Exam 1: Anti - Seizure meds (partial summary of key stuff! not enough time to do all the info) Flashcards
First choice drugs for:
Tonic-clonic seizures
Carbamazepine, Valproic acid, Phenytoin, Lamotigrine
First choice drugs for:
Simple partial seizures
Carbamazepine, Phenytoin, Valproic acid, Lamotigrine
First choice drugs for:
Complex partial seizures
Carbamazepine, Phenytoin, Valproic acid, Lamotigrine
First choice drugs for:
Absence seizures
aka petite mal
Ethosuximide, Valproic acid
First choice drugs for:
Myoclonic and Atonic seizures
Valproic acid, Clonazepam
First choice drugs for:
Status Epilepticus seizures
Diazepam (1), Lorazepam (1)
Phenytoin (2)
First choice drugs for:
Infantile spasms
ACTH, Corticosteroids
First choice drugs for:
Lennox Gastaut syndrome
Clonazepam, Lamotigrine
First choice drugs for:
Febrile seizures
Diazepam
Drugs for the chemical class:
Hydantoins
Phenytoin
Drugs for the chemical class:
Tricyclics
Carbamazepine
Drugs for the chemical class:
Barbiturates
Phenobarbital
Drugs for the chemical class:
Valproates
Valproic acid, Valproate sodium
Drugs for the chemical class:
Succinimides
Ethosuximide
Drugs for the chemical class:
Benzodiazepines
Clonazepam, diazepam, lorazepam
Drugs for the chemical class:
GABAergic drugs
Gabapentin
Drugs for the chemical class:
Others
Lamotrigine, topiramate
Efficacy of birth control pills is _____ due to seizure medications inducing _____ enzyme.
If a medication must be given during pregnancy, _____ and _____is the safest
Efficacy of birth control pills is decreased due to seizure medications inducing CYP 450 enzyme.
If a medication must be given during pregnancy, phenobarbital and lamotrigine is the safest
Phenytoin Side Effects:
Side Effects
Nystagmus (rhythmic, oscillating eye movement)
Diplopia (double vision) DOSE-RELATED
Ataxia (loss of coordination of voluntary muscles) DOSE –RELATED
Gingival hyperplasia (overgrowth of gum tissues in the mouth)
Hirsutism (excessive hair growth of face or body in women)
Sedation (CNS depression)
Coarsening of facial features (occurs with long-term therapy)
Mild peripheral neuropathy (diminished deep tendon reflexes) (occurs with long-term therapy)
Abnormalities in Vitamin D metabolism with osteomalacia (occurs with long-term therapy)
Megaloblastic anemia (decreased folate levels)
Aplastic anemia
Teratogenicity (Pregnancy Category D)
Fetal hydantoin syndrome (increased risk of congenital malformations like cleft lip and palate)
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Valproic acid/Valproate BLACK BOX WARNING OF SIDE EFFECTS:
BLACK BOX WARNING OF SIDE EFFECTS
Hepatotoxicity →higher risk in patients <2 years old and on multiple medications
Oral or Intravenous L-carnitine may help reduce hepatotoxicity
Teratogenicity → spina bifida (Pregnancy Category D)
Pancreatitis
Lamotrigine BLACK BOX WARNING OF SIDE EFFECTS:
BLACK BOX WARNING OF SIDE EFFECTS
Skin rashes like Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
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MOA for:
Phenytoin
Blocks Axonal Na+ channels in their native state
inhibit generation of rapidly repetitive action potentials
increases GABA-mediated inhibition
Decreases Ca+ influx
MOA for:
Carbamazepine
Blocks Na+ channels
MOA for:
Phenobarbital
Potentiates GABA mediated inhibitoy stimuli in the presence of GABA by prolonging the opening of Cl- channels
Inhibits Na+ Channels and Ca+ channels
Blocks excitaroty AMPA recpetors
Directly opens GABA-A recpetors
MOA for:
Ethosuximide
Blocks T-Type Ca++ Channels in thalamic neurons
MOA for:
Valproic Acid/ Valproate
Blocks Na+ channels
Enhances GABA Mediated inhibition
Increases K+ Currents
Blocks T-Type Ca++ Channels
Blocks Excitatory NMDA recptor-mediated excitation
MOA for:
Lamotrigine
Blocks Na+ channels
MOA for:
Gabapentin
Unclear
MOA for:
Topiramate
Blocks Na+ channels
Augments the action of GABA at GABA-A recpetors
Antagonizes glutamate recptors
inhibits carbonic anhydrase
MOA for:
Felbamate
Blocks Na+ channels
MOA for:
Clonazepam (Benzodiazepine)
Benzodiazepine that facilitiates actions of GABA
MOA for:
Lorazepam (Benzodiazepine)
Benzodiazepine that facilitiates actions of GABA
MOA for:
Diazepam (Benzodaizepine)
Benzodiazepine that acts on parts of the limbic system, thalamus, and hypothalamus and induces calming effects