CNS Flashcards
side effects of ethosuximide (4)
Ethosuximide causes Fatigue GI distress Headache Itchiness Stevens-Johnson syndrome
side effects of benzodiazepines (3)
- sedation
- dependence/tolerance
- respiratory depression (less than barbituates)
side effects of phenytoin (10)
- nystagmus, diplopia
- ataxia
- gingival hyperplasia
- hirsuitism
- megaloblastic anemia, peripheral neuropathy
- teratogen (fetal hydantoin syndrome)
- SLE-like syndrome
- cytochrome P-450 induction
- Stevens-Johnson syndrome
- osteopenia
side effects of carbamezapine (8)
- diplopia
- ataxia
- blood dyscrasia (agranulocytosis, aplastic anemia)
- liver toxicity
- teratogen
- cytochrome P-450 induction
- SIADH
- Stevens-Johnson syndrome
side effects of valproic acid (5)
- GI distress
- hepatotoxicity (measure LFTs)
- neural tube defects in fetus (DO NOT USE IN PREGNANCY)
- tremor
- weight gain
side effects of gabapentin (2)
- sedation
2. ataxia
side effects of phenobarbitol (4)
- sedation
- dependence/tolerance
- cytochrome P-450 induction
- cardiorespiratory depression
side effects of topiramate (4)
- sedation
- mental dulling
- kidney stones
- weight loss
side effects of lamotrigine (1)
- Stevens-Johnson syndrome
epilepsy drugs that cause Stevens-Johnson syndrome (4)
- ethosuximide
- phenytoin
- carbamezapine
- lamotrigine
epilepsy drugs that cause SIADH (1)
- carbamezapine
epilepsy drugs that cause kidney stones (1)
- topiramate
epilepsy drugs that cause SLE-like syndrome (1)
- phenytoin
first line tx absence seizures
ethosuximide
first line tx tonic-clonic seizures (3)
- phenytoin
- carbamezapine
- valproic acid
first line tx simple and complex seizures
carbamezapine
acute tx status epilepticus
benzodiazepines
prophylaxis of status epilepticus
phenytoin
first line tx seizure in neonate
phenobarbital
eclampsia seizures treatment
1st line: MgSO4
2nd line: benzodiazepines
treatment trigeminal neuralgia
carbamezapine
ethosuximide mechanism
blocks thalamic T-type Ca channels
benzodiazepines mechanism
increase GABA-A action
phenytoin mechanism
increase Na channel inactivation (zero-order kinetics)
carbamezapine mechanism
increase Na channel inactivation
valproic acid mechanism
increase Na channel inactivation
increase GABA concentration by inhibiting GABA transaminase
gabapentin mechanism
inhibits high-voltage-activated Ca channels
phenobarbital mechanism
increase GABA-A action
topiramate mechanism
blocks Na channels
increase GABA action
lamotrigine mechanism
blocks voltage-gated Na channels
what is levetiracetam used for?
epilepsy
tigabine mechanism
increase GABA by inhibiting reuptake
vigabatrin mechanism
increase GABA by inhibiting GABA transaminase
what epilepsy drugs cause megaloblastic anemia (1)
- phenytoin
what epilepsy drugs cause agranulocytosis and aplastic anemia (1)
- carbamezapine
what epilepsy drugs cause hepatotoxicity (2)
- carbamezapine
2. valproic acid
drug class phenobarbital
barbituate
drug class pentobarbital
barbituate
drug class thiopental
barbituate
drug class secobarbital
barbituate
barbituate mechanism
facilitate GABA-A action by increase duration of Cl channel opening
can you use barbituates in porphyria?
NO!
side effects of barbituates (4)
- respiratory/cardiovascular depression
- CNS depression (worse with EtOH)
- dependence
- induces cytochrome P-450
overdose tx for barbituates
supportive (maintain breathing and BP)
drug class diazepam
benzodiazepine
drug class lorazepam
benzodiazepine
drug class triazolam
benzodiazepine
drug class temazepam
benzodiazepine
drug class oxazepam
benzodiazepine
drug class midazolam
benzodiazepine
drug class chlordiazepoxide
benzodiazepine
drug class alprazolam
benzodiazepine
mechanism benzodiazepine
facilitate GABA-A action by increase frequency of Cl channel opening
short-acting (more addictive) benzodiazepines
TOM (triazolam, oxazepam, midazolam)
effect of benzodiazepines on sleep
decrease REM sleep
drugs that bind the GABA-A receptor (3)
- barbituates
- benzodiazepines
- EtOH
overdose tx of benzodiazepines
flumazenil (competitive antagonist GABA receptor)
drug class zolpidem
nonbenzodiazepine hypnotic
drug class zaleplon
nonbenzodiazepine hypnotic
drug class esopiclone
nonbenzodiazepine hypnotic