Epilepsy Drugs Flashcards by Lauren Chorny

Benzodiazepines - MOA

Increase GABA_A action

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Carbamazepine - MOA

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Ethosuximide - MOA

Blocks thalamic T-type Ca2+ channels

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Gabapentin - MOA

Primirily inhibits high-voltage-activated Ca2+ channels; designed as GABA analog

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Lamotrigine - MOA

Blocks voltage-gated Na+ channels

Inhibits release of glutamate

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Levetiracetam - MOA

unknown

may modulate GABA and glutamate release

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Phenobarbital - MOA

increase GABA_A action

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Phenytoin - MOA

Blocks Na+ channels

zero order kinetics

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Tiagabine - MOA

increase GABA by inhibiting reuptake

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Topiramate - MOA

blocks Na+ channels

Increase GABA action

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Valproic Acid - MOA

increase Na+ channel inactivation

increase GABA concentration by inhibiting GABA transaminase

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Vigabatrin - MOA

Increase GABA

irreverisble GABA transaminase inhibitor

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Benzodiazepines - indications

status epilepticus

also for eclampsia seizures (first line MgSO4)

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Benzodiazepines - side effects

sedation, tolerance, dependence. respiratory depression

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carbamazepine - side effects

diplopia. ataxia, blood dyscrasias (agranulocytosis, aplastic anemia), liver toxicity, SIADH, Stevens-Johnson syndrome

teratogenesis (cleft lip/palate, spina bifida)

induction of cytochrome P450

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carbamazepine - indications

partial (focal) seizures

tonic-clonic seizures

first line trigeminal neuralgia

ethosuximide - indications

absence seizures

ethosuximide - side effects

EFGHIJ

Ethosuximide causes:

Fatigue

GI distress

Headache

Itching (and urticaria)

and stevens-Johnson syndrome

gabapentin - indications

partial (focal) seizures

peripheral neuropathy, postherpetic neuralgia

gabapentin - side effects

sedation, ataxia

lamotrigine - indications

partial (focal) seizures

tonic-clonic seizures

absence seizures

lamotrigine - side effects

stevens-johnson syndrome and toxic epidermal necrolysis

levetiracetam - indications

partial (focal) seizures

tonic-clonic seizures

leveitracetam - side effects

neuropsychiatric symptoms (personality change), drowsiness, fatigue, headache, gait instability

phenobarbital - indications

partial (focal) seizures tonic-clonic seizures status epilepticus \*first line in neonates

phenobarbital - side effects

sedation, tolerance, dependence, cardiorespiratory depression induction of CYP450

phenytoin - indications

partial (focal) seizures tonic-clonic seizures status epilepticus

phenytoin - side effects

PHENYTOIN P450 induction Hirsutism Enlarged gums Nystagmus Yellow-brown skin Teratogen (fetal hydantoin syndrome) Osteopenia Inhibited folate absorption Neuropathy Rare adverse events: SJS, DRESS syndrome, SLE-like syndrome Toxicity -\> diplopia, ataxia, sedation

tiagabine - indications

partial (focal) seizures

topiramate - indications

partial (focal) seizures tonic-clonic seizures migraine prevention

Topiramate - side effects

sedation, mental dulling, word-finding difficulty, kidney stones, weight loss, glaucoma

valproic acid - indications

partial (focal) seizures tonic-clonic seizures absence seizures myoclonic seizures, bipolar disorder, migraine prophylaxis

valproic acid - side effects

GI distress, rare but fatal hepatotoxicity (measure LFTs), pancreatitis, neural tube defects, trumor, weight gain, SJS, SIADH contraindicated in pregnancy

vigabatrin - indications

partial (focal) seizures

vigabatrin - side effects

permanent visual loss