Epilepsy Flashcards
What are the 2 types of seizures
- Focal Seizures
- Generalised Seizures
What is the 1st and 2nd Line treatment for Focal seizures
1st Line:
Lamotrigine / Levetiracetam
2nd Line:
Carbemazapine, Oxcarbazepine, Zonisamide
What is the 1st Line treatment for all types of Generalised Seizures
1st Line:
Sodium Valproate
apart from Absence Seizure
==> Ethosuximide
What is the 2nd Line treatment for Tonic-clonic and Absence seizure with others
Levetiracetam / Lamotrigine
What is the 2nd Line treatment for Atonic and Tonic seizures
Lamotrigine
What is the 2nd Line treatment for Myoclonic seizures
Levetiracetam
What is the 2nd Line treatment for for Absence seizure on its own
Sodium Valproate
What is the 1st Line treatment for status Epilepticus in Community
- Rectal Diazepam
- Buccal Midazolam
What is the 1st Line treatment for status Epilepticus in Hospital
IV Lorazepam
What is the 2nd Line treatment for status Epilepticus in both community and hospital
if unresponsive for 5 to 10 mins
- re administer 1st Line
What is the 3rd Line treatment for status Epilepticus in both community and hospital
- Levitiractam
- Phenytoin
- Sodium Valproate
What is the 4th Line treatment for status Epilepticus in both community and hospital
- Phenobarbital
- Generalised Anaesthesia
Which drugs interact with Carbamazaepine, Phenytoin, Sodium Valproate to induce hepatotoxicity
- Amiodarone
- Itraconazole
- Macrolides
- Alcohol
Which drugs interact with Carbamazaepine, Phenytoin, Sodium Valproate to lower seizure thresholds
- Tramadol
- Theophylline
- Quinolones
Phenytoin + Anti Folates Interaction
Anti Folates (methotrexate, trimethoprim)
Phenytoin causes folate deficiency
Carbamazepine + Hyponatraemic Drugs Interaction
They interact as Carbamazepine causes hyponatraemia
What is the Therapeutic Range of Carbamazepine
4 to 12 mg/L
What is the Therapeutic Range of Phenytoin
10 to 20mg/L
(same as theophylline)
What are the signs of Carbamazepine toxicity
HAND BAG
H hyponatraemia
A ataxia
N nystagmus
D drowsiness
B blurred vision
A arrhythmias
G gi disturbances
What are the signs of Phenytoin toxicity
SNACHED
S slurred speech
N nystagmus
A ataxia
C confusion
H hyperglycaemia
D double vision
What are the side effects of Carbamazaepine, Phenytoin, Sodium Valproate
- Depression/suicide
- Hepatotoxicity
- Hypersensitivity
- Blood Dyscrasia
- Vitamin D deficiency
Carbamazepine specific Side effects
- Hyponatraemia
- Oedema
Phenytoin specific Side effects
- Coarsening appearance
- Facial hair
Sodium Valproate specific Side effects
- Pancreatitis
- Teratogenic
What is the main side effects of Lamotirgine
Skin Rash ==> Stevens Johnsons Syndrome
What is the main Vigabatrin Side effect
Encephalopathy
Which anti-epilpetics cause Respiratory Depression
- Pregabalin
- Gabapentin
Which Anti-epileptic medications cause Blood Dyscrasias
C.VET.PLZ
C carbamazepine
V valproate
E ethosuximide
T topiramate
P phenytoin
L lamotrigine
Z zonisamide
