Sketchy Pharm: Carbamazepine, Phenytoin, Gabapentin, Tiagabine, Vigabatrin Flashcards
Many narrow-spectrum anti-epileptics can ______________ generalized seizures (such as carbamazepine).
worsen/exacerbate
Carbamazepine, in addition to being used for focal seizures, is used for ______________.
trigeminal neuralgia (a condition of usually unilateral, electric-shock like pain that lasts for a few seconds but repeats)
What kind of seizures can carbamazepine treat?
Focal (think of the waitress shaking just her arm)
What are the side effects of carbamazepine?
- Diplopia (misaligned headlights)
- Ataxia (falling stack)
- SIADH (guy with water cup on his head in the car)
- Leukopenia (hour glass with falling grains)
- CYP inducer
- Teratogenesis (spider on guy’s shirt and neural exhaust tube)
- DRESS syndrome (eosinophilia represented on dress with pink dots)
- SJS (driver with mask)
What is the mechanism of carbamazepine and phenytoin?
Binds to and prolongs the inactivation of voltage-gated sodium channels
The side effects of phenytoin include ____________.
- diplopia (headlights crossed)
- nystagmus
- ataxia (falling burger stack)
- low folate (salad – foliage –falling onto hood of TOw truck)
- gingiva hyperplasia (bubble gum expanding)
- hirsutism (hairy beard)
- lupus (the tow truck driver’s wolf companion)
- DRESS eosinophilia (pink dots on DRESS)
- SJS (guy whose car is getting towed removing mask –also more common in the HLA B1502 phenotype)
- teratogenicity (cleft hat bill)
- CYP inducer
- osteoporosis (cracked bone axle)
What is status epilepticus?
Continuous seizures without breaks –treat with IV benzodiazepines, phenobarbital, and phenytoin
True or false: gabapentin activates GABA channels.
False! They close voltage-gated calcium channels (“GrAB A PiNT” ice-cream truck with closed calci-yum door)
What are the indications of gabapentin?
- post-herpetic neuralgia (Zeus –representing zoster –on the ice cream truck)
- diabetic neuropathy (diasweeties with the frayed wire on the side of the truck)
- narrow-spectrum anti-convulsant
Side effects of gabapentin include ______________.
ataxia (stack of ice cream falling over)
What is the mechanism of vigabatrin?
It inhibits GABA transaminase, thereby increasing amounts of GABA in the CNS (the GABA cab getting raised to have its TRANSmission service).
What is the mechanism of tiagabine?
It blocks GABA reuptake channels, leading to increased CNS levels of GABA (the tie stuck in the GABA cab getting lifted).
