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CNS II > antiepileptic drugs > Flashcards

antiepileptic drugs Flashcards

1. List prototype drugs for the major classes of antiepileptic drugs, describe their mechanism of action, spectrum of antiepileptic activity, and list their major side effects. 2. Describe the metabolism and elimination of the prototype antiepileptic drugs and the possible drug interactions. 3. Describe the signs and symptoms of status epilepticus and its treatment.

1
Q

SE of Na+ channel blocking AEDs

A

diplopia, nystagmus, ataxia, vertigo, sleepiness, cognitive slowing

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2
Q

phenytoin class

A

Na+ channel blocking AED

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3
Q

carbamazepine class

A

Na+ channel blocking AED

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4
Q

valproic acid class

A

Na+ channel blocking AED

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5
Q

phenobarbitol class

A

Na+ channel blocking AED/GABAA

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6
Q

Lamotrigine class

A

Na+ channel blocking AED

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7
Q

topiramate class

A

Na+ channel blocking AED

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8
Q

zonisamide class

A

Na+ channel blocking AED

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9
Q

phenytoin metabolism

A

liver (P450),

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10
Q

drug that is 1st order initially then slows to zero order

A

phenytoin

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11
Q

drug that causes gum hyperplasia

A

phenytoin

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12
Q

drug that causes osteopenia

A

phenytoin

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13
Q

drug that causes dose dependant neutropenia

A

carbamazepine

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14
Q

drug that autoinduces P450

A

carbamazepine

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15
Q

drug that has a metabolite that is active against seziures but increases adverse effects

A

carbamazepine

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16
Q

drug to use if you cant tell if seziures are partial or generized

A

valproic acid

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17
Q

drug that inhibits hepatic metabolism of other AEDS

A

valproic acid

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18
Q

MOA of valproic acid

A

blocks Na+, also T-type Ca++ channels, and may effect GABAA

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19
Q

Adverse Effects of valproic acid

A

weight gain, tremors, hair loss, jaundice

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20
Q

fat, bald, shaky and yellow

A

valproic acid

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21
Q

drug used as adjunctive therapy for partual and GTC seziures

A

lamotrigine

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22
Q

drug that can cause rash, up to stevens=johnson

A

lamotrigine

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23
Q

adverse effects of topiramate

A

confusion/psychosis, renal stones

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24
Q

Na+ channel AED excreted by the kidney

A

topiramate

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25
Q

drug NOT to give in pt with hx of kidney stones

A

topiramate

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26
Q

lacosimide class

A

Na+ channel AED, (2nd generation)

27
Q

how benzos help seizures

A

enhance GABAA channel

28
Q

benzos used for seizures

A

diazapam, lorazepam, clonazepam

29
Q

barbos used for seizures

A

phenobarbital

30
Q

drugs that have GABA secondary effects

A

topiramate, gabapentin, valproic acid

31
Q

metabolism of clonazepam

A

hepatic

32
Q

SE of clonazepam

A

sedation, ataxia, psychosis, memory problems

33
Q

AED that can worsen seziures when tolerance occurs

A

clonazepam

34
Q

AED that is rapidly absorbed to fat

A

diazepam

35
Q

drug used to treat status epilepticus

A

diazepam

36
Q

problem with using diazepam longterm

A

marked sedation and tolerance

37
Q

SE of phenobarbital

A

cognitive slowing, hyperactivity in kids

38
Q

AED with the worst cognitive slowing effects

A

phenobarbital

39
Q

type of drug used for absence seizures only

A

T channel Calcium channel agents

40
Q

type of seziure that generates 3 Hz spike and wave pattern

A

absence

41
Q

MOA of T channel Ca++ channel AEDs

A

hyperpolarsing channels that generate rhymic pacemaker activity in thalmus

42
Q

DOC for absence seizures

A

ethosuximide

43
Q

drugs that can be used for absence seizures

A

ethosuximide, valproic acid, zonisamide, lamotrigine

44
Q

drug that can ONLY be used against absence seizures

A

ethosuximide

45
Q

SE of ethosuximide

A

GI irritation, lethargy

46
Q

site of ethosuximide metabolism

A

liver

47
Q

gabapntin MA

A

binds to Ca++ a2g subunit and impedes excessive synaptic glu release

48
Q

adverse effects of gabapentin

A

sedation, ataxia, weight gain, peripheral edema

49
Q

AED used off label for neuropathic pain

A

gabapentin

50
Q

MOA of levatiracetam

A

bids to SV2A synaptic vesicle protein

51
Q

adverse effects of levatiracetam

A

somnolence, ataxia, irritability

52
Q

do you treat with AEDs after an initial seziure

A

no

53
Q

better idea, combo therapy or pushing one drug to toxicity

A

monotherapy

54
Q

DOCs for partial seziures

A

carbamazepine, penytoin, lamotrigine

55
Q

DOC for absence only

A

ethosuximide

56
Q

DOC for absence + other type

A

valproic acid

57
Q

DOC for primary generalized seizures

A

valproic acid, lamotrigine, topiramate, levetiracetam

58
Q

carbamazepine + phenytoin =

A

lower levels of both drugs

59
Q

erythimycin + phenytoin =

A

phenytoin toxicity

60
Q

general effect of AEDs on many drugs

A

may slow clearance by slowing glucuronidation

61
Q

AEDs that are P450 inducers

A

pehnobarbital, phenytoin, carbamazepine

62
Q

AED that can cause neural tube defects

A

valproic acid and carbamazepine

63
Q

DOC for status elipticus

A

IV benzo, plus IV fosphenytoin

CNS II (25 decks)

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