Anticonvulsants (Exam #1) Flashcards
What is the general MOA for all anticonvulsants (3)?
- Increase GABA
- Decrease glutamate
- BOTH
What are the two targets of glutamate DECREASING anticonvulsant meds?
- Inhibit Na channels
- Inhibit Ca channels
What type of channel is targeted in the treatment of absence seizures?
Ca
What anticonvulsant drug is known as THE inducer of CYP450s? What other two drugs also induce?
Phenobarbital
- Phenytoin
- Carbamazepine
What anticonvulsant drug is known as THE inhibitor of CYP450s?
Valproate (Valproic Acid)
What is the MOA of Phenytoin and Fosphenytoin, and what are these used to treat?
MOA: Decrease glutamate
- Blocks Na channels
Used for seizures (partial and generalized tonic-clonic)
What are the two elimination patterns seen with Phenytoin and Fosphenytoin?
- FIRST order with LOW doses
- ZERO order with HIGHER doses
What is the primary AE of Phenytoin?
Gingival hyperplasia
What is an important AE associated with ALL anticonvulsants that decrease glutamate via blocking Na channels? What allele should be tested for?
Which drug is worst?
SJS
- Test for HLA-B 1502 allele
Carbamazepine WORST
What is the MOA of Carbamazepine, and what type of seizure is this DOC for? What is an alternative use of this med?
MOA: Decrease glutamate
- Blocks Na channels
DOC for partial seizures
- Also, trigeminal neuralgia
What is the MOA of Lamotrigine, and what is it used to treat?
MOA: Decrease glutamate
- Blocks Na channels
Used for seizures (partial)
What is the MOA of Topiramate, and what is it used to treat? What is an alternative use of this med?
MOA: Decrease glutamate
- Blocks Na channels
Used for seizures (partial and generalized tonic-clonic)
- Also, migraine prevention
What is the primary AE of Topiramate?
Acute myopia/glaucoma
What is the MOA of Levetiracetam, and what is it used to treat?
MOA: Increase GABA AND decrease glutamate
- Binds SV2A
Used for seizures (partial)
What is the MOA of Phenobarbital, and what is it used to treat?
MOA: Increase GABA
- Opens Cl channels
Used for seizures (partial and generalized tonic-clonic)
What is the MOA of Gabapentin and Pregabalin?
GABA analog
What is Gabapentin used to treat? What is an alternative use?
Used as ADJUNCT for seizures (partial and generalized tonic-clonic)
- Also, neuropathic pain
What is the MOA of Tiagabine?
Inhibit GABA reuptake via GAT-1
What is the MOA of Vigabatrin?
Inhibit GABA metabolism by irreversibly inhibiting GABA-T
What are the two primary AEs of Vigabatrin?
- Visual field problems
- Retinal damage
What is the DOC for absence seizures?
Ethosuximide
What is the MOA of Ethosuximide, and what is it used to treat?
MOA: Decrease glutamate
- Inhibit Ca channels
DOC for absence seizures
What anticonvulsant drug has the least incidence of SJS?
Ethosuximide
What is the primary AE associated with Ethosuximide?
Hiccup
What is the MOA of Valproate (Valproic Acid), and what is it used to treat?
MOA: blocks Ca AND Na channels
Used to treat MIXED seizures (absence AND general tonic-clonic)
What medication is used to treat MIXED seizures, and how does this relate to its MOA?
Valproate (Valproic Acid)
- Blocks Ca AND Na channels
What is the primary AE associated with Valproate (Valproic Acid)?
Hepatotoxicity
- MONITOR LFTs
What two drugs are the DOC for status epilepticus? What drug class are these apart of?
Benzos
- Diazepam
- Lorazepam
