AED Drugs

Question 1

EthoSUXimide

Answer 1

Sucks to have Silent Seizures (1st line Absent)

Blocks thalamic T-type Ca2+ channels

Question 2

Ethosuximide side effects

Answer 2

EFGHIJ - Ethosuximide causes Fatigue, GI distress, Headache, Itching (Hypersensitivity) and Stevens-Johnson Syndrome

Question 3

Benzodiazepines (Lorazepam and diazepam)

Answer 3

1st line for emergent - Status epilepticus

Increases GABA-A action

Question 4

Benzo side effects

Answer 4

1) Sedation
2) Tolerance
3) Dependence
4) Resp distress

Question 5

Phenytoin uses

Answer 5

1) Simple
2) Complex
3) Tonic-clonic (first line)
4) Status epilepticus (1st line for prophylaxis)

Question 6

Fosphenytoin use

Answer 6

Parenteral use (prodrug) - hydrophilic can be used for emergent uses

Question 7

Phenytoin side effects

Answer 7

Nystagmus + diplopia
Gingival hyperplasia
Stevens-Johnson Syndrome
Teratogen
Ataxia
Sedation
Hypersensitvity
Cognitive slowing
Increased seizure activity
CYP450 inducer

Question 8

Steven-Johnson Syndrome

Answer 8

1) Flu-like illness
2) Red/purple rash
3) Top epidermal layer dying

Question 9

Carbamazepine

Answer 9

Simple
Complex
Tonic clonic  (first line for all three)
Increase Na+ channel inactivation
1st line for trigeminal neuralgia

Question 10

Carbamazepine side effects

Answer 10

Teratogen
Hypersensitivity Rxn
Cognitive slowing
Blood issues (anemia, agranulocytosis)
CYP450 inducer

Question 11

Clonazepam use

Answer 11

Status epilepticus

Question 12

Difficulty with phenytoin administration

Answer 12

Non-linear PK makes a narrow therapeutic window

Question 13

Valproate mechanism

Answer 13

T-type Ca2+ channel blocker (Na+ channel blocker)

Question 14

Valproate side effects

Answer 14

Teratogen
Stevens Johnson
Cognitive slowing
Weight gain
Hepatotoxicity

Question 15

Valproate administration

Answer 15

I.V.

P.O

Question 16

Valproate use

Answer 16

Simple
Complex
Tonic-Clonic (first line)
Absence

Question 17

Gabapentin uses

Answer 17

Simple
Complex
Tonic Clonic

Question 18

Gabapentin mech

Answer 18

Inhibits Ca2+ channels

Enhances GABA release

Question 19

Gabapentin adverse reactions

Answer 19

Sedation
Weight gain
Ataxia

Question 20

Topirimate mech

Answer 20

Modulation of AMPA receptors

Question 21

Topirimate use

Answer 21

Simple, complex, tonic clonic

Question 22

Why are increasing dose of gabapentin not efficacious?

Answer 22

decrease in bioavailability with increasing dose

Question 23

Which drugs bind to proteins in the plasma?

Answer 23

Phenytoin
Valproate
Tiagabine
Clonazepam

Question 24

Lamotrigine adverse effects

Answer 24

Steven-Johnson Syndrome

Hypersensitivity

Question 25

Lamotrigine mech

Answer 25

Inhibit N/P type Ca2+

Question 26

What patient population is phenobarbital the first line?

Answer 26

Neonates

Question 27

Phenobarbital adverse effects

Answer 27

``` Tolerance Dependence Teratogen Hypersensitivity Cognitive slowing Megaloblastic anemia Children (paradoxical excitatory EFFECT) ```

Question 28

What drug inhibits CYP450?

Answer 28

Valproate

Question 29

What behavioral risk is increased with AED use?

Answer 29

Suicide

Question 30

Topirimate adverse effects

Answer 30

Renal stones Cognitive slowing Metabolic acidosis (inhibition of carbonic anhydrase inhibitor)

Question 31

Tiagibine adverse effects

Answer 31

Increase seizure activity in undiagnosed patients

Question 32

What do you give patients in refractory period of status epilepticus when first drug lines don't work?

Answer 32

Valproate | Phenobarbital