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SUMPHARM > AED RX > Flashcards

AED RX Flashcards

1
Q

What is imbalance btwn excite and inhib current in brain, which use NA, CL, K, and Ca ions across neuronal membranes?

A

Seizures- Focal and Generalized

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2
Q

What are the excitartory ions?

A

NA and CA

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3
Q

What are the inhibitory ions?

A

K+ hyperpolorize

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4
Q

What are the ligand gated particles that also excite or inhib membranes?

A

Glutamate-EXCITE, GABA-INHIB

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5
Q

Can you cure seizures?

A

NO. AEDs do not reverse or prevent or modifyGoals- DEC frequency 2. Find triggers 3. DEC injury 4. Improve QOL

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6
Q

When to start therapy?

A

First event on high risk 2. All with SECOND episode

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7
Q

What should be considered with all RX?

A

Gender, age, comorbities, preg, other meds, avail, cost

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8
Q

What are step if no change in seizure frequency?

A
  1. MaX DOSE-titrate 2. ADD Switch but taper down original and titrate other
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9
Q

What is EBM for children with partial/focal onset seizures?

A

OXC

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10
Q

What is EBM for Adults with partial onset seizures?

A

CBZ, LEV, PHT, ZNS

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11
Q

What is EBM for Elderly with partial onset seizures?

A

GBP, LTG

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12
Q

What is EBM for Children and Adults with General/2+ onset that is tonic-clonic seizures?

A

A grade- NONE poor evidence

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13
Q

What is EBM for Children with General/2+ onset absence seizures?

A

ESM, VPA. NONE For juveniles

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14
Q

what is MC used For partial/focal onset, 2/2 generalized, ?

A

CBZ, LTG, LEV, OXC, TMP, ZNS

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15
Q

What is MC used for PRIMARY GENERAL?

A

ESM- ABSENCE ONLY, LTG, LEV, TMP, VPA, ZNS

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16
Q

Use this drug for elderly epileptic focal?

A

LTG, LEV

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17
Q

Which drugs are ok for women of childbearing age?

A

LTG, LEV, ZNS- AVOID VALPO

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18
Q

What drug are AVOIDED for PRIMARY GEN seizure

A

GBP PReGBP, TGB, VGB

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19
Q

Which AED MOA is blocking Na channels?

A

PHY, CBZ, VPA

20
Q

Which AED MOA is blocking Ca channel?

21
Q

What other MOA of AED?

A

INC outward positiv of K or INC inhibtory GABA, DEC excitory Glutamate

22
Q

What is inital dose pf Phenytoin?

A

15-20 mg 3 didvided every 2-4hrs, MAX 2000

23
Q

CAN ER and DR divalproex be used interchangably?

A

NO, DR BID vs ER QD

24
Q

Which Meds need Hepatic Dose ADJ?

A

Phenobartial, PHY-monitor free unbound levels, Valporate

25
Q

What AED need caution in Hepatie and Renal?

A

ESM-ethosuximide

26
Q

SJS Diplopia, hyponatremia, and blood disorders is realted to…

27
Q

Mr. Victor’s is have concerns with wt. gain, alopecia. His lab reveal INC bilirubin, INC ALT, and thrombocytopenia? What drug is he on?

28
Q

Aunt brenda has been more aggressive, Bipolar, not sleeping well lately. What could she be on?

A

ESM.- LABS- leukpenia, and Eosinophilla

29
Q

What should you tell pts if on AED ADE?

A

All cause drowsy, caution driving

30
Q

Whan do you moinitor drug level for PHY for partial seizures?

A

2 wks after new dose. IDEAL levels is 10-20. 1-2 for FREE UNBOUND

31
Q

Name MC used new AEDs?

A

Gabapentin, Lamotrigne, Pregablin (lyrica

32
Q

Lamotrigine and Topimated both work and treat which seizure?

A

Seizures- partial, gen tonic clonic, absenc myclonic. Blk NA channel. TOPA- adjuctive

33
Q

What other new AED are adjuctive for Partial seizures?

A

PGBP and GBP

34
Q

Which New AED DOES NOT cause drowsyness?

A

Lacosamide- avoid sever liver dz. Felbamate

35
Q

If you Pt has h/o IBS which new AED is ideal?

A

PGBP and GBP, Clonazepam- no GI effects

36
Q

Mr. Victor’s has lab reveal INC bilirubin, INC ALT? What drug is ok for him d/t lack of hepatic dose ADJ?

A

GBP, LEV, PGBP, Tigabine- slow and low

37
Q

What new AED required RENAL adj?

A

ALL- LTG, GBP, TPM, LEV, OXC, PGB, ZNS

38
Q

What are the MC rare SE for new AEDs?

A

ADE sigificant LTG- steven johnson rash, GBP- wt gain, TPM-mental, glaucoma, wt loss, LEV-mood, OXC-Hyponatremis, blood d/o, PGB-vision, thromobcypeni, ZNS- confusion, parastheisa, rash

39
Q

WHat drug enhances GABA, which will do what?

A

Clonazepam klonpin- Inhiitory for GAD. Also, STC adjuctn tonic and myoclonic sezures

40
Q

WHich is only AED the open potassium channels?

41
Q

These AED hav serious side effects such as?

A

Tiga-SJS, seizure, Viga- irreversilby vision loss

42
Q

Which med has no GI effect but has severe ARDS and dependence?

A

Clonazepam klonopin

43
Q

Which new AED DOES NOT require RENAL adj?

A

Clobazam, Clonazepam, Tigabine, Phenyltoin, Valporate

44
Q

What is a seizure lasting >5-30min w/ or w/o convuslsives? How is it Tx?

A

Status Epilepticus- supportive, O2, venilator. Children- Lorazepam IV, rectal gel. Maintencne PHY/ PB pheonbarb

45
Q

What RX is MOA unkonw, Hihg CYP interactison, treated for Lennox Gasstaut Dravet?

A

Epidiolex- Cannabidiol. NO effect on cannabidol receptor

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