Anticonvulsants Flashcards
generalized seizures
affect consciousness
- tonic-clonic(TC) seizures- jerking, shaking (stereotypical seizure)
- absence seizures (a.k.a petit mal)- 30 seconds or less, stop mid-action
2 types of seizures
generalized seizures
partial seizures
petit mal
absence seizure
partial seizures
- a.k.a. focal seizures
- may or may not affect consciousness (usually do NOT)
- localized; affect a specific area
pt. counseling for anticonvulsants
- NEVER stop anticonvulsants suddenly–ALWAYS TAPER: status epilepticus may occur
- may cause somnelence
classes of anticonvulsants
barbiturates
succinimides
sulfonamides
hydantoins
barbiturates
-decrease effectiveness of hormonal contraceptives
phenobarbital
Mysoline
Mebaral
phenobarbital
-barbiturate
Mysoline
primidone
- barbiturate
- ind. for partial and TC
- metabolized to phenobarbital
Mebaral
mephobarbital
- barbiturate
- ind. for TC and absence
- metabolized to phenobarbital
succinimides
-ind. for absence
Zarontin
methsuximide
Zarontin
ethosuximide
- succinimide
- ind. for absence
methsuximide
- succinimide
- ind. for absence
sulfonamides
-ind. for partial
-contraindicated in pts. allergic to sulfa drugs
Zonegran
Zonegran
zonisamide
-sulfonamide
hydantoins
Dilantin
Peganone
Cerebyx
hydantion counseling
- decrease effectiveness of hormonal contraceptives
- need to have good dental care (brush AND floss)- may cause gingival hyperplasia
- chronic alcohol intake may lower the level of drug in the body causing susceptibility to seizures
status epilepticus
multiple TC seizures without regaining consciousness
gingival hyperplasia
gums swell and may cover teeth
Dilantin
phenytoin
- hydantoin
- ind. for partial and TC
- capsule, chewable tablet, oral suspension, and parenteral
- parenteral ONLY ind. for status epilepticus
Peganone
ethotoin
- hydantoin
- ind. for partial and TC
Cerebyx
fosphenytoin
- hydantoin
- ind. ONLY for status epilepticus
- IV only; water soluble prodrug that is converted to phenytoin
- refrigerate for stability
Tegretol, Carbatrol, Epitol
carbamazepine
- anticonvulsant
- ind. for partial, TC, trigeminal neuralgia, and bipolar disorder
- BBW: agranulocytosis
trigeminal neuralgia
- disorder of the 5th cranial nerve (trigeminal nerve)
- results in face pain
agranulocytosis
decrease in the number of white blood cells (WBCs) which makes you more susceptible to illness
Felbatol
felbamate
- anticonvulsant
- ind. for partial and Lennox-Gastaut syndrome
- not a first-line drug; parent must sign consent form saying they have been warned of BBWs
- BBWs: agranulocytosis, hepatotoxicity, bone marrow suppression
Lennox-Gastaut syndrome
- severe, daily seizures of various types with onset in young children (2-3yo) that may continue into adulthood
- usually have some degree of mental retardation
- wear a helmet
Lamictal
lamotrigine
- anticonvulsant
- ind. for partial, TC, bipolar, and Lennox-Gastaut syndrome
- BBW: may cause serious rash
Neurontin
gabapentin
- anticonvulsant
- ind. for partial and pain associated with PHN
Horizant
gabapentin ER
- anticonvulsant
- ind. ONLY for RLS
Gralise
gabapentin ER
- anticonvulsant
- ind. ONLY for PHN
PHN
postherpetic neuralgia- nerve pain that occurs after shingles blisters have subsided
Lyrica
pregabalin
- anticonvulsant
- ind. for partial, pain associated with PHN, fibromyalgia, and pain associated with DPN
DPN
diabetic peripheral neuropathy- pain/tingling in the periphery of diabetic pt.
Keppra
levetiracetam
- anticonvulsant
- ind. for partial and TC
- had no drug interactions for a long time
Topamax
topiramate
- anticonvulsant
- ind. for partial, TC, Lennox-Gastaut syndrome, and migraine prophylaxis
- side effect: may cause significant weight loss
- do NOT use in pregnancy- may cause cleft lip/palate in child
Depakote
divalproex
- anticonvulsant
- ind. for partial, TC, absence, bipolar disorder, and migraine prophylaxis
- BBW: teratogenic effects, four-fold increase in risk of birth defects
teratogen
an agent that causes birth defects
Gabitril
tiagabine
- anticonvulsant
- ind. for partial
Trileptal
oxcarbazepine
- anticonvulsant
- ind. for partial
Vimpat
lacosamide
- anticonvulsant
- ind. for partial
Banzel
rufinamide
- anticonvulsant
- ind. for Lennox-Gastaut syndrom
Sabril
vigabatrin
- anticonvulsant
- tablet: ind. for partial seizures in adults
- powder for oral solution: ind. for West Syndrome
- BBW: can cause permanent vision loss (constricts field of vision, doesn’t make blind)*
- not a first-line drug
West Syndrome
severe form of infantile spasms in kids less than 2yo
