Anti epileptic Drugs Flashcards
What are three mode of action epileptic drugs
Enhance GABA mediated synaptic inhibition so increase GABA action
Reduce cell membrane electrical excitability so inhibit sodium channel
Inhibit T type calcium channel
Name the antiepileptic drugs
Sodium valproate
Phenytoin carbamazepine phenobarbital ethosuximide Vigabatrin Lamotrigine topiramate clobazam levetiracetam gabapentin
How carbamazepine get Metabolize
Metabolize in liver
What will induce by carbamazepine
CYP - 450 inducer
What is contra indication in carbamazepine when used in seizures
Not used in absent seizures
Where carbamazepine used as first line therapy
Trigeminal neuralgia
Where carbamazepine is not recommended
Primary generalized seizures in myoclonic seizures
What are the side effects of the carbamazepine
Ataxia dizziness diplopia blurred vision drowsiness depression of cardiac atrioventricular conduction rashes Steven Johnson syndrome osteomalacia folic acid deficiency hyponatremia GIT symptoms liver and thyroid dysfunction
Where phenytoin get hydroxylated
Liver
In phenytoin what will happen in low dose
First-order kinetics
When phenytoin get therapeutic plasma concentration what is the kinetic type
Zero order kinetics
What are the side effects of phenytoin
Megaloblastic anemia peripheral neuropathy ataxia Tremors vertigo hirsutism acne gum hyperplasia osteomalacia Depuytren contractures
What is the action of the sodium valproate
Act sodium and calcium channels andGABA a receptors
Where is sodium valproate metabolize
Liver
Sodium valproate act on where?
Sodium/calcium channels and GABA a receptors
Sodium valproate metabolized in?
Liver
For what seizures use Na valproate
Absence seizures & other types
What will prevented by Na valproate
Migraine and mania
What are the side effects of sodium valproate
Weight gain, loss of hair, pros, hepatotoxicity, teratogenicity, gastric irritation. Pancreatitis, coagulation disorders.
What is MOA of phenobarbital?
GABA receptor activation potent
What’s type of inducer
Cyp-450 inducers
Name the cyp-450 inducers
Carbemazepine/phenobarbital
What’s cyp-450 inhibitor
Sodium valproate
What’s action of ethosuximide?
Block T type calcium channels in thalamus neurons of absence seizures
Comment on phenobarbital plasma 1/2 life
It has long 1/2 life
What are side effects of phenobarbital?
Sedation, hepatitis, cholestasis, lethargy, hyperactivity, behavioral changes
Ethoxugimide exaggerate?
Tonic clonic seizures
Comment the ethosuximide t12?
Long TYT
What are ses of ethosuximide?
Nausea/anorexia/headache
Action of topiramate
Blockade of voltage gated sodium channels
Enhance GABa action
AMPA receptors blockade
What are side effects of the topiramate
Sedation weight loss dyspepsia fatigue cognitive impairment
What is the action of levetiracetam
Bind to protein synaptic vesicle protein 2A
Then inhibit the neurotransmitter release
