Epilepsy Drugs

Question 1

What are the 5 kinds of seizures? What class do they belong to?

Answer 1

Partial
Simple, Complex

Generalized
Tonic Clonic, Absence, Status Epilepticus

Question 2

Ethosuxamide
Type of Seizures?
MOA:
SE

Answer 2

For ABSENCE seizures only

Blocks T-type Ca channels on neurons in the THALAMUS hence t-type

SEs: 
Fatigue
GI Distress
HA 
Itching
Steven Johnson

Question 3

Benzos specifically Diazepam, Lorazepam
MOA
SEs

Answer 3

First Line for STATUS EPILEPTICUS

GABAa Action INCREASE ACTION

SEs: Sedation (falling in the daytime withthe longer lasting ones ie flurozepam, diazepam, chlorepoxidam; higher abuse potential with the shorter acting ones ie alprozelam, oxazepam, triazepam

Also for eclampsia seizures, but first line for that MgSO4

Question 4

Phenytoin
MOA
SEs

What version can be used parenterally?

Answer 4

Every seizure EXCEPT ABSENCE seizures

Inactivate Na channels by trapping them in the inactive state; zero order kinetics

GINGIVAL HYPERPLASIA, HIRSUITISM, SLE symptoms, megaloblastic anemia; induce P450

Fosphenytoin for parenteral use

Question 5

Carbamezapine
MOA
SE

Answer 5

First line for Partial (SImple and Complex) & Tonic Clonic, Trig Neuralgia

Inactivate Na Channels (traps it in inactive state)

SEs: Agranulocytosis, aplastic anemia, SIADH, induce P450

Question 6

Valproic Acid
MOA
SE

Answer 6

Anticonvulsant first line for tonic clonic, but works for all except Status Epilectus. Works for bipolar as well

Inactivate Na channel
Increase GABA by blocking GABA transaminase

SEs: Hepatoxicity, Teratogenic (neural tube defects); weight gain, tremor

Question 7

Gabapentin
MOA
SEs

Answer 7

Partial (Simple & Complex), Tonic Clonic

GABA analog that blocks Cav channels

SEs: Sedation, ataxia

Can also be used for peripheral neuropathy, POSTHERPETIC NEURALGIA (think shingles), migraine prophylaxis, Bipolar

Question 8

Phenobarbital

Answer 8

Partial (Simple & Complex), Tonic Clonic

Increase GABA action

SEs: Sedation, tolerance, dependence, induce P450, cardioresp depression

Safe in pregnancy, first line for neonates

Question 9

Topiramate
MOA
SEs

Answer 9

Partial (Simple & Complex), Tonic Clonic; Migraine Prevention

Blocks Na channels and AMPA-R channels
Increase GABA action

SEs: mental dulling, kidney stones

Question 10

Lamotrigine
MOA
SEs

Answer 10

Everything except Status Epilepticus

Block Nav

SEs: STEVEN JOHNSON & TEN
titrate slowly

Question 11

Levitiracetam
MOA
SEs

Answer 11

Partial (Simple & Complex), Tonic Clonic

MOA unknown, may modulate GABA and glutamate

Question 12

Tiagabine
MOA
SEs

Answer 12

Partial Seizures (simple & complex)

Increase GABA by preventing reuptake

Question 13

Vigabatrin

Answer 13

Partial (Simple & complex)

Increase GABA by IRREVERSIBLY inhibiting GABA tranaminase

what other drug blocks GABA transaminase????