Anticonvulsants Flashcards
Which drugs can be added to monotherapy?
valproic acid/depakote
gabapentin
levetiracetam/keppra
Which drugs are used for chronic pain?
- carbamazepine/tegretol
- gabapentin
- levetiracetam/keppra (neuropathic pain)
which drugs are used for status epilepticus
lorazepam
diasepam/valium
clonazepam/klonopin
which drugs can be used for absence seizures
ethosuximide/zarontin (first line
clonazepam/klonopin (first line)
valproic acid/depakote
slide 49
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what drugs can be used to treat partial seizures
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most generalized seizures are what type?
complex seizures
If there is a post-ictal state, the seizure was most likely
neurogenic
hynogenic seizures
happen between sleep and wake
If you see three small lesions on MRI, think
One larger lesion on MRI, think
metastatic ca
primary tumor
simple
complex
partial
generalized
- no change in consciousness
- change in level of consciousness
- one part or side of body affected
- entire body
60% of people with epilepsy have what type of seizure
focal/partial
is person conscious in a simple partial seizure?
yes
a person who can’t respond well while having a seizure is most likely having a
complex seizure
status epilepticus
danger
tonic clonic seizure for greater than 5 minutes
- danger for cerebral ischemia
MOA anticonvulsant drugs
alter sodium/ca channels
potentiate GABA
drugs for partial seizures
carbamasepine phenytoin diazepam primidone valproic acid lamotrigine
Are benzodiazapines first line for seizures?
No, third line unless status epilepticus, then first line
drugs for absence seizures
ethosuximide
valproic acid
clonazepam
drugs for generalized tonic clonic seizures
valproic acid
topiramate
phenobarbital
- enhanced GABA
- longest used anti-seizure medication
primidone
barbituate/anticonvulsant broken down into phenobarbital category D (not used in pregnancy)
indicated for all seizures except absence seizures
primidone
drug for grand mal seizures
diazepam/valium
diazepam/valium
increased sensitivity to GABA receptors/increased chloride influx inhibits synaptic transmission
- not good for chronic treatment of seizures
- indicated for grand mal seizures, status epilepticus, anxiety, panic disorders
- not used long term for seizures as tolerance is quick to develop
Clonazepam/klonopin
benzodiazepine/anticonvulsant
GABA receptor sensitivity increased
absence seizures or status epilepticus
*abuse potential
phenytoin/dilantin
anticonvulsant
reduces na and ca current
prophylaxis for seizures, not absence seizures
SE: nystagmus, gingical hyperplasia
*monitor with CBC and liver function tests
carbamazepine/tegretol
anticonvulsant
decrease na and ca current
prophylaxis for seizures excetp absence, chronic pain
*monitor with CBC and liver function test
SE: arrhthmias, bone marrow supression
valproic acid/depakote
anticonvulsant inhances GABA transmission all seizures including absence congenital birth defects SE: N, anxiety, folic acid antagonist
ethosuximide/zarontin
anticonvulsant
absence seizures
less hepatotoxic
SE: gingival hyperplasia, lupus like syndrome
what drug can be used for hiccups?
ethosuximide/zarontin
gabapentin/neurontin
anticonvulsant, atypical analgesic
increases GABA and ca ch
chronic pain, post-herpetic neuralgia, migraines, addictions
not so bad
lamotrigine/lamactil
anticonvulsant
tonic-clonic/gran mal seizures, complex partial, seizures resistant to other drugs, bipolar
SE: cleft palate
what drug treats seizures resistant to other drugs?
lamotrigine/lamactil
levetiracetam/keppra
what is also used to treat bipolar disorder
lamotrigine/lamactil
levetiracetam/keppra
anticonvulsant
tonic clonic, complex partial, resistant to other drugs tx
neuropathic pain
