Epilepsy Drugs Flashcards
Ethosuximide Use:
1st line Absence
Ethosuximide mech:
Blocks thalamic T-type Ca++ channels
Ethosuxmide SE:
GI, Fatigue, headache, urticaria, Steven-Johnson syndrome. EFGHIJ
Benzodiazepines (diazepam, lorazepam) clinical use?
1st line for acute Status epilepticus; Also for eclampsia seizures (MgSO4 is first line)
Benzodiazepine mech
Increase GABA(A) action
Benzodiazepine SE
Sedation, Tolerance, Dependence, Respiratory Depression
Phenytoin clinical Use:
First Line Tonic-Clinic. First Line-prophylaxis for Status Epilepticus. Also Treats Simple and Complex Seizures
Phenytoin mech
Increase Na+ channel inactivation; zero-order kinetics
Phenytoin SE:
Nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, peripheral neuropathy, megaloblastic anemia, teratogenesis (fetal hydantoin syndrome) SLE-Like syndrome, induction of CYP-450, lymphadenopathy, Stevens-Johnson Syndrome, Osteopenia
What do you use for parenteral Use?
Fosphenytoin
Carbamazepine Clinical use?
First line for Simple, Complex, and Tonic-clonic. Also first line for trigeminal neuralgia
Carbamazepine mech
increase Na channel inactivation
Carbamazepine SE
Diplopia, ataxia, blood dyscrasias (agranulocytosis, aplastic anemia), liver toxicity, teratogenesis, induction of CYP 450-, SIADH, Stevens-Johnson syndrome.
Valproic Acid clinical use?
First line Tonic-Clonic. Also used to treat Simplex, Complex, Tonic-Clonic, Absense. Also used for myoclonic seizures and bipolar disorder.
Valproic Acid Mech:
Increase Na+ channel inactivation, Increase GABA concentration by inhibiting GABA transaminase
Valproic Acid SE:
GI, distress, rare but fatal hepatotoxicity (measure LFTs), neural tube defects in fetus (spina bifida), tremor, weight gain, contraindicated in pregnancy.
Gabapentin Clinical use?
Simple, Complex, Tonic-Clonic Seizures. Also used for peripheral neuropathy, postherpetic neuralgia, migraine prophylaxis, bipolar disorder.
Gabapentin Mech:
Primarily inhibits high voltage activated Ca++ channels; designed as GABA analog
Gabapentin SE:
Sedation, Ataxia
Phenobarbital clinical use:
Simple, Complex, Tonic-Clonic
Phenobarbital Mech:
Increase GABA (A) action
Phenobarbital SE:
Sedation, tolerance, dependence, induction of CYP450, cardiorespiratory depression.