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WSU Neuro > Epilepsy: AEDs continuum > Flashcards

Epilepsy: AEDs continuum Flashcards

1
Q

Phenobarbital:

MOA and half-life

A

GABA-A agonist and prolonging opening of Cl channel. 80-100 hours

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2
Q

P450 enzyme inducers

A

phenobarbital, carbamazepine,

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3
Q

Phenobarbital:

Normal levels

A

15-40

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4
Q

Phenobarbital:

Adverse reactions

A

Teratogenic (cardiac/psych), decrease bone density and MSK (Dupuytrens,plantar fibromatosis, frozen shoulder.

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5
Q

Cheapest AED in the developing world.

A

Phenobarbital

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6
Q

Only AED that is NOT effective for focal seizures

A

ethosuximide (clobazam and rufinamide are not FDA approved)

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7
Q

AEDs best (Class 1 trials) for GTC

A

Lamotrigine (LTG), topiramate, levetiracetam, perampanel

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8
Q

AEDs for Absence

A

ETX > VPA = LTG

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9
Q

Best AED for Generalized myoclonic seizures

A

Keppra

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10
Q

AEDs with low or intermediate bio-availability

A

Neurontin, Ezogabine

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11
Q

AEDs with high protein binding (>85%)

A

PHT,CBZ,VPA,Clobazam, Tiagabine, Perampanel

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12
Q

AEDs with absent or minimal interactions

A

Gabapentin,Pregabalin, Topiramate, Keppra, Lacosamide, Vigabatrin

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13
Q

AEDs with long half lives (>30 hours)

A

PB, ETX, Zonisamide, Perampanel

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14
Q

Primidone:

MOA

A

25% converted to PB

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15
Q

Hepatic Enzyme inducers (5)

A

PHT, CBZ, Barbituates OXC TP, (PC BOT)

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16
Q

AEDs that are mainly renal excreted (3)

A

Gabapenting, Keppra, TP

17
Q

AEDs with weight loss (2)

A

TP, Zonisamide

18
Q

AEDs with migraine indication (3)

A

TP, Gabapentin, VPA

19
Q

AEDs with IV form available (4)

A

PHT(fospht), CPA, Barbituates, BZD

20
Q

AEDs with once daily dosing (4)

A

PHT, Zonisamide, VPA, PB

21
Q

Two AEDs to definitely avoid in women

22
Q

What things (4) reduce bioavailability of PHT

A

calcium,antacids,NG feedings,

23
Q

What meds can cause the accumulation (4) of PHT ?

A

Fluoxetine, azoles, amiodarone, isoniazid

24
Q

5 situations which will increase the protein free fraction.

A

hepatic and renal failure

malnutrition, pregnancy, old age

25
Q

At what dosage is there a disproportionate increase in serum PHT

26
Q

Two side effects of IV PHT

A

hypotension and aarhythmias

27
Q

CBZ: What you have to check in the asian population before giving.

28
Q

Unique thing about CBZ metabolism.

A

auto-induction for 2-4 weeks

29
Q

The one side effect that OXC has more than CBZ

A

hyponatremia (CI with diuretic)

30
Q

AED associated with hyperammonemia and reversible parkinsonism

31
Q

When does bioavailability of gabapentin

A

above 300mg

32
Q

Keppra: MOA

A

binding to synaptic vesicle protein SV2A decreaseing NT release

33
Q

Which AED is related to sulfonamides ?

A

Zonisamide

34
Q

AED for infantile spasms esp with tuberous sclerosis

A

Vigabatrin

35
Q

Major side effect of vigabatrin

A

retinal toxicity, requires close monitoring and d/c if not effective in 3 months

WSU Neuro (10 decks)

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