antiepileptic Flashcards
single attack can be triggered by
alcohol
hypoglycemia
pyrexia (high fever)
sleep deprivation
epilepsy can be primary and secondary. secondary can be due to:
meningitis, encephalitis
brain injury, scaring, tumor
blood glu alteration (DM)
adrenal insufficiency (hyponatremia) (metabolic disorder)
investigation to determine risk of seizure
blood test (glu, na, k)
EEG
brain CT, MRI scan
phenytoin
dose dependent SE
hypertrophy gum
confusion, difficulty to balance
immunosuppression
hypothyroidism
phenytoin
overdose SE
CONVULSION
ataxia (lack of voluntary coordination: gait abnormality, speech change, eye movement)
vertigo
folate/vit b deficiency
phenytoin
hypersensitivity SE
morbilliform (measles-like rash)
megaloblastic anemia
liver necrosis
carbamazepine
dose-dependent SE
GI folate/vit d deficiency diplopia nystamus drowsiness antidiuretic
carbamazepine
overdose SE
confusion
ataxia
behavioural-disturbance
carbamazepine
hypersensitivity SE
rashes SJS SLE bone marrow (anemia) lymphadenopathy hepatitis
valproate
MOA
block NA and Ca channel and inhibit GABA transaminase –> increase GABA
Valproate
dose-dependent SE
GI
sedation
weight increase
hair loss
valproate
hypersensitivity SE
hepatotoxicity
thrombocytopenia
Teratogenic anti-epileptic drugs
phenytoin
carbamazepine
valproate
lamotrigine
block Na channel
inhibit glutamate release (glutamate is main excitatory forces)
use of all the anti-epileptic
phenytoin, carbamazepine: all seizures except absence
valproate, lamotrigine: all seizures
vigabatrin: all seizures + those refractory to other anti-epileptics (so 2nd line)
pregabalin: generalised anxiolytic disorder + add on for partial seizures
diazepam: refractory + status epileptics
lorapenam: status epileptics
