AED Mechanisms of action

Question 1

Acetazolamide

Answer 1

Carbonic anhidrase inhibitor

Question 2

Carbamazepine

Answer 2

Prevention of repetitive firing of Na

Also works on Ca L type channels

Question 3

Clobazam

Answer 3

GABAa receptor agonist

Question 4

Clonazepam

Answer 4

GABAa receptor agonist

Question 5

Eslicarbazepine

Answer 5

Similar to CBZ, i.e., inhibition of voltage gated Na channels.

Question 6

Ethosuximide

Answer 6

Reduces thalamic low-threshold T-type calcium currents in thalamic neurons.

Question 7

Ezogabine

Answer 7

Potassium channel opener, particularly KCNQ2-5 channels

Question 8

Felbamate

Answer 8

Inhibition of NMDA

Potentiation of GABAa receptor.


Question 9

Gabapentin

Answer 9

Modulates voltage gated calcium channels.

Binds to the α2γ modulatory subunit of voltage-sensitive calcium channels

Question 10

Lacosamide

Answer 10

Binds to collapsing response mediator protein 2 (CRMP-2), which is associated with neuronal outgrowth.

Enhances slow inactivation of voltage gated Na channels, resulting in stabilization of neuronal membranes.


Question 11

Lamotrigine

Answer 11

Inhibition of voltage gated Na channels.

Inhibits high-voltage calcium currents (mediated by multiple channel types, N,P/Q,T-types).


Question 12

Levetiracetam

Answer 12

Acts on the synaptic vesicle protein 2A (SV2A).

Inhibits N type Ca currents.

Question 13

Oxcarbazepine

Answer 13

Metabolite MHD is a blocker of voltage-gated Na channel

Question 14

Perampanel

Answer 14

Non competitive antagonist of AMPA receptors on post-synpatic neurons.

Question 15

Phenytoin

Answer 15

Blockage of voltage-sensitive Na channels

Question 16

Pregabalin

Answer 16

Decreases central excitability by binding to auxiliary subunit of high-voltage Ca channel.

Question 17

Rufinamide

Answer 17

Reduces the recovery capacity of Na channels, prolonging their inactive state.

Question 18

Tiagabine

Answer 18

Inhibits GABA re-uptake into neurons or glia.

Question 19

Topiramate

Answer 19

Blockage of voltage dependent Na channels

Increase in GABAa receptor activity.



AMPA/kaynate antagonist

.

Carbonic anhydrase inhibition.

Question 20

Valproate

Answer 20

Inhibition of voltage-sensitive Na channels.



Activation of K conductance.

Increases

GABA by inhibition of GABA-transaminase (GABA-T).



Possibly reduces low threshold (T-type) Ca channel current. Reduces Ca L-type channels.

Question 21

Vigabatrin

Answer 21

Inhibition of GABA-T, preventing the breakdown of GABA, increasing its concentration.

Question 22

Zonisimide

Answer 22

Blocks repetitive firing of voltage Na channels.



It reduces T-type calcium current without affecting L-type current.



It exerts mild carbonic anhydrase inhibition. 


Question 23

Phenobarbital

Answer 23

Main mechanism is post-synaptic binding of GABAa receptors (prolongs opening time, increasing Cl influx).