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Pharmacology > Anticonvulsants > Flashcards

Anticonvulsants Flashcards

1
Q

Enhanced Na+ Channel Inactivation

A 
Phenytoin
Carbamazepine
Divalproex/Valproate
Lacosamide
Lamotrigine
Zonisamide
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2
Q

Decrease current through T-Type Ca2+ Channels

A

Divalproex

Ethosuxamide

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3
Q

Enhanced GABA Transmission

A

Benzo’s - frequency
Barbiturates - duration
Gabapentin
Divalproex

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4
Q

Reduced Excitatory NT release/Receptor blockade

A

Gabapentin, Pregabalin
Phenobarbital
Topiramate
Levetiracetam - SV2A

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5
Q

Phenytoin

A

MOA: Enhanced Na+ Channel Inactivation

Binds Albumin
Can make Absence WORSE!

SE: Gingival Hyperplasia, Cystic Acne, Hypertrichosis, SJS
Aplastic anemia, Folate Deficiency
Decrease insulin secretion (bad for diabetics)

Teratogen: FAS, Phalange dysplasia

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6
Q

Valproate/Divalproex

A

MOA: Several.
Enhanced Na+ Channel Inactivation, Works on T-Type Ca2+ channels, Inhibits GABA reuptake

Generalized Tonic-Clonic, Absence, Myoclonic

SE: Alopecia, Aplastic Anemia, Weight Gain
Hepatitis

Teratogen: FAS

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7
Q

Lamotrigine

A

MOA: Enhanced Na+ Channel Inactivation

Generalized Tonic-Clonic, Absence
Simple Partial

SE: Rashes, SJS - Must be titrated

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8
Q

Gabapentin

A

MOA: alpha2-delta T-Type Ca2+ Channels
Increase GABA release

SE: Weight gain

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9
Q

Pregabalin

A

MOA: alpha2-delta T-Type Ca2+ Channels
Increase GABA release

SE: PR Prolongation
Need an EKG and Renal Adjustment

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10
Q

Topiramate

A

MOA: Blocks Na+ channels, Enhances GABA, Reduces kainate activity

Generalized Tonic-Clonic, Lennox-Gastaut

SE: Cognitive Dysfunction (word recognition), Weight Loss, Rashes, Glaucoma

KIDNEY STONES - Need serum Bicarbonate
Renal Dose Adjustment

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11
Q

Levetiracetam

A

MOA: Binds SV2A (synaptic vesicle) modifying the release of glutamate and GABA

Generalized Tonic-Clonic, Simple Partial
Generally the best to avoid drug interactions and contraindications!

SE: Psychiatric issues (ANGER)
Requires Renal Dose adjustment

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12
Q

Zonisamide

A

MOA: Enhanced Na+ Channel Inactivation, poorly understood

Generalized Tonic-Clonic, Myoclonic

SE: Weight loss, rash
KIDNEY STONES - Need serum Bicarbonate
Renal Dose Adjustment

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13
Q

Ethosuxamide

A

MOA: Decrease current through T-Type Ca2+ Channels

Absence seizures

SE: N/V, Sedation, Neutropenia
Monitor CBC and LFTs

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14
Q

Perampanel

A

Adjunct for Tonic-Clonic
Mono for Partial seizures

Renal and Liver Dose adjustment

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15
Q

Lacosamide

A

MOA: Enhanced Na+ Channel Inactivation

Simple Partial

SE: Slowed Cardiac conduction
NEED AN EKG!!!

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16
Q

Carbamazepine

A

MOA: Enhanced Na+ Channel Inactivation

Not 1st but - Partial, General, Mixed Type
Can make Absence WORSE!
Strong CYP inducer

SE: Hyponatremia - don’t use in patients with Hypertension
Aplastic anemia, SJS (HLA-B1502)

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17
Q

Oxcarbezapine

A

MOA: Enhanced Na+ Channel Inactivation

Not 1st but - Partial, General, Mixed Type
Can make Absence WORSE!

SE: Hyponatremia - don’t use in patients with Hypertension
Less side effects otherwise than Carbamazepine

18
Q

Myoclonic

A
  1. Valproate
  2. Levetiracetam
  3. Zonisamide
19
Q

Enzyme Induction

A

Increase metabolism of other drugs
Phenobarbital
Phenytoin
Carbamazepine

** Be careful with birth control!

20
Q

Myoclonic

A
  1. Valproate
  2. Levetiracetam
  3. Zonisamide
21
Q

MOA: Enhanced Na+ Channel Inactivation

Not 1st but - Partial, General, Mixed Type
Can make Absence WORSE!

SE: Hyponatremia - don’t use in patients with Hypertension
Less side effects otherwise than Carbamazepine

A

Oxcarbezapine

22
Q

Complex Partial

A
  1. Levetiracetam
  2. Lamotrigine
  3. Oxycarbamazepine
  4. Carbamazapine
  5. Lacosamide
23
Q

Complex Partial

A
  1. Levetiracetam
  2. Lamotrigine
  3. Oxycarbamazepine
  4. Carbamazapine
  5. Lacosamide
24
Q

MOA: Enhanced Na+ Channel Inactivation

Not 1st but - Partial, General, Mixed Type
Can make Absence WORSE!

SE: Hyponatremia - don’t use in patients with Hypertension
Aplastic anemia, SJS (HLA-B1502)

A

Carbamazepine

25
Q

MOA: Enhanced Na+ Channel Inactivation

Not 1st but - Partial, General, Mixed Type
Can make Absence WORSE!

SE: Hyponatremia - don’t use in patients with Hypertension
Aplastic anemia, SJS (HLA-B1502)

A

Carbamazepine

26
Q

MOA: Enhanced Na+ Channel Inactivation

Simple Partial

SE: Slowed Cardiac conduction
NEED AN EKG!!!

A

Lacosamide

27
Q

MOA: Decrease current through T-Type Ca2+ Channels

Absence seizures

SE: N/V, Sedation, Neutropenia
Monitor CBC and LFTs

A

Ethosuxamide

28
Q

MOA: Enhanced Na+ Channel Inactivation, poorly understood

Generalized Tonic-Clonic, Myoclonic

SE: Weight loss, rash
KIDNEY STONES - Need serum Bicarbonate
Renal Dose Adjustment

A

Zonisamide

29
Q

MOA: Enhanced Na+ Channel Inactivation

Not 1st but - Partial, General, Mixed Type
Can make Absence WORSE!
Strong CYP inducer

SE: Hyponatremia - don’t use in patients with Hypertension
Aplastic anemia, SJS (HLA-B1502)

A

Carbamazepine

30
Q

MOA: Binds SV2A (synaptic vesicle) modifying the release of glutamate and GABA

Generalized Tonic-Clonic, Simple Partial

SE: Psychiatric issues (ANGER)
Requires Renal Dose adjustment

A

Levetiracetam

31
Q

MOA: Blocks Na+ channels, Enhances GABA, Reduces kainate activity

Generalized Tonic-Clonic, Lennox-Gastaut

SE: Cognitive Dysfunction (word recognition), Weight Loss, Rashes

KIDNEY STONES - Need serum Bicarbonate
Renal Dose Adjustment

A

Topiramate

32
Q

MOA: Enhanced Na+ Channel Inactivation

Generalized Tonic-Clonic, Absence
Simple Partial

SE: Rashes, SJS - Must be titrated

A

Lamotrigine

33
Q

MOA: Binds SV2A (synaptic vesicle) modifying the release of glutamate and GABA

Generalized Tonic-Clonic, Simple Partial
Generally the best to avoid drug interactions and contraindications!

SE: Psychiatric issues (ANGER)
Requires Renal Dose adjustment

A

Levetiracetam

34
Q

MOA: Blocks Na+ channels, Enhances GABA

Generalized Tonic-Clonic, Lennox-Gastaut

SE: Cognitive Dysfunction (word recognition), Weight Loss, Rashes
Glaucoma

KIDNEY STONES - Need serum Bicarbonate
Renal Dose Adjustment

A

Topiramate

35
Q

MOA: Enhanced Na+ Channel Inactivation

Binds Albumin
Can make Absence WORSE!

SE: Gingival Hyperplasia, Cystic Acne, Hypertrichosis, SJS
Aplastic anemia, Folate Deficiency

Teratogen: FAS, Phalange dysplasia

A

Phenytoin

36
Q

MOA: Several.
Enhanced Na+ Channel Inactivation, Works on T-Type Ca2+ channels, Inhibits GABA reuptake

Generalized Tonic-Clonic, Absence, Myoclonic

SE: Alopecia, Aplastic Anemia, Weight Gain

Teratogen: FAS

A

Divalproex/Valproate

37
Q

MOA: Several.
Enhanced Na+ Channel Inactivation, Works on T-Type Ca2+ channels, Inhibits GABA reuptake

Generalized Tonic-Clonic, Absence, Myoclonic

SE: Alopecia, Aplastic Anemia, Weight Gain
Hepatitis

Teratogen: FAS

A

Valproate/Divalproex

38
Q

MOA: Enhanced Na+ Channel Inactivation

Binds Albumin
Can make Absence WORSE!

SE: Gingival Hyperplasia, Cystic Acne, Hypertrichosis, SJS
Aplastic anemia, Folate Deficiency
Decrease insulin secretion (bad for diabetics)

Teratogen: FAS, Phalange dysplasia

A

Phenytoin

39
Q

Cleft Lip and Palate

A

Phenytoin & Phenobarbital

40
Q

Myelomeningocele

A

Carbamazepine & Valproate

41
Q

Myelomeningocele

A

Carbamazepine & Valproate

42
Q

Teratogenic Drugs

A

Phenytoin
Carbamazepine
Valproate
Topiramate

Pharmacology (19 decks)

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