Antiepileptics

Question 1

Carbamazepine (Tegretol)

Therapeutic Plasma Level:
4–12 mcg/mL

Answer 1

Used to treat: Focal and Generalized Tonic Clonic Seizures

Chemically related to tricyclic antidepressants

Can WORSEN myoclonic or absence seizures

Autoinduction of hepatic enzymes

Question 2

Oxcarbazepine (Trileptal)

Answer 2

Used to treat: Focal and Generalized Tonic Clonic Seizures

Chemical Analogue of Carbamazepine

Question 3

Levetiracetam (Keppra)

Therapeutic Plasma Level:
12–46 mcg/mL

Answer 3

Used to treat: Focal Seizures

Adjunct therapy

CNS Depression*

Question 4

Gabapentin (Neurontin)

Answer 4

Used to treat: Focal Seizures and Newly onset epilepsy-neuropathic pain

Chemical Analogue of GABA

CNS Adverse Effect*

Question 5

Phenobarbital

Therapeutic Plasma Level:
10–40 mcg/mL

Answer 5

Used to treat: Focal and Generalized Tonic Clonic Seizures

Sedation and Fatigue

Long Half-Life = Once Daily Dose

Enzyme inducer, increasing metabolism of drugs it interacts with

Question 6

Phenytoin

Therapeutic Plasma Level:
10–20 mcg/mL

Answer 6

Used to treat: Focal and Generalized Tonic Clonic seizures

Highly Protein Bound

Contraindicated in heart conditions that involve bradycardia

*Adverse Effects: Lethargy, abnormal movements, mental confusion, cognitive changes

Gingival Hyperplasia with long-term use

Toxic Levels can cause: Nystagmus, Ataxia, Dysarthria, and Encephalopathy

Question 7

Pregabalin (Lyrica)

Answer 7

Used to treat: Focal Seizures and Neuropathic Pain

Adjunct Therapy

Structurally Related to GABA

Schedule V Controlled Substance

CNS Depression

Question 8

Valproic Acid

Therapeutic Plasma Level:
50–125 mcg/mL

Answer 8

Used to treat: Focal, Generalized Tonic Clonic, Absence, Myoclonic Seizures, and Bipolar

Highly Protein Bound