Epilepsy drugs

Question 1

Phenytoin

Answer 1

1st line: generalized tonic clonic, status epilepticus (prophylaxis)
Also: simple partial, complex partial

MOA: increase Na channel inactivation
*Fosphenytoin for parenteral use.

“gingival hyperplasia, ataxia, nystagmus”
“phenyotoin makes you ugly, valproic acid kill you”

Question 2

Carbamazepine

Answer 2

1st line: generalized tonic clonic, partial simple, partial complex

MOA: increase Na channel inactivation
1st line for trigeminal neuralgia

“aganglocytosis, SIAHD, SJS(chinese)”

Question 3

Lamotrigine

Answer 3

Use: partial simple, partial complex, generalized tonic clonic

MOA: blocks voltage gated Na+ channels
*SJS (the biggest cause, need to titrate)

Question 4

Gabapentin

Answer 4

Use: partial simple, partial complex, generalized tonic clonic

MOA: primarily inhibit high voltage activated Ca2+ channel
Also used for peripheral neuropathy, postherpetic neuralgia, migraine prophylaxis, biopolar disorder

Question 5

Topiramate

Answer 5

Use: partial simple, partial complex, generalized tonic clonic

MOA: blocks Na+ channel, increase GABA action
Also used for migraine prevention
“also called dopamax bc it slows you down”
“Kidney stone”

Question 6

Phenobarbital

Answer 6

Use: partial simple, partial complex, generalized tonic clonic

MOA: increase GABAa action
1st line in chilren
“Same as benzos”
“Phenobarbital=BArbital=BARBIE (kids)”

Question 7

Valproic acid

Answer 7

1st line: generalized tonic clonic
Use:partial simple, partial complex, generalized absence

MOA: increase Na channel inactivation,
increase GABA concentration
“USE IT FOR MYOCLONIC seizures”

“neural tube defects, fulminant hepatitis”
“yellow, fat, ugly, bold”

Question 8

Ethosuximide

Answer 8

1st line: absence

MOA: blocks thalamic T type Ca2+ channels
also Gabapentin

Question 9

Benzodiazepine (diazepam or lorazepam)

Answer 9

1st line: status epilepticus (1st line for acute)

MOA: increases GABAa action
Also used for seizures of eclampsia (1st line is MgSO4)

Question 10

Tiagabine

Answer 10

Use: partial simple, partial complex

MOA: blocks GABA reuptake

Question 11

Vigabatrin

Answer 11

Use: partial simple, partial complex

MOA: irreversibly inhibit GABA transamidase, so increase GABA

Question 12

Levetiracetam

Answer 12

Use: partial simple, partial complex, generalized tonic clonic

MOA: unknown, may modulate GABA and glutamate release.

Question 13

Kid had absence seizures but develops tonic clonic…

Answer 13

valproic acid.

Question 14

CAPHE

VALET

Answer 14

CAPHE: carpamezepine, phenytoin, phenobarbital
used for partial

VALET: valproic acid, ethoxumide for generalized
but ethoxumide for absence