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Neuro Block 2 Pharm > Drugs to treat epilepsy > Flashcards

Drugs to treat epilepsy Flashcards

1
Q

moa of carbamazepine

A

↓Na+ channels

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2
Q

AE of carbamazepine

A

∙ CNS (dizziness/drowsiness, ataxia, vision)
∙ BBW for agranulocytosis
∙ Derm effects rare
∙ constipation or dry mouth, n/v
Screen for HLA-B 1502 in ASIANS (↑risk SJS)

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3
Q

metabolism of carbamazepine

A

HEP (CYP3A4) - inducer

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4
Q

clonazepam MOA

A

GABA allosteric agonist

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5
Q

clonazepam AE

A

somnolence, ataxia, dizziness, fatigue

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6
Q

metabolism of clonazepam

A

HEP (CYP3A4), no induction/inhibition

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7
Q

ethosuximide MOA

A

↓T-type Ca2+ channels

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8
Q

ethosuximide AE

A

somnolence, dizziness, headache, n/v, diarrhea, GI upset

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9
Q

metabolism of ethosuximide

A

HEP (CYP3A4), no induction/inhibition

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10
Q

felbamate MOA

A

∙ ↓NMDA

∙ ↑GABA

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11
Q

AE of felbamate

A

AE: BBW aplastic anemia, BM suppression, hepatic disease

∙ n/v, constipation

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12
Q

metabolism of felbamate

A

M: HEP, CYP inducer & inhibitor

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13
Q

gabapentin MOA

A

∙ ↓alpha-2 delta-1 of Ca2+ channel

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14
Q

gabapentin AE

A

somnolence, dizziness, ataxia, fatigue

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15
Q

metabolism of gabapentin

A

M: NONE, No induction/inhibition

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16
Q

lacosamide MOA

A

∙ ↓Na+ channels

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17
Q

AE of lacosamide

A

dizziness, headache, diplopia, n/v

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18
Q

metabolism of lacosamide

A

M: HEP, CYP (inhibitor)

E: UR DRUG

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19
Q

lamotrigine MOA

A

∙ ↓Na+ channels

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20
Q

lamotrigine AE

A

AE: BBW rash (TEN/SJS), dizziness, diplopia, ataxia, blurred vision, rhinitis

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21
Q

lamotrigine metabolism

A

M: HEP, UGT inducer (no CYP)

22
Q

levetiracetam MOA

A

unknown

23
Q

AE of levetiracetam

A

HA, URTI, somnolence

24
Q

metabolism of levetiracetam

A

M: None, no induction/inhibition
E: UR D & M

25
Q

oxycarbazepine MOA

A

∙ ↓Na+ channels

∙ ↑K+ & ↓Ca2+ channels (possibly)

26
Q

AE of oxycarbzaepine

A

AE: dizziness, diplopia, headache, n/v, nystagmus/somnolence/ataxia

27
Q

Metabolism of oxycarbazepine

A

M: HEP, conjugation
∙ induce & inhibitor
E: UR D & M

28
Q

phenytoin MOA

A

∙ ↓Na+ channels

Fosphenytoin is a pro-drug dose in phenytoin equivalents

29
Q

phenytoin AE

A

∙ CNS (nystagmus, headache, ataxia)
∙ Gingival hyperplasia
∙ Derm effects rare
∙ Hematologic changes (dyscrasias)

30
Q

phenytoin DME

A

D: Highly protein bound
M: HEP, CYP (inducer)
E: Stool, ZERO ORDER ELIMINATION

31
Q

pregabalin MOA

A

∙ ↓alpha-2 delta-1 of Ca2+ channel

32
Q

pregabalin AE

A

dizziness, somnolence, peripheral edema

33
Q

pregabalin metabolism

A

M: none, no induction/inhibition
E: UR DRUG

34
Q

topiramate MOA

A

∙ ↓Na+ channels
∙ ↑K+ current, ↑GABA, ↓glutamate

Weak carbonic anhydrase inhibitor, routine monitoring of serum bicarb required;

35
Q

topiramate AE

A

dizziness, fatigue, ataxia, paresthesias, abnormal vision, psychomotor slowing

36
Q

topiramate metabolism

A

M: minor, no induction/inhibition
E: UR DRUG

37
Q

valproate moa

A

∙ ↑GABA

∙ ↓Na+ channels

38
Q

valproate AE

A

∙ CNS related to infusion rate (dizziness)
∙ Heme = thrombocytopenia, ↑BT
∙ Derm effects are rare
∙ n/v, hepatic tox (KIDS)

39
Q

valproate metabolism

A

M: HEP,CYP & UGT (inhibitor)

40
Q

zonisamide MOA

A

∙ ↓Na+ channels
∙ ↓T-type Ca2+ channels

Weak carbonic anhydrase inhibitor, routine monitoring of serum bicarb required

41
Q

zonisamide AE

A

somnolence, anorexia, dizziness

42
Q

zonisamide DME

A

D: accumulates in RBCs
M: HEP, CYP and UGT
∙ No induction/inhibition
E: UR D & M

43
Q

which drugs are category C

A

lamotrigine

44
Q

which drugs are category D

A

carbamazepine, clonazepam, phenytoin, topiramate

45
Q

which drugs are category X

A

valproate

46
Q

describe fetal hydantoin syndrome

A

craniofacial abnormalities, fingernail hypoplasia, growth deficiency, developmental delay, cardiac defects, clefts

47
Q

3 general MOA for AEDs

A
  1. promote inactive state of Na channel
  2. pre/post enhancement of GABA
  3. inhibition of Ca channels
48
Q

partial & secondarily generalized siezures

A

∙ Lamotrigine
∙ Carbamazepine
∙ Levetiracetam
∙ Oxcarbazepine

49
Q

primary generalized tonic-clonic seizures

A

∙ Valproate
∙ Lamotrigine
∙ Levetiracetam

50
Q

absence seizures

A

∙ Ethosuximide

∙ Valproate

51
Q

atypical absence, myoclonic, atonic seizures

A

∙ Valproate
∙ Lamotrigine
∙ Levatiracetam

52
Q

treatment of SE

A

First - Benzo (IV lorazepam > IM Midazolam)

SEcond - IV AED (valproate)

Neuro Block 2 Pharm (10 decks)

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