Epilepsy drugs Flashcards by Evan Cumpston

Phenytoin Indications

1st line - Tonic-Clonic
1st line - status epilepticus prophylaxis
Partial seizures

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Phenytoin MOA

Use-dependent Na channel blocker

Inhibits glutamate release

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Phenytoin Toxicity

Nystagmus/diplopia/ataxia
Sedation
Gingival hyperplasia
Hirsutism
Megaloblastic anemia (decraesed folate absorb)
Teratogenic
Rash
P450 induction
Lymphadenopathy
Stevens-Johnson syndrome
Osteopenia

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Carbamazapine Indications

1st line - Tonic-Clonic

1st line - Partial

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Carbamazapine MOA

Use-dependent Na channel blocker

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Carbamazapine Toxicity

Diplopia/ataxia
Drowsiness
Blood dyscrasias
Teratogen

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Ethosuximide Indications

1st line - Absence

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Ethosuximide MOA

Reduces low threshold (t-type) thalamic Ca channels

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Ethosuximide Toxicity

Gastric distress

Lethargy

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Valproic Acid Indications

1st line - Tonic-clonic
Partial
Absense
Myoclonic

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Valproic acid MOA

Blocks repetitive firing
Reduce T-type Ca currents
Increased GABA concentraions

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Valproic acid Toxicity

GI
Weight gain
Hair loss
Hepatotoxicity
Teratogenic

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Felbamate Indications

Partial seizures refractory to others

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Felbamate MOA

NMDA antagonist (potentiates GABA)

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Felbamate Toxicity

Aplastic anemia

Hepatic failure

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Gabapentin Indications

Adjunct in partial seizures

Pregabalin Indications

Adjunct in partial seizures

Neuropathic pain management

Pregabalin MOA

Reduce neurotransmitter release

Alpha-2-delta of voltage gated Ca channels

Lamotrigine Indications

Partial

Generalized Tonic-Clonic

Lamotrigine MOA

Blocks repetitive action potentials

Blocks voltage gated Na channels

Lamotrigine Toxicity

Steves-Johnson syndrome

Topiramate Indications

Blocks spread of seizures

*add on in partial

Topiramate MOA

Blocks Na channels

Incrases GABA action

Topiramate Toxicity

Fatigue
Confusion
Nausea

Tiagabine Indications

Partial add-on

Tiagabine MOA

Inhibits GABA reuptake, GAT-1

Tiagabine Toxicity

Dizziness Tremor Somnolence

Levetiracetam Indications

Adjunctive in partial Adjunctive in myoclonic Adjunctive in generalized tonic-clonic

Levetiracetam Toxicity

Somnolence Asthenia Dizziness

Zonisamide Indications

Adjunctive treatment in adults with partial seizures | *stops spread*

Zonisamide MOA

Reduces voltage-dependent transient inward current (T-type) | Also works at Na channels

Zonisamide Toxicity

``` Ataxia Anorexia Nervousness Fatigue Speech impairment ```

Vigabatrin Indications

Adjunctive complex partial | Adjunctive infantile spasms

Vigabatrin MOA

Irreversibly inhibits GABA transaminase (and therefore breakdown)

Vigabatrin Toxicity

Permanent effects on vision (restricted prescribing program)

Clobazam Indications

Adjunctive with Lennox-Gastaut syndrome | *severe epilepsy

Clobazam MOA

Blocks voltage gated Na and Ca channels Suppresses neuronal hypersynchronization Inhibits Carbonic anhydrase

Lacosamide Indications

Adjunctive treatment of partial seizures

Lacosamide MOA

Enhances slow inactivation of Na channels