Epilepsy drugs

Question 1

ethosuximide: MOA, uses

Answer 1

used for absence seizures. bloocks thalamic T-type Ca receptors

Question 2

Sides effects of ethosuximide

Answer 2

EFGHIJ: fatigue, GI probs, headache, itching, and Stevens-Johnson

Question 3

What drugs are used for seizures in eclampsia?

Answer 3

MgSO4 is first line. after that try benzodiazepines.

Question 4

Uses and MOA of phenytoin

Answer 4

may be used for simple, complex, toni-clonic, and status epilepticus. one of the first line treatments for tonic clonic and first line for prevention of status epilepticus. works by increasing Na channel inactivating. (has zero order kinetics).

Question 5

What are some side effects of phenytoin?

Answer 5

MANY. nystagmus, diplopia, ataxia, gingival hyperplasia, megaloblastic anemia, teratogenesis, SLE-like syndrome, P-450 induction, stevens johnsons, osteopenia, peripheral neuropathy
teratogenesis: fetal hydantoin syndrome of microcephaly, dysmorphic craniofacial features, hypoplastic nales and distal phalanges, cardiac defects, IUGR, and MR.

Question 6

What are the uses of carbamazepine? MOA

Answer 6

first line for simple, complex, tonic clonic (ie. it is first line for every seizure it treats). used for tirgeminal neuralgia. increases Na Channel inactivation.

Question 7

Side effects of carbamazepine?

Answer 7

diplopia, ataxia, blood dyscrasis (agranulocytosis, aplastic anemia), liver, teratogenesis, induction of P-450, SIADH, Steven’s Johnsons
teratogenesis: neural tube defects, craniofacial defects, fingernail hypoplasia, developmental delay, IUGR (seems like fewer cardiac effects than phenytoin?)

Question 8

What is the MOA and uses of valproic acid?

Answer 8

used for all seizures but status epilepticus (simple, complex, tonic-clonic, absence). also used for bipolar and myoclonic siezures. causes Na channel inactivation, increased GABA conc

Question 9

important side effects of valproic acid

Answer 9

rare but fatal hepatotoxicity- measure LFTs, spina bifida in fetus, tremor weight gain

Question 10

What are the first line treatments for tonic clonic seizures?

Answer 10

valproic acid, cabamazepine, and phenytoin

Question 11

First line for acute status epilepticus? What about for prevention of status epilepticus?

Answer 11

acute: benzos; prevention: phenytoin

Question 12

What is the first line treatemnt for seizures in a neonate?

Answer 12

phenobarbital

Question 13

What is gabapentin?

Answer 13

inhibits high voltaged Ca channels and was designed as a GABA analog. may also be used for peripheral neuropathy, postherpetic neuralgia, migrains, bipolar

Question 14

Topiramate: uses, and sides

Answer 14

blocks Na channels and incr. GABA activation

used for simple, complex, tonic-clonic, and migrain. may cause sedation, kidney stones, weight loss

Question 15

Lamotrogine: uses, sides

Answer 15

MUST titrate slowly- can cause Stevens-Johnson

used for simple, complex, tonic clonic, and abscence

Question 16

What is the first line for complex seizures?

Answer 16

carbamazepine