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20 Antiepileptic drugs > Adjunct drugs for partial seizures 1 > Flashcards

Adjunct drugs for partial seizures 1 Flashcards

1
Q

Adjunct drugs for partial seizures - 14 drugs

A 
Clorazepate
Felbamate
Gabapentin
Lamotrigine
Topiramate
Tiagabine
Levetiracetam
Zonizamide
Pregabalin
Vigabatrin
Lacosamide
Ezogabine
Rufinamide
Clobazam
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2
Q

Clorazepate - MOA

A

Enhances GABA-mediated chloride influx

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3
Q

Clorazepate - indications

A

Anxiety disorders.

Partial seizures.

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4
Q

Clorazepate - Adverse effects

A

Confusion
Drowsiness
Drug tolerance
Lethargy

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5
Q

Clorazepate - interactions

A

Decreased met by: Cimetidine and disulfiram.
Increased met by: rifampin.
Clonazepam increases CNS depression with alcohol

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6
Q

Felbamate - MOA

A

Blocks glycine coactivation of NMDA receptors, inhibits the initiation of seizures.

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7
Q

Felbamate - Indications

A

Limited to partial seizures that are refractory to other drugs.

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8
Q

Felbamate - contraindications

A

Bone marrow depression, hepatic disease, hypersensitivity

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9
Q

Felbamate - adverse effects

A

Aplastic anemia (fatal), fatigue, GI reactions, headache, hepatic toxicity and acute failure, insomnia

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10
Q

Felbamate - interactions

A

Increased met by: Carbamazepine, phenytoin. Increased CNS depression with alcohol

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11
Q

Gabapentin - MOA

A

Increases GABA release

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12
Q

Gabapentin - indications

A

Partial seizures.
Postherpetic neuralgia.
Restless leg syndrome.

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13
Q

Gabapentin - adverse effects

A

(usually minimal)

Ataxia, dizziness, drowsiness, nystagmus, tremor

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14
Q

Lamotrigine - MOA

A

Blocks voltage-sensitive Na+ channels, interfering with neuronal membrane conduction and release of excitatory neurotransmitters

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15
Q

Lamotrigine - Clinical use

A

Partial seizures.
Generalized tonic-clonic, atonic and absence seizures.
Lennox-Gastaut syndrome.
Manic phase of bipolar disorder.

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16
Q

Lamotrigine - contraindications

A

Hypersensitivity. Use cautiously in pts who are taking valproate or have hepatic/renal disease

17
Q

Lamotrigine - adverse effects

A

Ataxia, diplopia, dizziness, drowsiness, headache, nausea, rash, Steven-Johnson syndrome. Risk of aseptic meningitis

18
Q

Lamotrigine - interactions

A

Decreased met by: valproate. Increased met by: Carbamazepine, phenobarbital and phenytoin. Decreases levels of valproate.

19
Q

Which drugs can be used in LGS?

A

Lamotrigine
Rufinamide (only this indication)
Clobazam

20
Q

Rufinamide - MOA

A

Modulates activity of Na+ channels, and prolongs the inactive state of the channel

21
Q

Clobazam - MOA

A

Increase inhibition by GABA at GABAa receptors

22
Q

Clorazepate, felbamate, gabapentin and lamotrigine - safety in pregnancy

A

All are category C.

Lamotrigine may decrease folate levels.

20 Antiepileptic drugs (5 decks)

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