AED (anti-epileptic drugs) ADR

Question 1

Phenytoin (Dilantin) and Fosphenytoin (Cerebyx)

Answer 1

Nystagmus, mental status changes, unsteady gait

Question 2

Carbamazepine (Tegretol)

Answer 2

(HLA)-B*1502 allele (BBW)

Question 3

Valproic acid (Depakote), DOC?

Answer 3

Drowsiness, cognitive impairment, N/V, DOC for tonic clonic seizures

Question 4

Phenobarbital, DOC?

Answer 4

Delayed intellectual development, hyperactivity, DOC for neonatal seizures (reserved)

Question 5

Ethosuximide (Zarontin), DOC?

Answer 5

GI, N/V- minimized with smaller and more frequent doses, DOC for absence seizures

Question 6

Benzodiazepines-DOC?: Lorazepam (Ativan)- antidote?, Clonazepam (Klonopin), Diazepam (Valium)

Answer 6

Sedation and respiratory depression, DOC used first for status epilepticus, Flumazenil= antidote

Question 7

Gabapentin (Neurontin)

Answer 7

Minimal ADR (eliminated renally)- fatigue, somnolence, dizziness, ataxia

Question 8

Lamotrigine (Lamictal)

Answer 8

Well tolerated in children and elderly, diplopia, drowsiness, ataxia, HA, rash (most serious)

Question 9

Toprimate (Topamax), DOC?

Answer 9

Inhibits carbonic anhydrase= kidney stones, metabolic acidosis, ataxia, impaired concentration, attention deficit, confusion, fatigue, somnolence, DOC for partial seizures

Question 10

Tiagabine (Gabitril)

Answer 10

CNS- dizziness, asthenia, nervousness, tremor, diarrhea, depression (neuropathic pain)

Question 11

Levetiracetam (Keppra)

Answer 11

Aggression?

Question 12

Oxcarbazepine (Trileptal)

Answer 12

Rash, hyponatremia, dizziness, nausea, HA, diarrhea, not as effective oral contraceptives

Question 13

Zonisamide (Zonegran)

Answer 13

Does not induce or inhibit the P450 system, dizziness, somnolence, anorexia, HA, Inhibits carbonic anhydrase= kidney stones, metabolic acidosis

Question 14

Felbamate (Felbatol)

Answer 14

Alplastic anemia, acute liver failure

Question 15

Lacosamide (Vimpat), Schedule?

Answer 15

Dizziness, N/V, double vision, abnormal coordination, ataxia, nystagmus, Schedule V

Question 16

Ezogabine (Potiga), Schedule? MOA?

Answer 16

Dizziness, somnolence, fatigue, urinary retention, psychotic symptoms, hallucinations, retinal abnormalities, possible vision loss, bluish skin discoloration (could be permanent), Schedule V, Potassium channel facilitator that activates KCNQ channels, reducing the degree of depolarization needed to open the channel

Question 17

Perampanel (Fycompa), MOA? Dose?

Answer 17

Dizziness, somnolence, vertigo, ataxia, anger, irritability, aggression, blurred vision, dysarthria, serious psychiatric adverse effects, noncompetitive antagonist of AMPA receptors (subtype of glutamate receptors) on post-synaptic neurons, Recommended starting dose is 2 mg at HS, Max dose is 12 mg HS

Question 18

Rufinamide (Banzel)

Answer 18

Somnolence and vomiting, HA, dizziness, fatigue, nausea, diplopia, tremor, shorten QT interval (no digoxin or magnesium!)

Question 19

Vigabatran (Sabril), Indication? DI?

Answer 19

Concentric peripheral visual field deficit (pVFD) which is potentially irreversible (pts are usually unaware of
the visual field loss, particularly in its initial mild phase), monotherapy for infantile spasms, Phenytoin