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pharm 2 > antiepileptics table > Flashcards

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
    *
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2
Q

divalproex sodium/valproic acid moa

A

GABA

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3
Q

divalproex sodium/valproic acid target level

A

50-120mg/L

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4
Q

divalproex sodium/valproic acid ADEs of importance

A
  • alopecia
  • tremor
  • DO NOT USE IN PREGNANCY
    *
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5
Q

what should be monitored with all antiepiletpics

A

suicidiality

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6
Q

what should be monitored with valproic acid/ divalproex sodium

A
  • ast/alt
  • plattlets
  • ammonia when pt has pain and fatique
  • rx levels
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7
Q

tegretol (carbamazepine) levels

A

4-12mg/L (8 ideally)

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8
Q

tegretol (carbamazepine) important ADEs

A
  • **Ataxia, **
  • ** SIADH,**
  • rash,
  • somnolence

SIADH could lower threshold

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9
Q

tegretol (carbamazepine) ddi

A

high risk due to induction of 3A4 and CA2

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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
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11
Q

*Trileptal (oxcarbazepine) ddi

A

alos an inducer of p450, less than carbamazepine

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12
Q

oral contraceptive with carbamazepine and oxcarbazepine

A

less effective

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13
Q

important ade of oxcarbazepine

A
  • ataxia,
    * vertigo,
  • SIADH
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14
Q

oxcarbazepine monitoring

A

sodium

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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)
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16
Q

phenyotin interactions

A

many possible

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17
Q

Zonegran (zonisamide) important ADE

A
  • AVOID SULFA Allergy,
  • anorexia,
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18
Q

Keppra (levetiracetam) interactions

A

none, 100% renally eliminated

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19
Q

Keppra (levetiracetam) important ade

A
  • Elevated mood, mood change and agitation
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20
Q

Keppra (levetiracetam) monitoring

A

renal function

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21
Q

*Luminal (phenobarbital) interactions

A

many

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22
Q

*Luminal (phenobarbital) ade

A
  • **Ataxia, **
  • confusion,
  • **nystagmus, **
  • rash,
  • **bradycardia **
    * addiction possible
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23
Q

*Luminal (phenobarbital) moa

A

binds GABA= increased cl conductance

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24
Q

controlled neuroleptic agents

only highlighted ones not all from list

A
  • phenobarbital
  • pregabalin
  • ezogabine
  • cannabidiol
  • diazepam nasal spray
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25
Q

Neurontin
(gabapentin) dosing

A

usually TID or more, hard to absorb more than 600mg per dose

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26
Q

Neurontin/(gabapentin) ades

A
  • **dizziness, **
  • edema,
  • ataxia
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27
Q

what antiepileptic can cause vision loss

A

vigabatrin

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28
Q

Topamax (topiramate) addtional tx use?

A

migraines

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29
Q

Topamax (topiramate) important ADEs

A
  • Cognitive decline, number one reason to stop
  • ataxia,
  • weight loss,
  • **nephrolithiasis, **
  • metabolic acidosis
30
Q

Topamax (topiramate) monitoring

A
  • Adequate hydration (nephrolithasis)
  • cognition often limits dosing
31
Q

preffered agent for abscene seizures

A

ethosuxamide

32
Q

ethosuxamide ade

A

n,v

33
Q

pregabalin important ade’s

A
  • **Angioedema, **/edema,
  • ataxia,
    * neuropathy
34
Q

which antiepiletpic could cause aplastic anemia

A

felbatol

35
Q

which antiepileptic could be used for LGS for 1yr and older

A

rufinamide

36
Q

ezogabine important ades

A

* tremor,,
* confusion,
* vision change

37
Q

Potiga (ezogabine) important monitioring

A
  • Retinal abnormality,
  • QT prolongation
38
Q

which classes of antiepileptics likes to cause SIADH

implication>?

A

carbazepine and its derivatives, causes hypervolemic hyponatremia=decreased seizure threshold

39
Q

M/A LGS or Dravet
Syndrome 2 years
and older

A

Epidiolex
(cannabidiol)

40
Q

Epidiolex (cannabidiol) moa

A

Low affinity for cannabinoid receptors, no euphoria; multimodal
pathways, structurally
distinct,

41
Q

which antiepileptics can cause ataxia

A
  • carbazepine
  • oxcarbazapine
  • phenobarbital
  • gabapentin
  • topiramate
  • pregabalin
42
Q

which antiepiletpic is avoived with sulfa allergies

A

zonisamide

43
Q

which antiepileptic is 100% renal elim

A

levatriacetam

44
Q

which antiepileptic can cause mood changes

A

levatriacetam

45
Q

which antiepileptic can cause autoinduction

A

carpazepine

46
Q

which antiepileptic can cause angioemdema

A

pregabalin

47
Q

which antiepileptic can cause alopecia

A

valproate

48
Q

which antiepileptics can cause tremors

A

valproate and ezogaabine

49
Q

SJS risk with which antepiletpic/allele

A

carbazapine/ HLAB1502

50
Q
  • divalproex/valproic acid
  • carbamazepine
  • oxcarbazepine
  • phenytoin
  • phenobarbital
  • primidone
    *

what do these have in common?

A

which antiepileptics can cause osteoporosis

what would pt take to alleviate this?

51
Q
  • N, V, D
  • alopecia
  • tremor
  • DO NOT USE IN PREGNANCY
    *
A

divalproex sodium/valproic acid ADEs of importance

52
Q
  • ast/alt
  • plattlets
  • ammonia when pt has pain and fatique
  • rx levels
A

what should be monitored with valproic acid/ divalproex sodium

53
Q
  • **Ataxia, **
  • dizziness,
  • fatigue and sedation,
  • ** SIADH,**
  • rash,
  • somnolence
  • N,V,D

SIADH could lower threshold

A

tegretol (carbamazepine) important ADEs

54
Q

high risk due to induction of 3A4 and CA2

A

tegretol (carbamazepine) ddi

55
Q
  • CBC,
  • ** Sodium, **
  • LFT,
  • levels, ** remember autoinduction, **
  • active metabolite,
  • HLA- B*1502 variation in those of asiain descent=increase risk SJS
A

tegretol (carbamazepine) monitoring

56
Q
  • Dizziness,
  • somnolence,
  • HA, N, V
  • ataxia,
  • fatigue,
    * vertigo,
  • SIADH
A

important ade of oxcarbazepine

57
Q
  • Lethargy,
  • fatigue,
  • impaired cognition and coordination,
  • gingival hyperplasia (rx should be stopped to tx this)
A

*Dilantin (phenytoin) important ADE
(suspension and chewables are 100% free acid, capsules are 92%

58
Q
  • AVOID SULFA Allergy,
  • somnolence,
  • dizziness,
  • anorexia,
  • fatigue
A

Zonegran (zonisamide) important ADE

59
Q
  • Elevated mood, mood change and agitation
  • somnolence,
  • HA, N, V,
  • sedation,
  • dizziness
A

Keppra (levetiracetam) important ade

60
Q
  • **Ataxia, **
  • confusion,
  • **nystagmus, **
  • rash,
  • N, V,
  • **bradycardia **
    * addiction possible
A

*Luminal (phenobarbital) ade

61
Q
  • phenobarbital
  • pregabalin
  • ezogabine
  • cannabidiol
  • diazepam nasal spray

what do these have in common?

A

controlled neuroleptic agents

only highlighted ones not all from list

62
Q
  • Somnolence,
  • **dizziness, **
  • N, V,D,
  • edema,
  • ataxia
A

gabapentin ades

63
Q
  • Cognitive decline, number one reason to stop
  • fatigue,
  • ataxia,
  • somnolence,
  • weight loss,
  • **nephrolithiasis, **
  • metabolic acidosis
A

Topamax (topiramate) important ADEs

64
Q
  • **Angioedema, **/edema,
  • dizziness,
  • somnolence,
  • ataxia,
  • HA,
    * neuropathy
A

pregabalin important ade’s

65
Q
  • Dizziness,
    * tremor,
  • somnolence,
  • confusion,
  • fatigue,
  • vision change
A

ezogabine important ades

66
Q
  • carbazepine
  • oxcarbazapine
  • phenobarbital
  • gabapentin
  • topiramate
  • pregabalin

what do these have in common?

A

which antiepileptics can cause ataxia

67
Q

50-120mg/L

A

divalproex sodium/valproic acid target level

68
Q

4-12mg/L (8 ideally)

A

tegretol (carbamazepine) levels

69
Q

lamtrigine ADEs

A
  • Nausea,
  • edema,
  • somnolence,
  • rash,
  • diplopia,
  • ataxia
70
Q

when is lamotrigine DC’d

A

if rash appears, risk for SJS/TED

pharm 2 (20 decks)

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