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Neuropath > AEM's and Triptans > Flashcards

AEM's and Triptans Flashcards

1
Q

carbamazepine

A 
enhanced fast inactivation of Na channel
broad spectrum
CYP450 inducer, auto-induction (self metabolism)
Toxicities:
- Hematoogical penias
- hypocalcemia/vit. D. def/ osteoporisis
-hepatotoxicity
-hyponatremia
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2
Q

oxcarbazepine

A

enhanced fast inactivation of Na channel
fewer CNS/ hematological side effects
less potent CYP450 inducer compared to carbamazepine
Renal clearance instead of hepatic

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3
Q

eslicarbazepine

A

enhanced fast inactivation of Na channel

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4
Q

lamotrigine

A

enhanced fast inactivation of Na channel

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5
Q

phenytoin

A 
enhanced fast inactivation of Na channel
broad spectrum
Zero order pharmkinetics (Saturable)
inducer of CYP450
Toxicities:
- gingival hyperplasia 
- hypothyroidism
- hypocalcemia/Vit.D def/osteoporosis
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6
Q

topiramate

A 
enhanced fast inactivation of Na channel
AMPA receptor antagonist 
GABA agonist 
broad spectrum 
renal clearance
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7
Q

valproic acid

A

enhanced fast inactivation of Na channel
inhibition GABA metabolism by GABA-T or SSD
promotes GABA production via glutamic acid decarboxylase
T-type Ca channel antagonist for absence seizure
broad spectrum

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8
Q

zonisamide

A

enhanced fast inactivation of Na channel

T-type Ca channel antagonist for absence seizure

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9
Q

lacosamide

A

enhanced fast and slow inactivation of Na channel

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10
Q

perampanel

A

AMPA receptor antagonist

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11
Q

Felbamate

A

NMDA receptor antagonist at glycine site

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12
Q

Tiagabine

A

GABA reuptake inhibitor of GAT-1

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13
Q

Vigabatrin

A

inhibitor of GABA met. by GABA-T
Ocular toxicity w/ central retinal damage
renal clearance

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14
Q

barbiturates

A

phenobarbital (broad spectrum) and primidone(for tonic/clonic)
GABA independent
increase duration of Cl- channel opening

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15
Q

benzodiazapines

A

lorazepam, diazepam, clonaxepam (for myoclonic), clorazepate
potentiates GABA binding to receptor, allosteric change
increases chloride conductance
GABA dependent

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16
Q

ethosuximide

A

T-type Ca channel antagonist

used for Absence seizures only

17
Q

Levetiracetam

A

Synaptic vesicle protein

renal clearance

18
Q

Brivaracetam

A

synaptic vesicle protein

19
Q

Gabapentin

A

alpha-2-delta Ca channel

renal clearance

20
Q

pregabalin

A

alpha-2-delta Ca channel

renal clearance

21
Q

Status epilepticus drugs

A

lorazepam, diazepam, phenobarbital, phenytoin, valproic acid, levetiracetam

22
Q

phenobarbital

A

C-IV agent
CYP450 inducer
CNS depressant
hypocalcemia/Vit.D def./ osteoporosis

23
Q

CYP450 inducer interactions

A

carbamazepine, phenytoin, phenobarbital, valproate

  • increase clearance of contraceptives
  • increased clearance of warfarin
  • increased clearance of antivirals
24
Q

Inhibitors of glucruonosyltransferases (UGT)

A

valproic acid and lamotrigine

causes accumulation of parent drug

25
Q

inducers of UGT

A

phenytoin, carbamazepine, phenobarbital

cause reduction of parent drug

26
Q

Other triptans

A 
almotriptan
naratriptan
zolmitriptan
rizatriptan
eletriptan
frovatriptan
27
Q

Naratriptan

A

70% bioavailability, half-life 6 hrs

28
Q

Zolmitriptan

A

5HT1d agonist on synaptic terminal

fast onset nasal spay

29
Q

frovatriptan

A

half-life 24 hrs

30
Q

sumatriptan

A

fastest onset with SC or nasal spray

half-life 1-2 hrs

31
Q

MOA inhibitors

A

sumatriptan, rizatriptan and zolmitriptan contraindicated

32
Q

dihydroergotamine (DHE)

A

interact with alpha, dopamine and 5HT receptors
longer lasting effects but don’t work as fast as triptans
side effects include:
- emetic action and severe vasoconstriction

33
Q

Treatment during pregnancy

A

all trimesters = acetaminophen + codeine
1 and 2 trimester = aspirin or ibuprofen
Triptans used cautiously
never use DHE

34
Q

migrane prevention

A

propranolol, timolol (decreases cortical spreading depression, CSD)
Tricyclic antidepressants:
- amitriptyline, imipramine
Anticonvulsants:
- topirimate, valproate
Ca channel blocker:
- verapamil (First choice for prevention)

Neuropath (7 decks)

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