AEDs

Question 1

4 types of CNS effects that AEDs can produce and which is the most common?

Answer 1

sedative effects (most common)
motor/sensory
cognitive
psychiatric

Question 2

Name two AEDs which are rarely used (reversed for severe epilepsy) because of their irreversible side effects?

Answer 2

Vigabatrin
Felbamate

Question 3

Which AEDs tend to most often be enzyme inducers? Older or newer?

Answer 3

Older

Question 4

Which AEDs tend to most often be enzyme inhibitors? Older or newer?

Answer 4

Newer

Question 5

What are the “big 4” AED medications in teratology?

Answer 5

phenytoin
phenobarbital
carbamazepine
valproic acid

Question 6

4 common categories of mechanisms for AEDs and their targets

Answer 6

1. inactivation of voltage-gated sodium channels (voltage-gated sodium channels)
2. antagonism of glutamate receptors (glutamate AMPA or NMDA receptors)
3. enhanced GABAergic neurotransmission (GAT-1, GABA-T/SSADH, GAGAa recepts)
4. inhibition of T-type calcium channels (T-type calcium channels)

Question 7

Major target of carbamazepine

Answer 7

voltage-gated sodium channels

Question 8

Major target of perampanel

Answer 8

glutamate

Question 9

Major target of cethosuximide

Answer 9

T-type calcium channels

Question 10

Major target of valproate

Answer 10

multiple mechanism

Question 11

Name the 2 mechanisms underlying the teratogenic effects of these antiepileptic drugs.

Answer 11

folic acid deficiency
creation of oxidized metabolites

Question 12

Teratogenic effects seen in babies

Answer 12

Neurotube defects
Hydantoin-Barbiturate Embryopathy
Renal anomalies
Patent ductus arteriosus
Pyloric stenosis
Cleft lips and cleft palates

Question 13

What medication decreases the risk of teratogenic effects occurring with AED use?

Answer 13

high dose folic acid