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Epilepsy > AEDs > Flashcards

AEDs Flashcards

1
Q

Which AEDs are indicated for focal seizures?

A

Carbamazepine (Tegretol), Oxcarbazepine (Trileptal), Eslicarbazepine (Aptiom), Lacosamide (Vimpat), Perampanel (Fycompa)

Aptiom is primarily used as adjunct and Vimpat is expensive!

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2
Q

Which AEDs are broad spectrum?

A

Valproate (Depakote), Lamotrigine (Lamictal), Levetiracetam (Keppra), Clobazam (Onfi), and Topiramate (Topomax)
***Onfi and Topomax mainly used as adjunct

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3
Q

Which AEDs are used to treat absence seizures?

A

1st line: Ethosuximide, 2nd line: Valproate

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4
Q

Which AED can be used for atonic seizures?

A

Rufinamide

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5
Q

adverse effects of Carbamazepine? (3)

A

hyponatremia, aplastic anemia, pancytopenia

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6
Q

adverse effects of Clobazam? (1)

A

somnolence

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7
Q

adverse effects of Ethosuximide? (1)

A

aplastic anemia

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8
Q

adverse effects of Felbamate? (2)

A

aplastic anemia, hepatotoxicity

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9
Q

adverse effects of Gabapentin (2)?

A

edema, dizziness

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10
Q

adverse effects of Lacosamide? (1)

A

PR interval prolongation

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11
Q

adverse effects of Lamotrigine (1)

A

Stevens-Johnson syndrome

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12
Q

adverse effects of Levetiracetam (1)?

A

agitation, somnolence

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13
Q

adverse effects of Oxcarbazepine? (3)

A

hyponatremia, agranulocytosis, pancytopenia

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14
Q

adverse effects of Perampanel (1)

A

aggressive behavior

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15
Q

adverse effects of phenobarbital (2)

A

hepatotoxicity, somnolence

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16
Q

adverse effects of phenytoin? (3)

A

neuropathy, ataxia, gum hyperplasia

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17
Q

adverse effects of pregabalin (1)

A

edema

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18
Q

adverse effects of Primidone (2)?

A

ataxia, vertigo

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19
Q

adverse effects of Rufinamide (1)?

A

shortened QT interval

20
Q

adverse effects of Tigabine? (2)

A

Steven-Johnson syndrome, agitation

21
Q

adverse effects of Topiramate? (4)

A

weight loss, cognitive dysfunction, kidney stones, parasthesias

22
Q

adverse effects of Valproate? (1)

A

irreversible visual field defect

23
Q

adverse effects of Zonisamide? (2)

A

weight loss, kidney stones

24
Q

Which AEDs are enzyme inducers? (6)

A

Carbamazepine, Lamotrigine, Oxcarbazepine, Phenobarbital, Phenytoin, Topiramate

25
Q

Which AEDs are enzyme inhibitors? (2)

A

Felbamate and Valproic Acid

26
Q

What AED when coadministered with Valproate, increases Valproate levels?

A

Phenytoin; Valproate is 90% protein bound and phenytoin will compete for protein binding

27
Q

Which AED has autoinduction?

A

Carbamazepine has autoinduction with increased clearance over 2-4 wks

28
Q

Which AEDs reduces the efficacy of OCPs? (4)

A

Oxcarbazepine (at doses > 900mg/d), Eslicarbazepine, Perampanel (at dose of 12mg, not 8mg), Felbamate

29
Q

Name the Na channel blockers (6)?

A

Oxcarbazepine, Carbazepine, Eslicarbazepine, Lamotrigine, Phenytoin, Rufinamide

30
Q

How Lacosamide a different Na channel blocker?

A

blocks NA channels (enhancing slow inactivation, unlike most Na channel blockers that enhance fast Na channel activation)

31
Q

Which AEDs act on GABA? (8)

A

Valproate, phenobarbital, Clonazepam, Clobazam, Tigabine, Vigabatrin

32
Q

Which AEDs act on Ca channels? (3)

A

Ethosuximide, Gabapentin, Zonisamide

33
Q

Mechanism of Valproate?

A

GABA potentiation, blocks Ca channels, blocks Na channels

34
Q

Mechanism of action of Perampenel?

A

non-competitive AMPA glutamate receptor antagonist

35
Q

Mechanism of action of Primidone?

A

converted in the liver to phenobarbital and phenylethylmalonamide

36
Q

Mechanism of action of Levetiracetam?

A

binds to synaptic vesicle protein SV2A

37
Q

Mechanism of action of Felbamate?

A

NMDA receptor antagonist; GABA enhancement; NA blocker

38
Q

Mechanism of action of Topiramate?

A

antagonism of AMPA/kainate receptors, augment GABA, block vol gated Na channels

39
Q

Lacosamide has greater efficacy and bioavailability if combined with what type of AEDs?

A

non-Na channel drugs

40
Q

Comorbid indications of Carbamazepine?

A

Mood stabilization, trigeminal neuralgia

41
Q

Comorbid indications of Clobazam?

A

Anxiety

42
Q

Comorbid indications of Gabapentin?

A

neuropathy, postherpetic neuralgia

43
Q

Comorbid indications of Lamotrigine?

A

Mood stabilization

44
Q

Comorbid indications of Pregabalin?

A

Neuropathy, fibromyalgia neuropathic pain

45
Q

Comorbid indications of Primidone?

A

essential tremors

46
Q

Comorbid indications of Topiramate?

A

Migraine

47
Q

Comorbid indications of Valproate?

A

Migraine, mood stabilization

Epilepsy (2 decks)

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