antiepileptics table Flashcards
1
Q
which antiepileptics can cause osteoporosis
what would pt take to alleviate this?
A
- divalproex/valproic acid
- carbamazepine
- oxcarbazepine
- phenytoin
- phenobarbital
- primidone
*
2
Q
divalproex sodium/valproic acid moa
A
GABA
3
Q
divalproex sodium/valproic acid target level
A
50-120mg/L
4
Q
divalproex sodium/valproic acid ADEs of importance
A
- alopecia
- tremor
- DO NOT USE IN PREGNANCY
*
5
Q
what should be monitored with all antiepiletpics
A
suicidiality
6
Q
what should be monitored with valproic acid/ divalproex sodium
A
- ast/alt
- plattlets
- ammonia when pt has pain and fatique
- rx levels
7
Q
tegretol (carbamazepine) levels
A
4-12mg/L (8 ideally)
8
Q
tegretol (carbamazepine) important ADEs
A
- **Ataxia, **
- ** SIADH,**
- rash,
- somnolence
SIADH could lower threshold
9
Q
tegretol (carbamazepine) ddi
A
high risk due to induction of 3A4 and CA2
10
Q
tegretol (carbamazepine) monitoring
A
- CBC,
- ** Sodium, **
- LFT,
- levels, ** remember autoinduction, **
- active metabolite,
- HLA- B*1502 variation in those of asiain descent=increase risk SJS
11
Q
*Trileptal (oxcarbazepine) ddi
A
alos an inducer of p450, less than carbamazepine
12
Q
oral contraceptive with carbamazepine and oxcarbazepine
A
less effective
13
Q
important ade of oxcarbazepine
A
-
ataxia,
* vertigo, - SIADH
14
Q
oxcarbazepine monitoring
A
sodium
15
Q
*Dilantin (phenytoin) important ADE
(suspension and chewables are 100% free acid, capsules are 92%
A
- Lethargy,
- fatigue,
- impaired cognition and coordination,
- gingival hyperplasia (rx should be stopped to tx this)
16
Q
phenyotin interactions
A
many possible
17
Q
Zonegran (zonisamide) important ADE
A
- AVOID SULFA Allergy,
- anorexia,
18
Q
Keppra (levetiracetam) interactions
A
none, 100% renally eliminated
19
Q
Keppra (levetiracetam) important ade
A
- Elevated mood, mood change and agitation
20
Q
Keppra (levetiracetam) monitoring
A
renal function
21
Q
*Luminal (phenobarbital) interactions
A
many
22
Q
*Luminal (phenobarbital) ade
A
- **Ataxia, **
- confusion,
- **nystagmus, **
- rash,
- **bradycardia **
* addiction possible
23
Q
*Luminal (phenobarbital) moa
A
binds GABA= increased cl conductance
24
Q
controlled neuroleptic agents
only highlighted ones not all from list
A
- phenobarbital
- pregabalin
- ezogabine
- cannabidiol
- diazepam nasal spray
25
Neurontin
(gabapentin) dosing
usually TID or more, hard to absorb more than 600mg per dose
26
Neurontin/(gabapentin) ades
* **dizziness, **
* **edema**,
* **ataxia**
27
what antiepileptic can cause vision loss
vigabatrin
28
Topamax (topiramate) addtional tx use?
migraines
29
Topamax (topiramate) important ADEs
* **Cognitive decline**, number one reason to stop
* **ataxia,**
* **weight loss,**
* **nephrolithiasis, **
* **metabolic acidosis**
30
Topamax (topiramate) monitoring
* Adequate hydration (nephrolithasis)
* cognition often limits dosing
31
preffered agent for abscene seizures
ethosuxamide
32
ethosuxamide ade
n,v
33
pregabalin important ade's
* **Angioedema, **/edema,
* ataxia,
*** neuropathy**
34
which antiepiletpic could cause aplastic anemia
felbatol
35
which antiepileptic could be used for LGS for 1yr and older
rufinamide
36
ezogabine important ades
*** tremor,**,
* confusion,
* **vision change**
37
Potiga (ezogabine) important monitioring
* Retinal abnormality,
* QT prolongation
38
which classes of antiepileptics likes to cause SIADH
| implication>?
carbazepine and its derivatives, causes hypervolemic hyponatremia=decreased seizure threshold
39
M/A LGS or Dravet
Syndrome 2 years
and older
Epidiolex
(cannabidiol)
40
Epidiolex (cannabidiol) moa
Low affinity for cannabinoid receptors, no euphoria; multimodal
pathways, structurally
distinct,
41
which antiepileptics can cause ataxia
* carbazepine
* oxcarbazapine
* phenobarbital
* gabapentin
* topiramate
* pregabalin
42
which antiepiletpic is avoived with sulfa allergies
zonisamide
43
which antiepileptic is 100% renal elim
levatriacetam
44
which antiepileptic can cause mood changes
levatriacetam
45
which antiepileptic can cause autoinduction
carpazepine
46
which antiepileptic can cause angioemdema
pregabalin
47
which antiepileptic can cause alopecia
valproate
48
which antiepileptics can cause tremors
valproate and ezogaabine
49
SJS risk with which antepiletpic/allele
carbazapine/ HLAB1502
50
* divalproex/valproic acid
* carbamazepine
* oxcarbazepine
* phenytoin
* phenobarbital
* primidone
*
| what do these have in common?
which antiepileptics can cause osteoporosis
| what would pt take to alleviate this?
51
* N, V, D
* alopecia
* tremor
* DO NOT USE IN PREGNANCY
*
divalproex sodium/valproic acid ADEs of importance
52
* ast/alt
* plattlets
* ammonia when pt has pain and fatique
* rx levels
what should be monitored with valproic acid/ divalproex sodium
53
* **Ataxia, **
* dizziness,
* fatigue and sedation,
* ** SIADH,**
* rash,
* somnolence
* N,V,D
| SIADH could lower threshold
tegretol (carbamazepine) important ADEs
54
high risk due to induction of 3A4 and CA2
tegretol (carbamazepine) ddi
55
* CBC,
* ** Sodium, **
* LFT,
* levels, ** remember autoinduction, **
* active metabolite,
* **HLA- B*1502 variation** in those of asiain descent=increase risk SJS
tegretol (carbamazepine) monitoring
56
* Dizziness,
* somnolence,
* HA, N, V
* **ataxia,**
* fatigue,
*** vertigo,**
* **SIADH**
important ade of oxcarbazepine
57
* Lethargy,
* fatigue,
* **impaired cognition and coordination**,
* **gingival hyperplasia** (rx should be stopped to tx this)
*Dilantin (phenytoin) important ADE
(suspension and chewables are 100% free acid, capsules are 92%
58
* **AVOID SULFA Allergy,**
* somnolence,
* dizziness,
* **anorexia**,
* fatigue
Zonegran (zonisamide) important ADE
59
* Elevated mood, **mood change and agitation**
* somnolence,
* HA, N, V,
* sedation,
* dizziness
Keppra (levetiracetam) important ade
60
* **Ataxia, **
* **confusion,**
* **nystagmus, **
* rash,
* N, V,
* **bradycardia **
*** addiction possible**
*Luminal (phenobarbital) ade
61
* phenobarbital
* pregabalin
* ezogabine
* cannabidiol
* diazepam nasal spray
| what do these have in common?
controlled neuroleptic agents
| only highlighted ones not all from list
62
* Somnolence,
* **dizziness, **
* N, V,D,
* **edema**,
* **ataxia**
gabapentin ades
63
* **Cognitive decline**, number one reason to stop
* fatigue,
* **ataxia,**
* somnolence,
* **weight loss,**
* **nephrolithiasis, **
* **metabolic acidosis**
Topamax (topiramate) important ADEs
64
* **Angioedema, **/edema,
* dizziness,
* somnolence,
* ataxia,
* HA,
*** neuropathy**
pregabalin important ade's
65
* Dizziness,
*** tremor,**
* somnolence,
* confusion,
* fatigue,
* **vision change**
ezogabine important ades
66
* carbazepine
* oxcarbazapine
* phenobarbital
* gabapentin
* topiramate
* pregabalin
| what do these have in common?
which antiepileptics can cause ataxia
67
50-120mg/L
divalproex sodium/valproic acid target level
68
4-12mg/L (8 ideally)
tegretol (carbamazepine) levels
69
# lamtrigine ADEs
* Nausea,
* edema,
* somnolence,
* rash,
* diplopia,
* ataxia
70
when is lamotrigine DC'd
if rash appears, risk for SJS/TED
