Anti-epileptic Drugs Flashcards

1
Q

What are the two broad MOA of anti-epileptic drugs?

A

reduce excitability, increase inhibition

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2
Q

What 1 receptor and 2 channels have decreased excitability from anti-epileptic drugs?

A

Glutamate receptor, Na+ Channel, Ca2+ channel

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3
Q

What is the MOA of phenytoin, carbamazepine, oxcarbazepine, and lamotrigine?

A

stabilize inactive conformation of Na+ channel

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4
Q

SE of carbamazepine, oxcarbazepine, lamotrigine?

A

Rash (rarely Stevens-Johnson); slow initial titration important, may cause contraceptive failure

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5
Q

SE of phenytoin?

A

Rash, gingival hyperplasia, hirsutism, lupus-like reaction, can cause contraceptive failure

Mild myelosuppression, increase LFT
long term- cerebellar degeneration, peripheral neuropathy, osteoporosis

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6
Q

What are carbamazepine and oxcarbazepine used to treat?

A

complex partial seizures, bipolar disorder and neuropathic pain

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7
Q

What is Lamotrigine used to treat?

A

generalized epilepsies, absence seizures, bipolar, neuropathic pain

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8
Q

What is phenytoin used to treat?

A

Acute seizure

tonic/clonic

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9
Q

Toxicities related to Phenytoin? EXAM QUESTION

A

Dizziness, nystagmus, ataxia, incoordination

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10
Q

Which three Na+ channel blockers are hepatic enzyme inducers?

A

phenytoin, carbamazepine, lamotrigine

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11
Q

What drug does lamotrigine compete with for excretion?

A

Depakote (Valproic Acid)

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12
Q

Who can absolutely not be taking valproate? possible exam question

A

Pregnant women- teratogenicity

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13
Q

SE of valproate?

A

weight gain, hair turnover, hyperammonemia, blood dyscrasias, teratogenicity

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14
Q

When are benzodiazepines used as anti-epileptic medications?

A

Status Epilepticus

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15
Q

What can valproate be used to treat?

A

Broad spectrum use in seizures, IV for status epilepticus, bipolar, migraine, cluster headaches

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16
Q

Name two drugs besides benzodiazepines that GABAergic and used as anti-epileptics.

A

Vigabatrin and Tigabine

17
Q

MOA of vigabatrin?

A

GABA transaminase binder (slows down inrtacellular breakdown of GABA)

18
Q

MOA of tigabine?

A

GABA reuptake inhibitor

19
Q

MOA of GABA analogs?

A

Block presynaptic influx of Ca2+

20
Q

Name two GABA analogs.

A

Gabapentin, Pregabalin

21
Q

SE of gabapentin?

A

Sedation

22
Q

What are gabapentin and pregabalin used to treat?

A

adjunct for partial complex epilepsy

neuropathic pain

23
Q

Name two glutamate receptor blockers.

A

Topiramate and Felbamate

24
Q

MOA of felbamate

A

Primarily NMDA receptor blocker

May have effect Na, Ca, GABA

25
Q

SE of felbamate?

A

Aplastic Anemia, Acute Hepatic Failure (not used much anymore)

26
Q

Use of felbamate?

A

partial onset of seizures, epilepsy

27
Q

MOA of topiramate?

A

Primarily AMPA and Kainate Ca channel blocker

May have effect Na, and GABA

28
Q

SE of topiramate?

A

mild metabolic acidosis, kidney stones, modest weight loss, acute glaucoma, sedation

29
Q

Use of topiramate?

A

partial onset seizures
secondary generalized seizures
primary generalized epilepsy
migraines and cluster headache prevention

30
Q

MOA of ethosuximide?

A

blocks t-type ca+ channels in thalamo-cortical circuits

31
Q

SE of levetiacetam?

A

well tolerated, mostly sedation

rarely irritabilty, aphasia, thrombocytopenia

32
Q

Use of ethosuximide?

A

Absence seizures only

33
Q

SE of ethosuximide?

A

nausea, sedation, irritability

34
Q

MOA of levetiacetam?

A

binds synpatic vesicle protein 2, leading to less NT release

35
Q

Use of levetiacetam?

A

partial onset seizures

secondary generalized seizures

36
Q

Carbamazepine toxicity?

A

Dizzy (sedation), drunk (Ataxic), double vision (Diplopia)

37
Q

Difference between toxicity and adverse reactions?

A

Toxicity is based on the expected mechanism of action while adverse reactions are not.