Anti seizure meds Flashcards
What are the 4 primary enzyme inducing anti seizure medications?
Phenobarbital
Primidone
Phenytoin
Carbamazepine
What is the primary enzyme inhibiting anti seizure medication?
Valproate
What is the MOA and ½ life of phenobarbital?
Binds to GABAA recetor: prolongs chloride channel opening
80 to 100 hour ½ life
What MOA of an anti seizure medication makes it likely to treat absence seizures?
T-type calcium channel blocker
What medications can treat absence seizures?
Ethosuximide, Valproate (Class I evidence)
Clobazam (Onfi), Lamotrigine, levetiracetam, Zonisamide
What are the long term side effects associated with phenobarbital?
Decreased bone density, Dupuytren contractures, plantar fibromatosis and frozen shoulder
What is the MOA and ½ life of phenytoin?
Na channel blocker
22 hour ½ life
What 2 types of seizures can phenytoin make worse?
Generalized myoclonic and absence
What are potential long term side effects associated with phenytoin?
Gingival hyperplasia, acne, hirsutism, cerebellar atrophy, decreased bone density, anemia and peripheral neuropathy
What is the MOA and ½ life of carbamazepine?
Na channel blocker
12 - 17 hours once autoinduction is complete
What 3 types of seizures can carbamazepine make worse?
Absence, atonic and myoclonic
Carbamazepine side effects
- Short term (1)
- Long term (2)
- Serious (1)
Hyponatremia
Weight gain and decreased bone density
Aplastic anemia
Oxcarbazepine (Trileptal) has what significant side effect (worse than carbamazepine)?
Hyponatremia
What kind of seizures are best treated with oxcarbazepine (Trileptal) and eslicarbazepine (Aptiom)?
Partial onset seizures (avoid in generalized seizures)
What is the ½ life of eslicarbazepine (Aptiom)?
13 - 20 hours serum
20 - 24 hours CSF (hence once daily dosing)
