AED Flashcards
What are the major mechanisms of action (MOA) for antiepileptic drugs (AEDs)?
Block voltage-gated Na+ channels (VGNaC), block voltage-gated Ca2+ channels (VGCC), enhance GABAergic neurotransmission, or reduce excitatory glutamatergic transmission.
Name four AEDs that are voltage-gated Na+ channel (VGNaC) blockers.
Phenytoin, Carbamazepine, Lamotrigine, Valproate.
What is the first-line drug for absence seizures?
Ethosuximide (Zarontin), a T-type Ca2+ channel blocker.
Which drug is considered the “Jack of all trades” for generalized tonic-clonic and absence seizures?
Valproate (Depakote).
Which AED causes gingival hyperplasia with long-term use?
Phenytoin (Dilantin).
Which AEDs are associated with Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TENS)?
Lamotrigine, Phenytoin, Carbamazepine.
Which AED is a CYP450 enzyme inducer, leading to multiple drug interactions?
Carbamazepine (Tegretol).
What AED is first-line for trigeminal neuralgia?
Carbamazepine (Tegretol).
Which AED has zero-order kinetics, meaning its elimination rate is independent of drug concentration?
Phenytoin (Dilantin).
What is the first-line treatment for status epilepticus?
IV Lorazepam (Ativan).
What is the second-line treatment for status epilepticus if benzodiazepines fail?
IV Phenytoin or Fosphenytoin.
Which AED is known for binding to synaptic vesicle protein SV2A, altering neurotransmitter release?
Levetiracetam (Keppra).
Which AED is most associated with weight gain and metabolic syndrome?
Valproate (Depakote).
Which AED carries a black box warning for hepatotoxicity and pancreatitis?
Valproate (Depakote).
What AED is used for migraine prevention and weight loss but has a risk of glaucoma?
Topiramate (Topamax).
Which AED is preferred in pregnancy due to its lower teratogenic risk?
Levetiracetam (Keppra).
What AEDs are considered teratogenic and should be avoided in pregnancy?
Valproate, Phenytoin, Carbamazepine, Topiramate.
What is Fetal Hydantoin Syndrome, and which AED causes it?
Characterized by abnormal craniofacial features and developmental delays, caused by Phenytoin.
What is the reversal agent for benzodiazepine overdose?
Flumazenil.
What AED is used mainly for neuropathic pain rather than epilepsy?
Gabapentin (Neurontin).
What is the mechanism of Gabapentin?
Blocks N-type VGCC and prolongs GABA activity.
What AED is a GABA-mimetic but has a narrow therapeutic index and no reversal agent if overdose occurs?
Phenobarbital (Luminal).
What AED requires slow tapering to prevent rebound seizures?
All AEDs, but especially benzodiazepines and barbiturates.
What AED has mood-stabilizing properties and is used in bipolar depression?
Lamotrigine (Lamictal).
Which AEDs reduce the effectiveness of hormonal contraceptives?
Carbamazepine, Oxcarbazepine, Phenobarbital, Topiramate.
