antiepileptic meds Flashcards
general AED info
drugs work in only 60-70% of patients match drug with seizure, trial and error nonadherance- 50% of tx failure withdrawal AED slowly and 1 med at a time all AED have suicidal risk many AED have drug level monitoring
phenytoin (dilantin) therapeutic index
10-20 mcg/mL
toxicity symptoms of phenytoin
nystagmus, sedation, ataxia, blurred/double vision
SE of phenytoin
drowsiness, gingivial hypertrophy, GI (give with food!)
RARE but serious– RASH! SJS or TEN
IV admin of pheny
slow, > 50 mg/min risk of CV collapse! monitor VS only compatible with NS, form precipitate with DS purple glove syndrome
Fosphenytoin general info
prodrug thats converted to pheny
not the same!
dosed in phenytoin equivalents (PE)
IV infusion of fosphenytoin
temporary paresthesia and groin itching resolves when infusion complete give slowly severe hypotension and arrhythmias (monitor heart) can be given IM too!
Carbamezepine general info
increases its own metabolism, leading to decreased half life over time
carbamezepine se
rare– bone marrow suppresion
skin rash!
increased risk of sunburn
d-d interactions with carba
grapefruit + lots of other drugs
Valproic acid SE
GI are most common
rare/serious: hepatotoxicity & pancreatitis, blood dyscrasias
gabapentin info
used for seizures in higher doses
used for neuropathic pain, migraines, multimodal pain mgmt
SE of gabapentin
somnolence, dizziness, ataxia, fatigue, nystagmus
pregabalin other uses
fibromyalgia, diabetic neuropathy
SE of pregabalin
dizziness, somnolence, blurred vision, weight gain, euphoria
