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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
Which AEDs are common inducers?
CBZ Phenobarb phenytoin
26
Which AEDs are inducers but usually dont induce?
OXC Topiramate LTG zonisamide
27
Which AEDs usually inhibit other AEDs
VPA felbamate (must take caution when using this with multiple AEDs)
28
Which AEDs are free of interactions
- gabapentin - keppra - pregabalin - vigabatrin
29
All the Na channel AEDs
CBZ LTG Phenytoin Topamax VPA Zonisamide
30
AEDs that block T type voltage gated Ca channels
Ethosuxamide VPA zonisamide
31
Low protein binding AEDs
Gabapentin Levitiracetam Vigabatrin Ethosuxamide ***slippery GLoVE makes it hard to bind protein***
32
High protein binding AEDs
VPA Tiagabine Phenytoin CBZ ***Very Tight Protein Connection***
33
Surgery can be used to treat seizures
jk
34
Vagus nerve stimulation can also be used to treat refractory seizures
just know
35
Procedure commonly used palliatively for those suffering from generalized szs?
corpus callosotomy
36
Post op patients s/p corpus callosotomy can have?
L limb apraxia
37
Hemispherectomy can be used to treat seizures in
Sturge Weber Syndrome Hemimegalencephaly Antinatal MCA/ICA strokes Rasmussen Encephalitis Diffuse cortical dysplasia **Hemispherectomy leaves SHARDs of brain tissue everywhere!**
38
Rasmussen Encephalitis presents with
Epilepsia Partialis Continua (EPC) This is a focal motor status epilepticus that leads to progressive hemiparesis and progressive atrophy is seen on MRI
39
What receptor is assoc with Rasmussen Encephalitis
Glu R3
40
Common supplement to help tx for neonatal seizures
B6 pyridoxine
41
Ketogenic can also successfully tx seizures
just know
42
In what patients is keto diet contraindicated?
**Pyr**uvate carboxylase def **A**cute intermittent porphyria **M**yoclonic epilepsy with ragged red fibers **M**ELAS (mitochondrial epilepsy with Lactic acidosis and stroke like episodes) **C**ytochrome oxidase def **c**arnitine def Free fatty acid **o**xidation defects **PYRuvian COMA**
43
Special considerations for women with epilepsy?
AEDs that induce can lower OCP levels and cause pregnancy
44
In pregnancy, the goal is to maintain seizure freedom, monotherapy is preferred. Even if its not a safe preg drug
just know
45
Infants born to women taking AED inducing drugs are at higher risk for
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
New adjunct recommendation therapy for AEDs
Some concern for bone health, can ask patients to take Ca supplements if on AEDs long term
47

Laughing Your Way Neurology (6 decks)

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