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Neurology > Antiepileptics > Flashcards

Antiepileptics Flashcards

1
Q

Which are the sodium channel blockers?

A

Phenytoin
Carbamazepine
Sodium Valproate
Lamotrigine

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2
Q

Sodium channel blocker MOA?

A

Increases efflux and decreases influx of sodium ions to stabilise the neuronal membrane to decrease seizure activity

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3
Q

What types of seizures can phenytoin be used for?

A

Generalised tonic-clonic, focal

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4
Q

What is the pharmacology of phenytoin?

A

Has non linear pharmacokinetics, narrow therapeutic index, plasma protein bound (requires monitoring) and inducer of CYP enzymes

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5
Q

What are the side effects of phenytoin?

A

Double vision, nystagmus, slurred speech, ataxia, confusion, hyperglycaemia

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6
Q

What type of seizures can carbamazepine be used for?

A

Focal, generalised tonic clonic

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7
Q

What is the pharmacology of carbamazepine?

A

Autoinducer of CYP3A4 (induces its own metabolism)

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8
Q

What are the side effects of carbamazepine?

A

Dose-related: headache, ataxia, blurred vision, nausea, drowsiness, allergic skin reactions)

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9
Q

What kind of seizures can lacosamide be used for?

A

Focal only

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10
Q

What kind of seizures can sodium valproate be used for?

A

All forms of epilepsy BUT must be avoided in women of child-bearing potential.

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11
Q

What kind of seizures can lamotrigine be used for?

A

Focal and generalised tonic clonic

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12
Q

What is the pharmacology of lamotrigine?

A

Has a long half life and thus can be given once daily

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13
Q

What are the side effects of lamotrigine?

A

Nausea, dizziness, ataxia, blurred vision, behavioural changes, serious skin conditions.

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14
Q

Calcium channel blocker MOA?

A

inhibits calcium channels to inhibit the propagation of excitatory neurons

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15
Q

Examples of calcium channel blockers?

A

Levetiracetam, ethosuximide, gabapentin

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16
Q

Calcium channel blocker side effects?

A

GI upset, nausea, vomiting, dizziness, headache

17
Q

Examples of GABA enhancers?

A

benzodiazepines, phenobarbital, primidone, vigabatrin, topiramate

18
Q

Which benzodiazepines are used for maintenance treatment of seizures?

A

Clozabam, clonazepam

19
Q

Which benzodiazepines are used for status epilepticus?

A

Midazolam (IM, buccal, IN)
Diazepam
Lorazepam

20
Q

Side effects of benzos?

A

Drowsiness, sedation

21
Q

MOA of vigabatrin?

A

Inhibits GABA transaminase

22
Q

What is the place in therapy for phenobarbitone/primidone?

A

Primidone is the prodrug of phenobarbital. They can achieve good seizure control but are poorly tolerated due to sedative effect thus other AEDs are used instead.

23
Q

What drugs are preferred for focal seizures?

A

Carbamazepine

Lamotrigine

24
Q

What drugs are preferred for absence seizures?

A

Ethosuximide

25
Q

What drugs are preferred for tonic-clonic seizures?

A

Sodium valproate
Lamotrigine
Carbamazepine - hepatotoxic

26
Q

What drugs are preferred for myoclonic seizures?

A

Sodium valproate

Neurology (6 decks)

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