Anti-Epileptics Flashcards
What is the mechanism of action of levetiracetum (keppra)?
Unknown - may modulate neurotransmission by binding to synaptic vesicle protein 2A
What are the indications for levetiracetam (keppra)?
Monotherapy for focal seizures with or without secondary generalisation
Adjunct therapy for generalised tonic clonic seizures
What are precautions for levetiracetam?
Renal impairment
Other psychiatric condition or learning disability
What are some adverse effects of levetiracetam?
Mood changes - depression, emotional lability, anxiety, hostility, aggitation, aggressiveness, and nervousness
Drowsiness
Weakness
Insomnia
Vertigo
Ataxia
What is the mechanism of action of carbamazepine?
Prevents repeated neuronal discharges via blocking voltaged dependent and use dependent Na channels
What are some indications for carbamazepine?
Epilepsy - simple and complex seizure, and generalised tonic clonic
Trigenimal neuralgia
Bipolar disorder
What are some precautions with carbamazepine?
Absence and myoclonic seizure - increase occurrence
Ventricular conduction abnormalities
Hx of bone depression
Porphyrias
Thyroxine therapy
What are some adverse affects of carbamazepine?
Drowsiness
Ataxia
Blurred vision
Headache
Severe skin reaction
Multiorgan hypersensitivity syndrome
What are the first line therapies for the following types of seizures
- Focal
- Generalised
- Myoclonic
- Absent
- Focal - Carbamazepine
- Generalised - Valproate
- Myoclonic - Valproate
- Absent - Ethosuximide, Valproate
What are is the mechanism of action valproate?
Prevention of repeated neuronal signals via blockage of voltage and use dependent Na channels
Also enhance GABA, inhibit glutamate, and block T-type calcium channels
What are some indications for valproate?
Primary generalised (tonic clonic, myoclonic, absent, atonic) and partial seizures
Bipolar
Second line for migraine prevention
What are some adverse reaction to valproate?
N/V
Increased appetite, Weight gain
Hair thinning
Tremor
Abnormal bleeding time
Pancreatitis
Hepatic failure
