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pharm unit 3 drugs > Antiepileptic Drugs > Flashcards

Antiepileptic Drugs Flashcards

1
Q

Oxcarbamazepine (Trileptal) Misc

A

Designed to bypass carbamazepine epoxide; less protein-bound, less autoinduction, fewer interactions, less toxic, longer half-life than carbamazepine

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2
Q

Phenytoin (Dilantin) Class

A

Voltage-gated Na channel stabilizer

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3
Q

Carbamazepine (Tegretol) Class

A

Voltage-gated Na channel stabilizer

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4
Q

Oxcarbamazepine (Trileptal) Class

A

Voltage-gated Na channel stabilizer

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5
Q

Lamotrigine (Lamictal) Class

A

Voltage-gated Na channel stabilizer

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6
Q

Benzodiazapines Class

A

GABAergic anti-epileptic

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7
Q

Gabapentin (Neurontin) Class

A

GABA analog

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8
Q

Pregabalin (Lyrica) Class

A

GABA analog

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9
Q

Topiramate (Topamax) Class

A

Glutamate Receptor Blockers

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10
Q

Levetiracetam (Keppra) Class

A

Synaptic vesicle binder

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11
Q

Ethosuximide (Zarontin) Class

A

Voltage-gated Ca channel blocker

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12
Q

Phenytoin (Dilantin) MOA

A

Stabilize inactive conformation of Na channel

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13
Q

Carbamazepine (Tegretol)MOA

A

Stabilize inactive conformation of Na channel

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14
Q

Oxcarbamazepine (Trileptal) MOA

A

Stabilize inactive conformation of Na channel

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15
Q

Lamotrigine (Lamictal) MOA

A

Stabilize inactive conformation of Na channel

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16
Q

Valproate (Depakote) MOA

A

Unknown; likely affects Na-gated channels and GABA system

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17
Q

Benzodiazapines MOA

A

Bind GABA-A

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18
Q

Gabapentin (Neurontin) MOA

A

Block presynaptic influx of Ca

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19
Q

Pregabalin (Lyrica) MOA

A

Block presynaptic influx of Ca

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20
Q

Topiramate (Topamax)MOA

A

Partial AMPA, Kainate Ca receptor blocker; secondary effect at voltage-gated Na channel, GABA system

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21
Q

Levetiracetam (Keppra) MOA

A

Binds synaptic vesicle protein 2, leading to less NT release

22
Q

Ethosuximide (Zarontin) MOA

A

Blocks T-type Ca-channels in thalamo-cortical circuits

23
Q

Phenytoin (Dilantin) Therapeutics

A

Less effective for absence (particular pediatric), myoclonic, atonic seizures

24
Q

Carbamazepine (Tegretol) Therapeutics

A

More effective for complex partial seizure than primary generalized; bipolar disorder; neuropathic pain

25
Q

Oxcarbamazepine (Trileptal) Therapeutics

A

More effective for complex partial seizure than primary generalized; bipolar disorder; neuropathic pain

26
Q

Lamotrigine (Lamictal) Therapeutics

A

Primary generalized epilepsies, absence seizures; indicated in children; bipolar disorder; neuropathic pain

27
Q

Valproate (Depakote) Therapeutics

A

Broad spectrum: absence, myoclonic, tonic-clonic, primary generalized, partial onset, and secondary generalized seizures (but not absence seizures); IV for status epilepticus; bipolar treatment, migraine and long-term cluster headache prophylaxis

28
Q

Benzodiazapines Therapeutics

A

Status epilepticus (refractory); anesthesia

29
Q

Gabapentin (Neurontin) Therapeutics

A

Adjunct for partial complex epilepsy; more commonly used for neuropathic pain

30
Q

Pregabalin (Lyrica) Therapeutics

A

Adjunct for partial complex epilepsy; more commonly used for neuropathic pain

31
Q

Topiramate (Topamax) Therapeutics

A

Partial onset seizures, secondary generalized seizures, primary generalized epilepsy; migraine prevention, long-term prevention of cluster headaches

32
Q

Levetiracetam (Keppra) Therapeutics

A

Partial onset seizures, secondary generalized seizures; maybe primary generalized epilepsy

33
Q

Ethosuximide (Zarontin) Therapeutics

A

Absence seizures only (and neuropathic pain)

34
Q

Phenytoin (Dilantin) SE

A
  1. Rash, gingival hyperplasia, hirsutism, lupus-like reaction; can cause contraceptive failure 2. Mild myelosuppression, increased LFT; long-term: cerebellar degeneration, peripheral neuropathy, osteoporosis
35
Q

Carbamazepine (Tegretol) SE

A

Rash (rarely, Stevens-Johnson), mild myelosuppression, mild increase in LFTs; can cause contraceptive failure

36
Q

Oxcarbamazepine (Trileptal) SE

A

Rash (rarely, Stevens-Johnson), mild myelosuppression, mild increase in LFTs; can cause contraceptive failure

37
Q

Lamotrigine (Lamictal) SE

A

Rash, (rarely, Stevens-Johnson): slow initial titration important; may lead to contraceptive failure

38
Q

Valproate (Depakote) SE

A
  1. Weight gain, hair turnover, hyperammonemia (which can be mitigated with oral carnitine), teratogenicity, blood dyscrasias 2. Pancreatitis
39
Q

Benzodiazapines SE

A

Sedation

40
Q

Gabapentin (Neurontin) SE

A

Sedation

41
Q

Pregabalin (Lyrica) SE

A
42
Q

Topiramate (Topamax) SE

A
  1. Mild metabolic acidosis, kidney stones (due to some carbonic anhydrase activity); modest weight loss; rare acute glaucoma; sedation 2. Word-finding problems
43
Q

Levetiracetam (Keppra) SE

A

Well tolerated; sedation, mostly; rarely, irritability, aphasia, thrombocytopenia

44
Q

Ethosuximide (Zarontin) SE

A

Nausea (transient), sedation, irritability

45
Q

Phenytoin (Dilantin) Misc

A

IV infusion limited by hypotension; hepatic enzyme inducer (both auto- and hetero-inducer), highly protein bound

46
Q

Carbamazepine (Tegretol) Misc

A

Hepatic enzyme inducer (both auto- and hetero-inducer); highly protein bound; must increase dose in 1-2 wks due to autoinduction; side effects likely due to epoxide metabolite

47
Q

Oxcarbamazepine (Trileptal) Misc

A

Designed to bypass carbamazepine epoxide; less protein-bound, less autoinduction, fewer interactions, less toxic, longer half-life than carbamazepine

48
Q

Lamotrigine (Lamictal) Misc

A

May exacerbate myoclonic seizures; competes with valproic acid for excretion (potential synergy); hepatic enzyme inducer; not very protein bound

49
Q

Benzodiazapines Misc

A

Long-term usefulness limited by tolerance

50
Q

Gabapentin (Neurontin) Misc

A

Absorption limited by intestinal AA transporter (there is a Tm); limited protein binding; no metabolism or drug interaction in humans (so few side effects)

51
Q

Topiramate (Topamax) Misc

A

Carbonic anhydrase activity leads to mild metabolic acidosis, which leads to respiratory compensation, which leads to mild alkalosis, which leads to calcium ionization, which leads to tingling; treat with vitamin C (acidify urine)

52
Q

Ethosuximide (Zarontin) Misc

A

Readily absorbed, minimal first pass metabolism; not protein bound

pharm unit 3 drugs (13 decks)

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