Vigabatrin
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SEIZURE MEDS
- which do you NEVER use in Absence seizures because it can exacerbate it? |
NEVER use carbamezapine
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PHENYTOIN
- acts on what channel? |
VG Na+ channel
in CLOSED-INACTIVATED state ("state" dependent blockage) |
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PHENYTOIN
- describe the m-gate & h-gate of the closed-inactivated state of the VG Na+ channel |
m-gate OPEN
h-gate CLOSED |
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PHENYTOIN
- effective in partial or generalized seizures? |
- both
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PHENYTOIN
- metabolism? - elimination? |
- First pass
- Zero order kinetics (same as with EtOH & ASA) |
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PHENYTOIN
- drug to drug interaction ability |
- multiple cyp inducer
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PHENYTOIN
- in what condition would small amounts of phenytoin dosages cause large increases in plasma concentration? |
when
Hepatic Hydroxylation system is Saturated |
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PHENYTOIN
- list some major side effects - can have what hormone effect |
- Gingival Hyperplasia
- Osteomalacia - Diplopia - Stevens-Johnson type derm RxN - blocks insulin from beta islet cells |
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PHENYTOIN
- can cause Fetal Hydrantoin Syndrome if administered when? - what are the symptoms of Fetal Hydrantoin Syndrome |
1st semester
- Cleft palate - Digital abnormalities |
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PHENYTOIN
- water soluble analog given IV - above water soluble analog is given IV in what clinical condition? |
- Fosphenytoin
- Status epilepticus (after diazepam) |
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CARBAMEZAPINE
- DOC for? |
- Trigeminal Neuralgia
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ETHOSUXIMIDE
- MOA - clinical indications |
- blocks T-type Ca2+ channels
(in thalamus) - Absence seizures ("petit mal" seizures) |
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VALPROIC ACID
- MOA - used in which seizures? - can also be used in what other indications? |
- unknown
- all seizure types - Bipolar - Schizophrenia - Migraines |
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VALPROIC ACID
- Side effects |
- Hepatotoxicity
- Teratogenic - Weight gain - Hirsutism |
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VALPROIC ACID
- what are the birth defects seen in newborn? |
- Spina bifiida
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LAMOTRIGINE
- 2 important things |
- Best safety record in PREGNANCY
- High rate of Derm. Rxn'x (SJS) |
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GABAPENTIN (Neurotonin)
- besides seizures, it is also used for what indication? |
- management of chronic pain
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TOPIRAMATE
- blocks which channels? - SE? |
Na+ & Ca++ channels
Metabolic acidosis (weak inhibitor of carbonic anhydrase) |
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VIGABATRIN
- MOA - Clinical indication - SE |
Irreversible inhibitor of enzyme that breaks down GABA
West syndrome (only one) Visual field defect |
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WEST SYNDROME
- aka? - Triad seen - Tx? |
- Infantile Spasms
- Jackknife spasms - Infantile Epileptic Encephalopathy (HIM) - Hypsarrhythmia (pathognomonic) - Infantile spasms (jackknifing) - MR - Vigabatrin |
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STATUS EPILEPTICUS
- what is the 1st Tx to break it? - Followed by? |
- Diazepam (or Lorazepam)
- IV Fosphenytoin (or IV Phenytoin) |
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SEIZURE MEDS
- in what situations would you not use Ethosuximide for Absence seizures? - what drugs could you use? |
- if absence seizure is accompanied by other seizures
- Valproic acid (great, but teratogenic) - Lamotrigine (safe in pregnancy) - Clonazepam (intermediate acting BZD) |
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SEIZURE MEDS
- DOC for (Generalized) Tonic clonic seizures |
- Phenytoin
- Carbamezapine - Valproic acid |
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SEIZURE MEDS
- DOC for Prophylaxis of Status Epilepticus |
- Phenytoin
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SEIZURE MEDS
- DOC to prevent Seizures of Eclampsia |
- MgSO4
(2nd line is BZD) |
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SEIZURE MEDS
- DOC in pregnant women and children? |
- Phenobarbital
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