anticonvulsants

Question 1

Generalized classifications

Answer 1

absense
myoclonic
clonic
tonic
tonic clonic

Question 2

Valproate

Answer 2

Indication:
1. Tonic-clonic generalised seizures
2. Second line for complex partial (specific) seizures

Mechanism of action:
- Blocks Na+ channels to prevent Na+ influx
- Inhibits the major excitatory neurotransmitter, glutamate
- Enhances the major inhibitory neurtransmitter, GABA
- Blocks Ca+ channels
-
Adverse effects:
- Hair loss
- Menstrual irregularities
- Polycystic irregularities
- Hyperandrogenism
- Nausea and vomiting
-
Precautions
- Dont use in childbearing women
- Avoid in hepatic impairment-

Question 3

3 most common types of anticonvulsants

Answer 3

Anticonvulsants
1. Valproate
2. Levetiracetam
3. Lamotrigine
4. Topiramate
5. Carbamazepine

Question 4

WHAT IS Levetiracetam

Answer 4

Levetiracetam
Indication:
- Monotherapy for focal seizures
- Adjunctive therapy for tonic clonic seizures
Mechanism of action:
- Unknown
Adverse effects:
- Behavioural (depression, irritability)
- Drowsiness
Precautions:
- Renal impairment, but generally well tolerated

Question 5

WHAT IS Lamotrigine
WHAT DOES IT DO

Answer 5

Lamotrigine
Indication:
- Adjunctive or monotherapy for generalised or focal seizures
Mechanism of action:
- Enhances GABA
- Inhibits glutamate
- Stabilises presynaptic neuronal membrane
Adverse effects:
- Ataxia
- Sleepiness
- Blurry vision
- Double vision
- Headache
Contrainidicated:
- Do not use with valproate

Question 6

Anticonvulsant use in pregnancy and child bearing women

Answer 6

• Congenital malformation rate in infants is 2-3x higher for women who take anticonvulsants
• Anticonvulsants reduce effectiveness of some contraceptives

Question 7

WOMEN