AEDs Flashcards
carbamazepine S/E?
can cause hyponatraemia (through SIADH)
Tx of generalised/absence/myoclonic/tonic seizures?
valproate
Tx of focal seizures?
carbamazepine/lamotrigine
are AEDs okay in pregnant women?
all teratogenic to some degree
but weigh up pros/cons
valproate most teratogenic
what to prescribe alongside valproate?
Vit D
if can’t Tx absence seizures with valproate, what is second line?
ethosuximide
what to monitor in valproate?
liver function
vALTproate
if someone is having a seizure? (3)
(1) ensure patent airway
(2) put in recovery position
(3) check for provoking factors (e.g. plasma glucose, electrolytes, drugs and sepsis)
define status epilepticus?
seizure lasting >30 mins
but intervene after 5 mins
how long to wait to Tx a seizure?
5 mins
Tx status epilepticus?
ABC, recovery position with O2, secure airway
IV lorazepam 4mg IV (or rectal diazepam/ buccal midazolam)
repeat after 10 mins if still fitting
(NEVER have someone fitting for >20mins w/t anaesthetist present)
IV phenytoin infusion
intubate then propofol
lamotrigine S/E?
RASH
rarely Stevens–Johnson syndrome
carbamazepine S/E?
rash dysarthria ataxia nystagmus ⇓Na
Phenytoin S/E?
Ataxia, peripheral neuropathy, gum hyperplasia, hepatotoxicity
Sodium valproate S/E? (3 Ts)
Tremor, teratogenicity, tubby (weight gain)