Anti-epileptic Drugs Flashcards
1
Q
List the 6 common anti-epileptic drugs
A
- Carbamazepine
- Phenytoin
- Sodium Valproate
- Lamotrigine
- Levetiracetam
- Benzodiazepines
2
Q
List the following for: Carbamazepine
- Use
- Mechanism of action
- Adverse effects
- Warnings / contraindications
- Important drug reactions
A
Anti-epileptic
- Also for bipolar
- Also for chronic pain
- Sodium channel blocker
- Slows recovery of neurones from inactive to closed state
- Reduces neuronal transmission
- Suicidal thoughts / mood changes
- Bone marrow failure – low WCC
- Joint pain
- Tiredness / drowsiness
- Nausea and vomiting
- Osteoporosis
- Rashes – Stephen Johnson Syndrome
- Anaemia, thrombocytopenia or bone marrow failure
- Alcohol
- Oral contraceptive pill
- Some antibiotics
- Warfarin
- Other CYP 450 enzyme drugs
3
Q
List the following for: Phenytoin
- Use
- Mechanism of action
- Adverse effects
- Warnings / contraindications
- Important drug reactions
A
Anti-epileptic
- Mainly in status epilepticus
- As an adjunct in generalised seizures
- Sodium channel blocker
- Slows recovery of neurones from inactive to closed state
- Reduces neuronal transmission
However, ZERO ORDER KINETICS - Hypotension
- Bone marrow suppression
- Arrhythmias
- Tiredness / drowsiness
- Nausea and vomiting
- Mood changes / suicidal thoughts
- Osteoporosis
- Rashes – Stephen Johnson Syndrome
- Alcohol
- Oral contraceptive pill
- Some antibiotics
- Warfarin
- Other CYP 450 enzyme drugs
4
Q
List the following for: Sodium Valproate
- Use
- Mechanism of action
- Adverse effects
- Warnings / contraindications
- Important drug reactions
A
Anti-epileptic – 1st line
- Probably a mix of sodium channel blocker and GABAa effects
- Slows recovery of neurones from inactive to closed state
- Reduces neuronal transmission
- Significant lethargy
- Liver failure
- Pancreatitis
- Nausea and vomiting
- Mood changes / suicidal thoughts
- Osteoporosis
- Rashes – Stephen Johnson Syndrome
- Anaemia, thrombocytopenia or bone marrow failure
- Alcohol
- Oral contraceptive pill
- Some antibiotics
- Warfarin
- Other CYP 450 enzyme drugs
5
Q
List the following for: Lamotrigine
- Use
- Mechanism of action
- Adverse effects
- Warnings / contraindications
- Important drug reactions
A
Anti-epileptic
- Good for focal epilepsy
- Good if 1st line Sodium Valproate is contraindicated (for generalised epilepsy)
- Primarily a sodium channel blocker, however may ALSO affect calcium channels
- Slows recovery of neurones from inactive to closed state
- Reduces neuronal transmission
- Tiredness / drowsiness
- Nausea and vomiting
- Mood changes / suicidal thoughts
- Osteoporosis
- Rashes – Stephen Johnson Syndrome
- Anaemia, thrombocytopenia or bone marrow failure
- Alcohol
- Oral contraceptive pill
- Some antibiotics
- Warfarin
- Other CYP 450 enzyme drugs
6
Q
List the following for: Levetiracetam
- Use
- Mechanism of action
- Adverse effects
- Warnings / contraindications
- Important drug reactions
A
Anti-epileptic
- Good option for both generalised and focal epilepsy
Synaptic vesicle glycoprotein binder
- Binds synaptic vesicle glycoprotein
- Stops release of neurotransmitters into the synapse
- Reduces neuronal transmission
Doesn’t affect Na or Ca channels!
- Tiredness / drowsiness
- Nausea and vomiting
- Mood changes / suicidal thoughts
- Osteoporosis
- Rashes – Stephen Johnson Syndrome
- Anaemia, thrombocytopenia or bone marrow failure
- Alcohol
- Oral contraceptive pill
- Some antibiotics
- Warfarin
- Other CYP 450 enzyme drugs
7
Q
List the following for: Benzodiazepines
- Use
- Mechanism of action
- Adverse effects
- Warnings / contraindications
- Important drug reactions
A
Anti-epileptic
- Also for anti-anxiety
- Also for sleep aids
- Also for alcohol withdrawal
- GABAa agonist
- Increase Cl conductance
- More negative membrane potential (hyperpolarised) so less likely to fire
- Reduced neuronal firing
- Addiction
- Cardiovascular collapse
- Airway issues
- Tiredness / drowsiness
- Nausea and vomiting
- Mood changes / suicidal thoughts
- Osteoporosis
- Rashes – Stephen Johnson Syndrome
- Anaemia, thrombocytopenia or bone marrow failure
- Alcohol
- Oral contraceptive pill
- Some antibiotics
- Warfarin
- Other CYP 450 enzyme drugs
