Anti-seizure - Parker Flashcards
You should be seizure free for ______ years before drug withdrawal.
2 years
What’s the maximum IV dose of phenytoin?
50 mg/min
There are 3 inducers and 1 inhibitor that we should know for the anti-seizure meds. What are they?
Inducers: carbamazepine, phenytoin, and phenobarbital
Inhibitor: valproic acid
________ is an auto inducer, meaning it can speed up its own metabolism.
Carbamazepine
With these 2 related anti-seizure meds, you get hyponatremia secondary to the induction of ADH.
Carbamazepine and Oxcarbamazepine
Which has fewer toxicities: Carbamazepine or Oxcarbamazepine?
Oxcarbamazepine because it doesn’t have the 10,11 epoxide that carbamazepine has.
This anti-seizure med has many uses as well as many toxicities, including weight gain, hair loss, thrombocytopenia, liver toxicity, polycystic ovarian like disease, & contraindicated in Pregnancy!! Poor choice for young woman.
Valproic acid
______ is considered big and slow because it has a long ½ half so it takes a long to get in and up to steady state and a long time to come off. Its side effects include making you sleepy, cognitive slowing, and its associated with anemias, hepatic toxicities, and rash.
Phenobarbital
With this anti-seizure drug, you have to start low and go slow because you can get difficulties in cognitive function as well as risk of kidney stones.
Topiramate
________ is an anti-seizure drug that can reduce the efficacy of oral contraceptives at doses > 200 mg/day.
Topiramate
True or false: there is a worry of rash and hepatotoxicity with lamotrigine.
True
With this anti-seizure drug, it is well tolerated but you do see an increase in aggression and psychosis in the patient as side effects.
Levetiracetam
_______ is an anti-seizure drug with a similar profile to Levetiracetam, but it can cause PR interval prolongation, so must watch, especially in patients with bradycardia or bradyarrhythmia.
Locasamide
This anti-seizure drug is the drug of choice for absence seizures, but the problem with it is a high incidence of GI side effects.
Ethosuximide
______ and _____ are anti epileptic drugs that have kidney stone issues because of the carbonic anhydrase inhibition in the kidneys.
Topiramate and zonisamide
Steven Johnsons skin disease is associated with this AED.
Lamotrigine
Aromatic AEDs are associated with AED hypersensitivity reactions and you don’t want to use another one if you’re allergic to one. Which AEDs are aromatic?
Phenobarbital, phenytoin, carbamazepine, oxcarbamazepine, and lamotrigine
All pregnant women on an AED should get ____ mg/day of folic acid supplementation.
5 mg/day
Oral contraceptives may decreased the plasma concentration of this AED by ~50%.
Lamotrigine
Which AEDs reduce the efficacy of oral contraceptives?
Carbamazepine Oxcarbamazepine Felbamate Phenobarbital Phenytoin Primidone Topiramate (at doses > 200 mg/day)
Status epilepticus is considered a medical emergency. The first line treatments are benzodiazepines. The 2 often used are______ and ______.
IV lorazepam
IM midazolam
(Rectal diazepam can also be used
If a person goes into refractory status epilepticus because they did not respond to initial therapy, you can use high dose ______ to induce coma.
Propofol
