AEDs Flashcards
Agents that enhance VGSC inactivation
Phenytoin
Carbamazepine
Lamotrigine
Phenytoin metabolism
Metabolism by CYP2C9, 2C19
Potent inducer of CYP and UGT-glucuronidation
95% protein bound
Phenytoin adverse effects
Hirsutism
Osteomalacia
Teratogenic
Megaloblastic anaemia
Arrhythmia
Insulin inhibited
Lymphadenopathy
Ataxia
Neuropathy/Nystagmus
Diplopia
SJS/TEN
Lupus syndrome
Agranulocytosis/aplastic anaemia
Gum hyperplasia
Hepatotoxicity
Carbamazepine metabolism
Metabolism by CYP3A4
Potent CYP inducer
Carbamazepine adverse effects
Dizziness, ataxia
Headache, drowsiness
Diplopia, blurred vision
Mild generalised rash
Leukopenia
Agranulocytosis
SIADH
Lamotrigine metabolism
Metabolism by UGT-glucuronidation
Lamotrigine adverse effects
Maculo-papular rash
SJS/TEN/DRESS
Hypersensitivity
Diplopia/blurred vision
Photosensitivity
Tremor
Agitation
Nausea/vomiting
Aplastic anaemia
HLA associated with Carbamazepine induced SJS
HLA 1502
Ethosuximide MOA
T-type Ca channel blocker
Ethosuximide adverse effects
Fatigue
GI upset
Headache
Itch
SJS
Ethosuximide metabolism
CYP3A4
Keppra mechanism of action
Binds to neuronal synaptic vesicle glycoprotein 2A
Keppra adverse efects
Depression, agitation
Diarrhoea/vomiting
Dyspepsia
Drowsiness
Diplopia
Dyscrasias
DRESS/SJS/TEN
Psychosis
Sodium valproate MOA
Increases GABA levels
Blocks VGSCs and VGCCs
Sodium valproate pharmacology
CYP metabolism
Mostly protein bound
Sodium valproate adverse reactions
Nausea/vomiting
Alopecia
Liver toxicity
Pancreatitis
Weight gain
Oedema
SIADH
Ataxia
Agranulocytosis/aplastic anaemia
Tremor
Teratogenic
TEN
SJS
Encephalopathy
Topiramate MOA
Blocks VGSC
Antagonist at AMPA/Kainate-Rs
Augments GABA
Topiramate adverse effects
Psychosis
Acute angle glaucoma
Nephrolithiasis
Drowsiness
Anhidrosis
Vigabatrin MOA
Structure analogue of GABA –> increases GABA levels
Vigabatrin adverse effects
Visual field defects
Depression
Gabapentin MOA
GABA analogues
Gabapentin adverse effects
Myoclonus
Oedema
Dizziness
Ataxia
Somnolence/sedation
Oxcarbazepine MOA
Blocks VGSCs
Lacosamide MOA
Blocks VGSCs
Lacosamide adverse effects
AV block
AF
Perampanel MOA
Non-competitive antagonist at post-synpatic AMPA glutamate receptors
Perampanel adverse effects
Homicidal ideation
Tiagiabine MOA
inhibits neuronal GABA uptake
Tiagiabine adverse effects
Sedation, confusion
Zonisamide MOA
Blocks VGSCs and VGCCs
Modulates GABA
Zonisamide adverse effects
Psychosis
Acute angle glaucoma
Nephrolithiasis
Drowsy/poor concentration
Anhidrosis