Antiepileptic Drugs

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Benzodiazepines

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1st line in Status Epilepticus. Activates GABAa receptors to increase frequency of channel openings

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Carbamazepine

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Antiepileptic that is structurally related to tricyclic antidepressants. Undergoes autoinduction. Prolongs inactivation of Na channels

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Ethnosuximide

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Antiepiletic used as a 1st line in absence. Reduces currents on T-type Ca channels.

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Felbamate

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Antiepiletic that is reserved for refractory epileptic patients in partial and generalized seizures due to the risk of aplastic anemia and heptotoxicity. Patients must sign consent to use. Blocks the NMDA receptor and potentiates GABAa receptor responses.

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Oxcarbazepine

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An Antiepiletic prodrug drug that is structurally related to carbamazepine but can be effective in patients who have failed carbamazepine. Blocks Na and K channels.

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Phenobarbital

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A Schedule IV Antiepiletic medication that enhances GABAa receptors.

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Phenytonin

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An Antiepiletic drug that is highly effective in simple and generalized seizures.Prolongs inactivation of Na channels

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Fosphenytonin

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Prodrug of the Antiepiletic drug, phenytonin. It is used in the ER as an alternative and can cause less hypotension, no extravastion and can be administrated faster than phenytonin. It prolongs inactivation of Na channels

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Pregabalin

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An Schedule V Antiepiletic medication. Decreases glutamate transmission by acting on Ca channels. May modify GABA release.

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Primidone

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An Antiepiletic drug that is metabolized to phenobarbital that enhance GABAa receptor

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Rufinamide

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An Antiepiletic drug that is used as an adjunctive therapy for Lennoz-Gastaut Syndrome that blocks high-frequency firing of neurons through action Na channels

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Tiagabine

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An Antiepiletic drug that blocks GABA uptake

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Valproate

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An Antiepiletic drug that has many different routes of administration (tablets, syrup,capsule, injection). Blocks Na channels and NMDA receptor. May increase GABA release.

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Vigabatrin

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An Antiepiletic drug that is rarely used due to vision loss and has been recently re-approved in the USA under certain programs. Irreversibly inhibits GABA-transaminase.

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Zonisamide

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An Antiepiletic drug that has cross reactions with sulfonamides--hypersensitivities. Blocks Na and Ca channels.

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Gabapentin

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Antiepiletic that is analog of GABA. Decreases glutamate transmission by acting on Ca channels. May modify GABA release.

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Lacosamide

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A Schedule V Antiepiletic drug. Blocks Na channels and blocks CRMP-2

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Lamotrigine

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An Antiepiletic drug that blocks Na and channels. Inhibits glutamate release.

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Levetiracetam

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An Antiepiletic drug often used as a monotherapy despite its approval for adjunctive use. Acts on synaptic protein SV2A which modifies the release of glutamate and GABA through an action on vesicular function

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Topiramate

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Blocks glutamate binding on AMPA receptors. Blocks kainate receptors. Blocks Na channels and potentiate effect of GABA

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Seizure

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A group of cortical neurons that discharge abnormally in synchrony. Can be partial or generalized

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Epilepsy

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A medical disorder characterized by recurrent unprovoked seizures

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Partial Seizure

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One hemisphere, asymmeteric motor manifestations. Can be Simple Partial, Complex or Secondary Generalized.

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Generalized Seizures

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Involvement of both hemispheres, motor manifestations are bilateral and loss of consciousness. Seven types are absence, myoclonic, clonic, tonic, tonic-clonic, atonic, and infantile spasms.

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Status Epilepticus

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Recurrent seizures without an intervening period of consciousness before the next seizure or Any seizure lasting longer than 30 minutes whether or not consciousness is impaired

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1st Line Drugs used for Partial Seizures

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Carbamazepine, Phenytoin and Valproic Acid

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1st Line drugs used for Primary Generalized Tonic-Clonic

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Carbamazepine, Lamotrigine, Oxcarbazepine, Phenobarbital
Phenytoin, Topiramate and Valproic Acid

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1st Line drugs used for Absence Seizures

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Ethnosuximide, Lamotrigine, and Valproic Acid