Antiepileptics (CNS depression)

Question 1

Phenytoin

Answer 1

Voltage-gated Na channel stabilizer - for tonic-clonic seizures. good for short term, not long term. hepatic enzyme inducer

Question 2

Carbamezepine

Answer 2

Voltage-gated Na channel stabilizer - more effective for complex partial seizure than primary generalized, bipolar disorder, and neuropathic pain. hepatic enzyme inducer

Question 3

Oxcarbamazepine

Answer 3

Voltage-gated Na channel stabilizer - more effective for complex partial seizure than primary generalized, bipolar disorder, and neuropathic pain. hepatic enzyme inducer . Less toxic than Carbamezepine

Question 4

Lamotrigine

Answer 4

Voltage-gated Na channel stabilizer - more effective for complex partial seizure than primary generalized, bipolar disorder, and neuropathic pain. Very strong hepatic enzyme inducer

Question 5

Voltage-gated Na channel stabilizer side effects

Answer 5

Sedation, ataxia, diplopia (dizzy, drunk, double vision). also rash and contraceptive failure.

Question 6

Valproate (Valproic acid)

Answer 6

Unknown mechanism, likely affects Na-gated channels and GABA system. Does everything, but don’t give if potentially pregnant. - for seizure stuff, bipolar, migraine and long term cluster headache prophylaxis. need to monitor

Question 7

Benzodiazapines

Answer 7

GABAa agonist (GABAergic anti-epileptic) - for status epilepticus = seizures > 5 mins (refractory); anesthesia (sedation dose-limited)

Question 8

Gabapentin

Answer 8

GABA analog; blocks presynaptic influx of Ca (less excitatory neurotransmission) - adjunct for partial complex epilepsy; more common use for neuropathic pain. very non-toxic

Question 9

Pregabalin

Answer 9

GABA analog; blocks presynaptic influx of Ca (less excitatory neurotransmission) - adjunct for partial complex epilepsy; more common use for neuropathic pain. very non-toxic

Question 10

Topiramate

Answer 10

Glutamate receptor blocker; Ca receptor blocker, 2ndary effect at voltage-gaited Na channel, GABA system - for seizure stuff and migraine prevention, and long term prevention of cluster head aches. Word-finding problems. treat with vitamin C

Question 11

Felbamate

Answer 11

Glutamate receptor blocker; NMDA receptor blocker, secondary effect at voltage-gaited Na and Ca channels, GABA system - for seizures

Question 12

Levetiracetam

Answer 12

synaptic vesicle binder (binds synaptic vesicle protein 2) leading to less neurotransmitter release - for seizure stuff. well tolerated

Question 13

Ethosuximide

Answer 13

Voltage-gated Ca channel blocker (in thalami-cortixal circuits) - for absence seizures only and neuropathic pain