Anticonvulsants TBL

Question 1

Carbamezepine

Answer 1

1st line Tx for focal seizures (w/ or w/o 2ndary generalized seizures). Also a mood stabilizer. Note p450 inducer- many interactions.

Question 2

Phenytoin

Answer 2

high efficacy for focal seizures. P450 inducer.

Question 3

Gabapentin

Answer 3

a less good choice for focal seizures. Better interaction profile than carbamezapine or phenytoin.

Question 4

Valproate

Answer 4

most effective treatment for generalized seizures.

Question 5

Ethosuximide

Answer 5

best Tx for absence seizures

Question 6

What proportion of patients will have sustained remission with initial therapy and no severe side effects?

Answer 6

50%

Question 7

If pt is having bad side effects or continues to have seizures, what do you do?

Answer 7

Make sure they’re taking it first. If they are, then switch to a different first line drug.

Question 8

When is a pt considered truly pharmacoresistant?

Answer 8

If they fail 2 first line meds, either alone or in combo

Question 9

When is it ok to discontinue therapy for epilepsy?

Answer 9

2-4 years seizure-free.

Question 10

What’s the number 1 reason for non-adherence?

Answer 10

forgot! Physicians and patients agree on this.