AED

Question 1

Carbamazepine

Answer 1

Sodium channel blocker
Use-dependant blockade of Na+ channels
Reduced Ca2+ influx and decreased glutamate
Useful in most types of epilepsy
Can treat trigeminal neuralgia

Question 2

Carbamazepine contraindications

Answer 2

Question 3

Phenytoin

Answer 3

Primarily use-dependant blockade of Na+ channels
2nd line in status epilepticus
Zero order kinetics

Question 4

Phenytoin contraimplications

Answer 4

Question 5

Sodium valproate

Answer 5

Acts on Na+, increases GABA synthesis ad transcription of channel coding genes
Used in most types of epilepsy
- can suppress initial discharge

Question 6

Sodium valproate contraindications

Answer 6

Question 7

Lamotrigine

Answer 7

Na+ and Ca2+ channel blocker
More selective for dendrites of pyramidal neurons

Question 8

Lamotrigine contraindications

Answer 8

Question 9

Levetiracetam

Answer 9

Synaptic vesicle protein 2A (SV2A) inhibition
Decreased synchronised burst firing without effecting neuronal excitability

Question 10

Levetiracetam contraindications

Answer 10

Question 11

Benzodiazepines
- diazepam
- lorazepam
- midazolam

Answer 11

Potentiate GABA activity at GABA-A receptor
- positive allosteric modulators
Hyperpolarisation of cell via increased Cl- efflux

Midazolam short acting
Diazepam longer acting and active metabolites
Lorazepam - phase 2 metabolism so can be better in hepatic dysfunction

Question 12

Benzodiazepines contraindications
- diazepam
- lorazepam
- midazolam

Answer 12