Antiepileptic Drugs Flashcards

Question

Oxcarbamazepine (Trileptal) Therapeutics

Answer 1

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

Answer 2

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

Answer 3

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

Answer 4

Status epilepticus (refractory); anesthesia

Answer 5

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

Answer 6

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

Answer 7

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

Answer 8

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

Answer 9

Absence seizures only (and neuropathic pain)

Answer 10

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

Answer 11

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

Answer 12

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

Answer 13

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

Answer 14

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

Answer 15

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

Answer 16

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

Answer 17

Nausea (transient), sedation, irritability

Answer 18

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

Answer 19

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

Answer 20

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

Answer 21

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

Answer 22

Long-term usefulness limited by tolerance

Answer 23

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

Answer 24

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)

Answer 25

Readily absorbed, minimal first pass metabolism; not protein bound