Anti-epileptic Drugs Flashcards
What are the two broad MOA of anti-epileptic drugs?
reduce excitability, increase inhibition
What 1 receptor and 2 channels have decreased excitability from anti-epileptic drugs?
Glutamate receptor, Na+ Channel, Ca2+ channel
What is the MOA of phenytoin, carbamazepine, oxcarbazepine, and lamotrigine?
stabilize inactive conformation of Na+ channel
SE of carbamazepine, oxcarbazepine, lamotrigine?
Rash (rarely Stevens-Johnson); slow initial titration important, may cause contraceptive failure
SE of phenytoin?
Rash, gingival hyperplasia, hirsutism, lupus-like reaction, can cause contraceptive failure
Mild myelosuppression, increase LFT
long term- cerebellar degeneration, peripheral neuropathy, osteoporosis
What are carbamazepine and oxcarbazepine used to treat?
complex partial seizures, bipolar disorder and neuropathic pain
What is Lamotrigine used to treat?
generalized epilepsies, absence seizures, bipolar, neuropathic pain
What is phenytoin used to treat?
Acute seizure
tonic/clonic
Toxicities related to Phenytoin? EXAM QUESTION
Dizziness, nystagmus, ataxia, incoordination
Which three Na+ channel blockers are hepatic enzyme inducers?
phenytoin, carbamazepine, lamotrigine
What drug does lamotrigine compete with for excretion?
Depakote (Valproic Acid)
Who can absolutely not be taking valproate? possible exam question
Pregnant women- teratogenicity
SE of valproate?
weight gain, hair turnover, hyperammonemia, blood dyscrasias, teratogenicity
When are benzodiazepines used as anti-epileptic medications?
Status Epilepticus
What can valproate be used to treat?
Broad spectrum use in seizures, IV for status epilepticus, bipolar, migraine, cluster headaches