Anti-seizure Flashcards
what are the main MOA of anti-convulsant drugs (4)
- Sodium channel blockade (high dose)
- Calcium channel (T-type) blockade
- Potentiate GABA - inhibitory neurotransmission -
- Decrease Glutamate - excitatory neurotransmission
What is Valproic acid/ Depakote used for
Generalized/ tonic clonic seizures
What drugs are used for status epilepticus (4)
Diazepam/ Valium
Lorazepam /Ativan
Phenytoin/ Dilantin
Ethosuximide/ zarontin
What drug class is Primidone/ Mysoline
barbiturate anticonvulsant
What is a key characteristic of Primidone/ Mysoline
it has the longest half-life of all, and breaks down into phenobarbitol
what category is Primidone/ Mysoline
Category D, because kiddos have lower IQs, but it is hard to say whether it’s from the drug or from the seizures
What drug class is diazepam (valium)
benzodiazepine anticonvulsant
What is the MOA of diazepam (valium)
Increased sensitivity of GABA receptor sites to GABA with subsequent increased chloride influx which serves to inhibit CNS synaptic transmission
How does Clonazepam (klonopin) compare to diazepam (valium)
very similar. long acting. abuse potential
What drug class is phenytoin (dilantin)
anticonvulsant
What is the MOA of phenytoin (dilantin)
Reduces sodium and calcium and currents across neuronal membranes
What are the indications for phenytoin (dilantin)
Prophylaxis for all types of seizures except absence seizures
What are side effects of phenytoin (dilantin)
Nystagmus (horizontal), gingival hyperplasia, possible hepatotoxicity, bone marrow suppression
What can be supplemented to help prevent gingival hyperplasia
folate and coQ10
What drug class is carbamazepine (tegretol)
anticonvulsant
What are the indications for carbamazepine (tegretol)
Prophylaxis against all types of seizures except absence seizures. Also used to treat chronic pain such as trigeminal neuralgia and post-herpetic neuralgia. Tegretol has also been used in the treatment of schizophrenia and bi-polar disorder.
What are significant side effects of carbamazepine (tegretol)
Vertigo, nausea, vomiting. Possible bone marrow suppression and aplastic anemia (follow blood counts)
How is tegretol processed by the body
CYP450
What s the MOA of carbamazepine (tegretol)
Similar to phenytoin in the reduction of sodium and calcium currents across neuronal membranes
What are the indications of Valproic acid (depakote)
All seizure types, particularly in absence seizures and combined seizure conditions. Also used to treat bipolar disorder and chronic pain syndromes.
What is a characteristic of valproic acid (depakote)
Additive anti-seizure effects when combined with other anticonvulsants
What are side effects of valproic acid
nausea, insomnia, anxiety. Potential for severe hepatotoxicity. Known to be an antagonist of folic acid. Causes birth defects big time
What drug class is Ethosuximide/ Zarontin
anti-convulsant
What are side effects of Ethosuximide/ Zarontin
gingival hyperplasia, Headache, nausea, vomiting, fatigue, ataxia, blurred vision, confusion, skin rashes, insomnia, notable for possible hepatotoxicity and lupus-like syndrome
What are the indications for Gabapentin (neurontin)
: Adjunctive treatment of partial seizures. Also used in chronic pain syndromes such as post-herpetic neuralgia. Migraine headaches
What drug class is gabapentin (neurontin)
anticonvulsant, atypical analgesic
What is the MOA of gabapentin
Appears to potentiate GABA and also affects N-type calcium channels
What are side effects of gabapentin
Somnolence, dizziness, ataxia, headache and other CNS side effects. just not feeling right (dysphoria)
What are the indications for lamotrigine (lamactil)
Tonic-clonic (grand mal) seizures, complex partial seizures and seizures resistant to other drug treatments. Bipolar
What are the indications for Levetiracetam (Keppra)
Tonic-clonic seizures, complex partial seizures and seizures resistant to other drug treatments. ) May have benefits for other psychiatric and neurologic conditions such as Tourette’s syndrome, Alzheimer’s disease, autism and bipolar disorder. Along with other anticonvulsants such as Gabapentin, Keppra is also used to treat neuropathic pain.
