Ch 24 Drugs For Epilesy Flashcards
Two major categories of antiepileptic drugs (AED)
Traditional AEDs
Newer AEDs
Phenytoin [dilantin]
(traditional AED)
needs to be taken with food
Therapeutic uses:
- epilepsy (partial and tonic clonic seizures)
- cardiac dysrhythmias
Adverse effects:
- nystagmus
- sedation
- ataxia
- diplopia
- cognitive impairment
- gingival hyperplasia* (possible pt teaching: good oral hygiene to minimize risk)
- skin rash
- effects pregnancy
- cardiovascular effects
Drug interactions:
-causing decreased effects
- birth control
- warfarin
- glucocorticoids
-causing Increased levels
- diazepam
- isoniazid
- cimetidne
- alcohol*
- valporic acid
Fosphenytoin [Cerebrex]
(traditional AED)
converts to phenytoin when metabolized
Adverse effect:
temp. parethesia and itching mainly in groaing (eduacte pt. on this)
Carbamazepine [Tegretol]
(traditional AED)
-supress high frequency neuronal discharge surrounding seizure foci
Uses:
- epilepsy
- bipolar disorder
Adverse effects:
- neurologic: nystagmus & ataxia
- hematologic: leukopenia,anemia,thrombocytopenia
- birth defects
- dermatologic: rash
Drug interactions:
- warfarin
- birth control
- phenytoin
- phenobarbital
grape fruit juice*
Valporic Acid [depakene,depakote,depacon]
(traditional AED)
Uses:
- epilepsy
- bipolar
- migraine
Adverse effects:
- GI effects
- liver failure
- pancreatitis
Drug interactions:
- phenobarbital
- phenytonin
- topiramate
- meropenem
- imipenem/cilastatin
Ethosuximide [zarontin]
(traditional AED)
*drug of choice for absense seizures*
supressess neurons in the thalamus the are responsible for absense seizures
can cause:
- drowsiness
- dizziness
- lethargy
Phenobarbital
Actions:
- reduces seizures produces sedation
- anticonvulsant barbituate
- potentiates effect GABA
Uses:
- epilepsy (partial & generalized tonic clonic seizures)
- induction of sleep
- sedation
Adverse effects:
- neuropsychologic effects
- dependency*
- nystagmus
- ataxia
Drug interactions:
- birth control
- warfarin
- CNS depreasents
- valporic acid
**DRUG WITHDRAWAL**
Primidone [Mysoline]
(traditional AED)
everything the same as phenobarbital
Oxcarbazepine [oxtellar XR,trileptal]
(newer AED)
indicated for monotherapy and adjunctive therapy or partial seizures in adults and children
Adverse effects:
- dizziness
- drowsiness
- double vision
- nystagmus
- headache
- nausea
- vomiting
- ataxia
- stevens-johnson syndrome
- hyponatremia (sodium concentration below 125 mmol/L)
Lamotrigine [Lamictal]
(newer AED)
Therapeutic use:
- broad spectrum of antiseizure activity
- bipolar syndrome
Adverse Effects:
- dizziness
- diplopia
- blurred vision
- nausea
- vomiting
- headaches
- severe skin reaction
- risk of suicide
GABAPENTIN [neurontin,gralise]
(newer AED)
Therapeutic use:
-adjunctive therapy of partial seizures
Adverse reactions:
-very well tolerated
most common side effects:
- somnolence
- dizziness
- ataxia
- fatigue
- nystagmus
- peripheral edema
Pregabalin [lyrica]
(newer AED)
-adjunctive therapy of partial seizures (paired with diff. med to treat seizures)
Adverse effects:
- dizziness
- somnolence
- blurred vision
- significant weight gain
- difficulty thinking
- headache
- peripheral edema
- dry mouth
- rhabdmyolysis (break down of muscle tissue that release damaging protein into blood)
- hypersensitivity reactions: life-threatening angioedema
