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Laughing Your Way Neurology > Ch 3a - Epilepsy Drugs > Flashcards

Ch 3a - Epilepsy Drugs Flashcards

1
Q

SE of ACTH

A
  • hyperglycemia
  • HTN

immune suppression

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2
Q

MOA and SE of Carbamazepine (carbatrol, tegretol)

A

Sodium channel blocker

  • hyponatremia
  • agranulocytosis
  • liver inducer
  • autoinduction
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3
Q

MOA and SE of ethosuxamide

A

Ca channel blocker

GI side effects

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4
Q

MOA and SE of felbamate

A

Na channel antag, NMDA channel ag, GABA ag

liver failure

aplastic anemia

insomnia

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5
Q

SE of gabapentin

A

inhibits L type Ca channels

peripheral edema

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6
Q

MOA and SE of Lamotrigine

A

Na channel blocker

SJS

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7
Q

MOA and SE of oxcarbazapine

A

Na channel blocker

hyponatremia

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8
Q

MOA and SE of phenobarbital

A

Inc frequency of GABA Cl channel opening

hyperactivity

cognitive disturbance

Dupuytrens Contractures

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9
Q

MOA and SE of Phenytoin/Dilantin

A

Na channel blocker

gum hyperplasia

hypertrichosis

nonlinear kinetics

SLE-like syndrome

cerebellar atrophy

coarsening of facial features

arryhthmias if IV form given too fast

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10
Q

MOA and SE of tigabine

A

blocks GABA uptake

absence status

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11
Q

MOA and SE of topamax

A

NA Channel blocker, enhances chloride currents through GABA receptor

  • weight loss
  • kidney stones
  • oligohydrosis
  • glaucoma
  • metabolic acidosis
  • word finding difficulties
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12
Q

MOA and SE of valproate

A

Na channel blocker, Ca channel blocker

hepatotoxicity

weight gain

PCOS

alopecia

pancreatitis

tremor

hyperammonemia

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13
Q

MOA and SE of vigabatrin

A

Inhibits GABA-transaminase, which breaks down GABA

Vigorous, Irreversible, GABA TRansaminase, INhibitor

visual field deficits

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14
Q

MOA and SE of zonisamide

A

Na and Ca channel blocker

weight loss

kidney stones

oligohydrosis

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15
Q

MOA of keppra

A

binds to SV2A (synaptic vesicle protein), “may” block N type Ca channels and inhibit K channel

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16
Q

MOA of pregabalin (lyrica)

A

modulates P/Q type voltage gated Ca channels

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17
Q

oxcarbazepine vs carbamazepine

A

OXC is rapidly metabolized into MHD, an active metabolite

CBZ creates an epoxide during its metabolism, which is thought to be responsible for the SEs (liver, blood)

OXC > CBZ

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18
Q

AEDs that can worsen myoclonic seizures

A

Carbamazepine

Phenytoin

Gabapentin

Lamotrigine**

Tiagabine

Vigabatrin

**Although LTG can worsten myoclonus, it has been used successfully in JME

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19
Q

AEDs with mood stabilizer SEs

A

CBZ

LTG

OXC

VPA

CLOVe cigarettes help calm you down

20
Q

AEDs with weight loss SEs

A

Felbamate

topiramate

zonisamide

21
Q

AEDs with weight gain SEs

A
  • gabapentin
  • pregabalin
  • VPA
22
Q

AEDs that also help with migraines

A
  • topamax
  • Gabapentin
  • VPA
23
Q

AEDs that help with tremor

A
  • primindone
  • topamax

Topamax and Primindone for Tremor Prevention.

24
Q

Which AEDs are eliminated entirely by the kidneys?

A

Gabapentin

Vigabatrin

Keppra

Nephron-tin, Vigabtrin for Voiding, and Keppra by the kidneys

25
Q

Which AEDs are common inducers?

A

CBZ

Phenobarb

phenytoin

26
Q

Which AEDs are inducers but usually dont induce?

A

OXC

Topiramate

LTG

zonisamide

27
Q

Which AEDs usually inhibit other AEDs

A

VPA

felbamate

(must take caution when using this with multiple AEDs)

28
Q

Which AEDs are free of interactions

A
  • gabapentin
  • keppra
  • pregabalin
  • vigabatrin
29
Q

All the Na channel AEDs

A

CBZ

LTG

Phenytoin

Topamax

VPA

Zonisamide

30
Q

AEDs that block T type voltage gated Ca channels

A

Ethosuxamide

VPA

zonisamide

31
Q

Low protein binding AEDs

A

Gabapentin

Levitiracetam

Vigabatrin

Ethosuxamide

slippery GLoVE makes it hard to bind protein

32
Q

High protein binding AEDs

A

VPA

Tiagabine

Phenytoin

CBZ

Very Tight Protein Connection

33
Q

Surgery can be used to treat seizures

A

jk

34
Q

Vagus nerve stimulation can also be used to treat refractory seizures

A

just know

35
Q

Procedure commonly used palliatively for those suffering from generalized szs?

A

corpus callosotomy

36
Q

Post op patients s/p corpus callosotomy can have?

A

L limb apraxia

37
Q

Hemispherectomy can be used to treat seizures in

A

Sturge Weber Syndrome

Hemimegalencephaly

Antinatal MCA/ICA strokes

Rasmussen Encephalitis

Diffuse cortical dysplasia

Hemispherectomy leaves SHARDs of brain tissue everywhere!

38
Q

Rasmussen Encephalitis presents with

A

Epilepsia Partialis Continua (EPC)

This is a focal motor status epilepticus that leads to progressive hemiparesis and progressive atrophy is seen on MRI

39
Q

What receptor is assoc with Rasmussen Encephalitis

A

Glu R3

40
Q

Common supplement to help tx for neonatal seizures

A

B6 pyridoxine

41
Q

Ketogenic can also successfully tx seizures

A

just know

42
Q

In what patients is keto diet contraindicated?

A

Pyruvate carboxylase def

Acute intermittent porphyria

Myoclonic epilepsy with ragged red fibers

MELAS (mitochondrial epilepsy with Lactic acidosis and stroke like episodes)

Cytochrome oxidase def

carnitine def

Free fatty acid oxidation defects

PYRuvian COMA

43
Q

Special considerations for women with epilepsy?

A

AEDs that induce can lower OCP levels and cause pregnancy

44
Q

In pregnancy, the goal is to maintain seizure freedom, monotherapy is preferred. Even if its not a safe preg drug

A

just know

45
Q

Infants born to women taking AED inducing drugs are at higher risk for

A

hemorrhagic disease of the newborn.

These mothers should take Vit K daily until birth and then infants get Vit K IM at birth normally

46
Q

New adjunct recommendation therapy for AEDs

A

Some concern for bone health, can ask patients to take Ca supplements if on AEDs long term

47
Q
A

Laughing Your Way Neurology (6 decks)

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