epileptic drugs FA Flashcards
12 epilepsy drugs?
- phenytoin
- carbamazepine
- lamotrigine
- gabapentin
- topiramate
- phenobarbitol
- valproic acid
- ethosuximide
- Benzodiazepines (diazepam or lorazepam)
- Tiagabine
- Vigabatrin
- Levetiracetam
phenytoin is used for what general condition? mech?
-epilepsy
increases Na+ channel inactivation
In terms of partial (focal) epilepsy, is phenytoin used in simple epilepsy? in complex?
simple: yes
complex: yes
In terms of Generalized epilepsy, is phenytoin used for tonic-clonic seizures?
absence seizures?
status epilepticus?
- tonic clonic: 1st line
- absence: no
- status epilepticus: 1st line prophylaxis
what is the first line drug for status-epilepticus prophylaxis?
phenytoin
what is the parenteral version of phenytoin?
Fosphenytoin
what are the three first line drugs for Tonic-clonic seizures?
- phenytoin
- carbamazepine
- Valproic acid
In terms of partial (focal) epilepsy, is Carbamezapine used in simple epilepsy? in complex?
- simple: 1st line
2. complex: 1st line
what is the first line drug for simple partial (focal) seizures?
carbamezapine
what is the first line drug for complex partial (focal) seizures?
carbamezapine
In terms of Generalized epilepsy, is carbamezapine used for tonic-clonic seizures?
absence seizures?
status epilepticus?
- tonic clonic: 1st line
- absence: no
- status epilepticus: no
mech of carbamazepine?
increase Na+ channel inactivation
what is the 1st line drug for trigeminal neuralgia?
Carbamazepine
Carbamezapine is a drug used for…
partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
Lamotrigine is a drug used for…
partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
lamotrigine mech…
blocks voltage-gated Na+ channels
In terms of partial (focal) epilepsy, is lamotrigine used in simple epilepsy? in complex?
simple: yes
complex: yes
In terms of Generalized epilepsy, is lamotrigine used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
Gabapentin is a drug used for… (5)
- partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
- peripheral neuropathy
- postherpetic neuralgia
- migraine prophylaxis
- bipolar disorder
Mechanism of Gabapentin?
designed as GABA analogue, but primarily inhibits high-voltage-activated Ca2+ channels
In terms of Generalized epilepsy, is Gabapentin used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
In terms of partial (focal) epilepsy, is Gabapentin used in simple epilepsy? in complex?
simple: yes
complex: yes
Topiramate is a drug used for (2)
- partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
- migraine prevention
what is the mechanism of Topiramate?
blocks Na+ channels, increases GABA action
In terms of partial (focal) epilepsy, is Topiramate used in simple epilepsy? in complex?
simple: yes
complex: yes
In terms of Generalized epilepsy, is Topiramate used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
Phenobarbitol is a drug used for
partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
In terms of Generalized epilepsy, is Phenobarbital used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
In terms of partial (focal) epilepsy, is Phenobarbital used in simple epilepsy? in complex?
simple: yes
complex: yes
what is the mechanism of phenobarbital?
increase GABA- A action
phenobarbital is first line for epilepsy in what population?
children
Gabapentin is a drug used for… (5)
- partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
- peripheral neuropathy
- postherpetic neuralgia
- migraine prophylaxis
- bipolar disorder
Mechanism of Gabapentin?
designed as GABA analogue, but primarily inhibits high-voltage-activated Ca2+ channels
In terms of Generalized epilepsy, is Gabapentin used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
In terms of partial (focal) epilepsy, is Gabapentin used in simple epilepsy? in complex?
simple: yes
complex: yes
Topiramate is a drug used for (2)
- partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
- migraine prevention
what is the mechanism of Topiramate?
blocks Na+ channels, increases GABA action
In terms of partial (focal) epilepsy, is Topiramate used in simple epilepsy? in complex?
simple: yes
complex: yes
In terms of Generalized epilepsy, is Topiramate used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
which epilepsy drug is also used for peripheral neuropathy, postherpetic neuralgia, migraine prophylaxis and bipolar disorder?
Gabapentin
In terms of Generalized epilepsy, is Phenobarbital used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
In terms of partial (focal) epilepsy, is Phenobarbital used in simple epilepsy? in complex?
simple: yes
complex: yes
what is the mechanism of phenobarbital?
increase GABA- A action
phenobarbital is first line for epilepsy in what population?
children
Gabapentin is a drug used for… (5)
- partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
- peripheral neuropathy
- postherpetic neuralgia
- migraine prophylaxis
- bipolar disorder
Mechanism of Gabapentin?
designed as GABA analogue, but primarily inhibits high-voltage-activated Ca2+ channels
In terms of Generalized epilepsy, is Gabapentin used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
In terms of partial (focal) epilepsy, is Gabapentin used in simple epilepsy? in complex?
simple: yes
complex: yes
Topiramate is a drug used for (2)
- partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
- migraine prevention
what is the mechanism of Topiramate?
blocks Na+ channels, increases GABA action
In terms of partial (focal) epilepsy, is Topiramate used in simple epilepsy? in complex?
simple: yes
complex: yes
In terms of Generalized epilepsy, is Topiramate used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
Phenobarbitol is a drug used for
partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
In terms of Generalized epilepsy, is Phenobarbital used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
In terms of partial (focal) epilepsy, is Phenobarbital used in simple epilepsy? in complex?
simple: yes
complex: yes
what is the mechanism of phenobarbital?
increase GABA- A action
phenobarbital is first line for epilepsy in what population?
children
Gabapentin is a drug used for… (5)
- partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
- peripheral neuropathy
- postherpetic neuralgia
- migraine prophylaxis
- bipolar disorder
Mechanism of Gabapentin?
designed as GABA analogue, but primarily inhibits high-voltage-activated Ca2+ channels
In terms of Generalized epilepsy, is Gabapentin used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
In terms of partial (focal) epilepsy, is Gabapentin used in simple epilepsy? in complex?
simple: yes
complex: yes
Topiramate is a drug used for (2)
- partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
- migraine prevention
what is the mechanism of Topiramate?
blocks Na+ channels, increases GABA action
In terms of partial (focal) epilepsy, is Topiramate used in simple epilepsy? in complex?
simple: yes
complex: yes
In terms of Generalized epilepsy, is Topiramate used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
Phenobarbitol is a drug used for
partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
In terms of Generalized epilepsy, is Phenobarbital used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
In terms of partial (focal) epilepsy, is Phenobarbital used in simple epilepsy? in complex?
simple: yes
complex: yes
what is the mechanism of phenobarbital?
increase GABA- A action
phenobarbital is first line for epilepsy in what population?
children
the mechanism of action of Valproic acid?
increase Na+ channel inactivation, increase GABA concentration
Valproic acid is first line for what type of seizures?
tonic-clonic seizures (along with phenytoin and carbamazepine)
Valproic acid is used for what? (2)
- partial (focal) epilepsy (simple and complex) and general epilepsy (tonic-clonic (first line drug) and absence epilepsy)
- myoclonic seizures
which epilepsy drug is also used for myoclonic seizures?
valproic acid
In terms of Generalized epilepsy, is valproic acid used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: first line
absence seizures: yes
status epilepticus: no
In terms of partial (focal) epilepsy, is Valproic Acid used in simple epilepsy? in complex?
simple: yes
complex: yes
which epilepsy drug is first line in children?
phenobarbital
which epilepsy drug is used for migraine prevention
Topiramate
which epilepsy drug is also used for peripheral neuropathy, postherpetic neuralgia, migraine prophylaxis and bipolar disorder?
Gabapentin
Ethosuximide treats what type of epilepsy?
Absence epilepsy (First line!)
what is the first line drug for absence epilepsy?
Ethosuximide
Benzodiazapines (diazepam or lorazepam) are 1st line for what type of epileptic disorder?
status epilepticus
1st line drugs for status epilepticus are…
Benzodiazapines (diazepam or lorazepam)
In addition to being the 1st line drug for status epilepticus, Benzodiazapines (diazepam or lorazepam) are used for what?
seizures of eclampsia (first line is MgSO4)
what is first line for seizures of eclampsia?
MgSO4
mechanism of Benzodiazapines (diazepam or lorazepam)?
increase GABA A receptor frequency
What is Tiagabine?
drug for simple and complex partial (focal) seizures
In terms of partial (focal) epilepsy, is Tiagabine used in simple epilepsy? in complex?
simple: yes
complex: yes
Mechanism of Tiagabine?
Inhibits GABA uptake
In terms of Generalized epilepsy, is Tiagabine used for tonic-clonic seizures?
absence seizures?
status epilepticus?
none, Tiagabine only works for partial (focal) epilepsy (both simple and complex)
What is Vigabatrin?
drug for simple and complex partial (focal) seizures
In terms of partial (focal) epilepsy, is Vigabatrin used in simple epilepsy? in complex?
simple: yes
complex: yes
Mechanism of Vigabatrin?
Irreversibly inhibits GABA transaminase —> increases GABA
In terms of Generalized epilepsy, is Vigabatrin used for tonic-clonic seizures?
absence seizures?
status epilepticus?
none, Vigabatrin only works for partial (focal) epilepsy (both simple and complex)
What is Levetiracetam?
epileptic drug for simple and complex partial (focal seizures) and tonic-clonic seizures
In terms of partial (focal) epilepsy, is Levetiracetam used in simple epilepsy? in complex?
simple: yes
complex: yes
In terms of Generalized epilepsy, is Levetiracetam used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
mech of Levetiracetam?
Unknown– may modulate GABA and glutamate release
4 side effects of benzos?
- sedation
- tolerance
- dependence
- Stevens Johnson Syndrome
Stevens Johnson Syndrome?
prodrome of malaise and fever followed by rapid onset of erythematous/purpuric macules (oral, occular, genital). Skin lesions progress to epidermal necrosis and sloughing.
prodrome of malaise and fever followed by rapid onset of erythematous/purpuric macules (oral, occular, genital). Skin lesions progress to epidermal necrosis and sloughing.
Stevens Johnson Syndrome
Stevens Johnson syndrome is the side effect of what 5 epileptic drugs?
benzodiazepines Carbamazepine Ethosuximide Phenytoin Lamorigine
8 side effects of Carbamazepine?
- diplopia
- ataxia
- blood dyscrasias (agranulocytosis, aplastic anemia)
- liver toxicity
- teratogenesis
- induction of cytochrome p450
- SIADH
- SJS (stevens johnson syndrome)
these are the side effects of what drug?
- diplopia
- ataxia
- blood dyscrasias (agranulocytosis, aplastic anemia)
- liver toxicity
- teratogenesis
- induction of cytochrome p450
- SIADH
- SJS (stevens johnson syndrome)
Carbamazepine
phenytoin has what 13 side effects?
- nystagmus
- diplopia
- ataxia
- sedation
- gingival hyperplasia
- hirsutism
- megaloblastic anemia
- teratogenesis (fetal hydantoin syndrome)
- SLE-like syndrome
- Induction of cytochrome p450
- Lymphadenopathy
- SJS
- osteopenia
these are the side effects of what med:
- nystagmus
- diplopia
- ataxia
- sedation
- gingival hyperplasia
- hirsutism
- megaloblastic anemia
- teratogenesis (fetal hydantoin syndrome)
- SLE-like syndrome
- Induction of cytochrome p450
- Lymphadenopathy
- SJS
- osteopenia
phenytoin
5 side effects of Ethosuximide?
- GI stress
- fatigue
- HA
- urticaria
- SJS
what is the mnemonic EFGH?
Ethosuximide (epilepsy drug): Fatique, GI, HA (side effects)
these are the side effects of what drug?
- GI stress
- fatigue
- HA
- urticaria
- SJS
Ethosuximide
4 side effects of phenobarbital?
- sedation
- tolerance
- dependence
- induction of cytochrome p450
these are the side effects of what epilepsy drug?
- sedation
- tolerance
- dependence
- induction of cytochrome p450
phenobarbital
5 side effects of valproic acid?
GI distress
rare but fatal hepatotoxicity (measure LFTs)
neural tube defects in fetus (spina bifida)
tremor
weight gain
these are side effects of what epileptic drug?
GI distress
rare but fatal hepatotoxicity (measure LFTs)
neural tube defects in fetus (spina bifida)
tremor
weight gain
Valproic acid
which epileptic drug is contraindicated in preg?
Valproic Acid- causes neural tube defects in fetus (spina bifida)
which epileptic drug do you have to test LFTs for? Why?
Valproic acid– causes rare but fatal hepatotoxicity
side effects of Lamotrigine
SJS
4 side effects of topiramate
- sedation
- mental dulling
- kidney stones
- weight loss
these are the side effects of what anti-epileptic drug?
- sedation
- mental dulling
- kidney stones
- weight loss
topiramate
mech of phenytoin?
use-dependent blockade of Na+ channels —> inhib glutamate release from excitatory presynaptic neurons
phenytoin is used for what two things?
tonic-clonic seizures class IB antiarrhythmic