ASM [Antiseizure Medications]/ Treatments Flashcards
2020 AES Summary of ASM in the United States +
adrenocorticotropic
hormone
(ACTH)
epileptic spasms
BRAND NAME of:
clonazepam
(CZP)
Klonapin
clonazepam (CZP) | Klonapin
FDA approved to treat…
LGS, myoclonic and absence seizures
BRAND NAME of:
felbamate
(FBM)
Felbatol
felbamate (FBM) | Felbatol
FDA approved to treat …
Adult refractory focal seizures
Adjunctive treatment in LGS
BRAND NAME of:
everolimus
(EVL)
Zortress, Afinitor
everolimus (EVL) | Zortress, Afinitor
FDA approved to treat …
Adjunctive Treatment Tuberous Sclerosis Complex assoc. focal Seizures
BRAND NAME of:
clobazam
(CLB)
Onfi
clobazam (CLB) | Onfi
FDA approved to treat …
Adjunctive Treatment for LGS
BRAND NAME of:
rufinamide
(RUF)
Banzel
rufinamide (RUF) | Banzel
FDA approved to treat …
Adjunctive Treatment for LGS
BRAND NAME of:
vigabatrin
(VGB)
Sabril
vigabatrin (VGB) | Sabril
FDA approved to treat …
Monotherapy: Epileptic Spasms
Adjunctive Therapy: Refractory FIAS (Focal Impaired Awareness Seizures)
BRAND NAME of:
fenfluramine
(FEN)
Fintepla
fenfluramine (FEN) | Fintepla
FDA approved to treat …
Dravet Syndrome
BRAND NAME of:
stiripentol
(STP)
Diacomit
stiripentol (STP) | Diacomit
FDA approved to treat …
Dravet Syndrome
as Adjunctive Treatment with clobazam
BRAND NAME of:
cannabidiol
(CBD)
Epidiolex
cannabidiol (CBD) | Epidiolex
FDA approved to treat …
Seizures associated with: LGS, Tuberous Sclerosis Complex, Dravet Syndrome
BRAND NAME of:
carbamazepine
(CBZ)
Tegretol
carbamazepine (CBZ) | Tegretol
FDA approved to treat …
Focal onset sz, GTC sz, mixed sz types
BRAND NAME of:
topirmate
(TPM)
Topamax
topirmate (TPM) | Topamax
FDA approved to treat …
Focal onset & GTC sz
Adjunctive treatment in LGS
BRAND NAME of:
valproic acid & divalproex sodium
(VPA)
Depakene, Depakote
valproic acid & divalproex sodium (VPA) | Depakene, Depakote
FDA approved to treat …
Monotherapy: focal onset & absence sz
Adjunctive treatment: multiple sz types, including absence
BRAND NAME of:
primidone
(PRM)
Mysoline
primidone (PRM) | Mysoline
FDA approved to treat …
Monotherapy: focal onset and Tonic Clonic sz’s
BRAND NAME of:
phenytoin
(PHT)
Dilantin
BRAND NAME of:
fosphenytoin
(FOS)
Cerebyx
Difference between phenytoin and fosphenytoin
-phenytoin is an oral med
-fosphenytoin is the IV formulation (used for status epilepticus and for short-term use when unable to give meds orally)
phenytoin (PHT), fosphenytoin (FOS) | Dilantin, Cerebyx
FDA approved to treat …
focal onset & GTC seizures
BRAND NAME of:
phenobarbital
(PB)
Luminal
phenobarbital (PB) | Luminal
FDA approved to treat …
Focal & Generalized Onset seizures
BRAND NAME of:
perampanel
(PER)
Fycompa
perampanel (PER) | Fycompa
FDA approved to treat …
Focal Onset seizures
Adjunctive treatment for Primary GTC sz
BRAND NAME of:
levetiracetam
(LEV)
Keppra
levetiracetam (LEV) | Keppra
FDA approved to treat …
Focal onset seizures
Adjunctive Treatment: myoclonic sz in JME, primary Tonic Clonic seizures
BRAND NAME of:
lamotrigine
(LTG)
Lamictal
lamotrigine (LTG) | Lamictal
FDA approved to treat …
Withdrawal to monotherapy: Focal Onset
Adjunctive Treatment: Focal onset, LGS, primary Tonic Clonic Seizures
BRAND NAME of:
ethosuximide
(ESM)
Zarontin
ethosuximide (ESM) | Zarontin
FDA approved to treat …
Absence Seizures
BRAND NAME of:
brivaracetam
(BRV)
Briviact
brivaracetam (BRV) | Briviact
FDA approved to treat …
Focal onset sz
BRAND NAME of:
gabapentin
(GBP)
Neurontin
gabapentin (GBP) | Neurontin
FDA approved to treat …
Adjunctive treatment for focal seizures
BRAND NAME of:
eslicarbazepine
(ESL)
Aptiom
eslicarbazepine (ESL) | Aptiom
FDA approved to treat …
Focal onset seizures
BRAND NAME of:
cenobate
(CNB)
Xcapri, Ontozry
cenobate (CNB) | Xcapri, Ontozry
FDA approved to treat …
Focal onset seizures
BRAND NAME of:
zonisamide
(ZNS)
Zonegran
zonisamide (ZNS) | Zonegran
FDA approved to treat …
Adjunctive treatment for focal onset seizure
BRAND NAME of:
tiagabine
(TGB)
Gabitril
tiagabine (TGB) | Gabitril
FDA approved to treat …
Adjunctive treatment for focal onset seizures
BRAND NAME of:
pregablin
(PGB)
Lyrica
pregablin (PGB) | Lyrica
FDA approved to treat …
Adjunctive treatment for focal onset seizures
BRAND NAME of:
oxycarbazepine
(OXC)
Trileptal
oxycarbazepine (OXC) | Trileptal
FDA approved to treat …
Focal onset seizures
BRAND NAME of:
lacosamide
(LCM)
Vimpat
lacosamide (LCM) | Vimpat
FDA approved to treat …
Focal onset seizures
Broad Spectrum ASMs (treat both focal and gen. onset sz)
brivaracetam (BRV) | Briviact
clobazam (CLB) | Onfi
felbamate (FBM) | Felbatol
lamotrigine (LTG) | Lamictal
levetiracetam (LEV) | Keppra
perampanel (PER) | Fycompa
rufinamide (RUF) | Banzel
topirmate (TPM) | Topamax
valproic acid & divalproex sodium (VPA) | Depakene, Depakote
zonisamide (ZNS) | Zonegran
Narrow Spectrum ASMs (treat focal onset sz)
carbamazepine (CBZ) | Tegretol
cenobate (CNB) | Xcapri, Ontozry
eslicarbazepine (ESL) | Aptiom
gabapentin (GBP) | Neurontin
lacosamide (LCM) | Vimpat
oxycarbazepine (OXC) | Trileptal
phenobarbital (PB) | Luminal
phenytoin (PHT) | Dilantin
pregablin (PGB) | Lyrica
primidone (PRM) | Mysoline
stiripentol (STP) | Diacomit
tiagabine (TGB) | Gabitril
vigabatrin (VGB) | Sabril
ASM for absence sz
ethosuximide (ESM) | Zarontin
This AMS may worsen or precipitate myoclonic sz
lamotrigine (LTG) | Lamictal
These AMS have a potential to worsen certain generalized sz types
eslicarbazepine (ESL) | Aptiom
gabapentin (GBP) | Neurontin
oxycarbazepine (OXC) | Trileptal
tiagabine (TGB) | Gabitril
vigabatrin (VGB) | Sabril
Tell me about the ketogenic diet
The classic ketogenic diet (CKD) consists of a high-fat and low-protein and carbohydrate diet, with restricted calories and fluids. The diet mimics the fasting state, altering the metabolism to use fats as a primary fuel source; catabolism of fatty acids in the liver produces ketone bodies (KB), which induces urinary ketosis.
Besides medication what other epilepsy treatment options are there?
Ketogenic diet, VNS (vagal nerve stimulator), DBS (deep brain stimulator), RNS (responsive neurostimulator)
Bensodiazepines reduce
REM sleep
Phenytoin at toxic levels makes EEG:
Slows alpha frequency to theta range
At higher toxicity levels delta activity appears.
Side effect of phenytoin [PHT]
Gum hypertrophy and coarsening of facial features