BMB 2 - Anti-Seizure Medications Flashcards
What is the anti-seizure mechanism of action of phenobarbital?
Binds GABA-A;
prolongs duration of Cl- channels
What is the anti-seizure mechanism of action of phenytoin?
Inactivates Na+ channels
What is the anti-seizure mechanism of action of carbamazepine?
Inactivates Na+ channels
What is the anti-seizure mechanism of action of lamotrigine?
Inactivates Na+ channels
What is the anti-seizure mechanism of action of ethosuximide?
Blocks T-type Ca2+ channels
What is the anti-seizure mechanism of action of gabapentin?
Blocks presynaptic Ca2+ channels
What is the anti-seizure mechanism of action of pregabalin?
Blocks presynaptic Ca2+ channels
What is the anti-seizure mechanism of action of levetiracetam?
Decreases neurotransmitter release (via SAV2 inhibition)
What is the anti-seizure mechanism of action of valproate?
Blocks Na+ channels;
increases GABA
What is the anti-seizure mechanism of action of topiramate?
Blocks Na+ channels;
increases GABA
How is status epilepticus treated?
IV lorazepam + broad-spectrum anti-epileptic drugs
(If refractory, add more anesthetic agents.)
Which anti-epileptic medication is especially useful in treating neonatal seizures?
Phenobarbital
Which barbituate is useful in treating essential tremor?
Primidone
Name the broad-spectrum anti-seizure medications.
Valproate
Lamotrigine
Topiramate
Zonisamide
Levetiracetam
Name the narrow-spectrum anti-seizure medications.
Phenytoin
Phenobarbital
Carbamazepine
Oxcarbazepine
Gabapentin
Ethosuximide
Name the anti-seizure medications that are useful in treating focal seizures.
Carbamazepine
Oxcarbazepine
Lamotrigine
Topiramate
Gabapentin
Valproate
Name the anti-seizure medications that are useful in treating generalized seizures.
Lamotrigine
Valproate
Topiramate
Name the anti-seizure medications that are useful in treating absence seizures.
Ethosuximide
Which anti-seizure medications are relatively low-risk for pregnant patients?
Gabapentin
Lamotrigine
Levetiracetam
Which anti-seizure medications are relatively high-risk for pregnant patients?
Valproate
Phenobarbital
Primidone
Phenytoin
Carbamazepine
Oxcarbazepine
Topiramate
What are the teratogenic effects of valproate?
Cardiac, cleft, cognitive, and neural tube defects; hypospadias
What are the teratogenic effects of phenobarbital or primidone?
Cardiac defects
What are the teratogenic effects of phenytoin?
Cleft palate
What are the teratogenic effects of carbamazepine or oxcarbazepine?
Neural tube defects
What are the teratogenic effects of topiramate?
Cleft lip, hypospadias, low birth weight
Name some of the anti-seizure medications that are GABA-ergic.
Phenobarbital, primidone (the barbituates)
Name some of the anti-seizure medications that are sodium channel blockers.
Phenytoin, carbamazepine, oxcarbazepine, lamotrigine
Name some of the anti-seizure medications that are calcium channel blockers.
Ethosuximide, gabapentin, pregabalin
Name some of the anti-seizure medications that are SAV2 inhibitors.
Levetiracetam
Name some of the anti-seizure medications that have multiple drug targets.
Valproate, topiramate
(Hence why they are broad-spectrum.)
Which anti-seizure medications are P450 inducers?
Carbamazepine, phenobarbital, phenytoin, primidone
(to a smaller extent, also topiramate and oxcarbazepine)
Which anti-seizure medications are P450 inhibitors?
Valproate
What are the major potential negative side effects of phenobarbital use?
Renal and hepatic toxicities;
decreased bone density
What are the major potential negative side effects of phenytoin use?
Gingival hyperplasia, hirsutisum, dyslipidemia, osteoporosis
Which anti-seizure medication is notable as following zero-order kinetics?
Phenytoin
What are the major potential negative side effects of carbamazepine use?
Black box warning for Steven-Johnson syndrome, especially in patients with HLA-B1502;
also, aplastic anemia
Which two anti-seizure medications carry a risk of triggering Steven-Johnson syndrome?
Carbamazepine, lamotrigine
Ethosuximide use can sometimes result in some ___________ discomfort.
Ethosuximide use can sometimes result in some abdominal discomfort.
What is the main side effect of gabapentin or pregalin use?
Sedation
What is the main side effect of levetiracetam use?
Somnolence
What are the main side effects of valproate use?
Teratogenic, hepatotoxicity, pancreatitis
What are the main side effects of topiramate use?
Weight loss, nephrolithiasis, cognitive slowing
