Narrow spectrum Antiepileptics Agents

Question 1

name the narrow spectrum antiepileptics

(“Seize the night”)

Answer 1

Carbamazepine
(“classic car”)

Phenytoin
(“classic tow car”)

Gabapentin
(“Grab a pint! “ on ice-cream parlor)

Vigabatrin
(“raised V-Cab transmission”)

Tiagabine
(“tied up cab driver”)

Question 2

what can narrow spectrum antiepileptics be used for ?

Answer 2

• useful in treatment of focal seizures
• 2nd line agents used for maintainance during status epilepticus

Question 3

Carbamazepine

(“classic car”)

Answer 3

-1st line therapy for Trigeminal Neuralgia
(“three glowing gems”)
——————————————————————————–
-increases Na+ channel inactivation
(“inactivated salty chip bags”)

-induces CYP450
(“classic car Activated chrome plate CYP450”)

-can cause ataxia
(“unbalanced stack”)

-can cause diplopia
(“misaligned headlights of classic car”)

-can cause Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome {DRESS}
(“eosinophilic dress of waiter 1”)

-carbamazepine is teratogenic
(“driver has tarantula shirt”)

-may cause Stevens Johnson Syndrome (SJS) (“sloughed off mask of passenger next to driver of classic car “)
——————————————————————————–
-Carbamazepine can cause SIADH
(“Inappropriate wet head of classic car driver”)

-can cause agranulocytosis
(“sand timer”)

-carbamazepine therapy during pregnancy can cause neural tube defects
(“neural tube exauhst”)

Question 4

Phenytoin

(“classic tow car”)

Answer 4

-increases Na+ channel inactivation
(“inactivated salty chip bags”)

-induces CYP450
(“classic car Activated chrome plate CYP450”)

-can cause ataxia
(“unbalanced stack with waiter 2 “)

-can cause diplopia
(“misaligned headlights of tow car”)

-can cause Drug Reaction with Eosinophilia and Systemic Symptoms syndrome {DRESS}
(“eosinophilic dress of waiter 2”)

-carbamazepine is teratogenic
(“towed car driver has tarantula shirt”)

-phenytoin may cause folate deficiency leading to megaloblstic anemia
(“spilled salad above tow car”)

-may cause gingival hyperplasia
(“expanding gum”)

-may cause hirsutism
(“trucker with big bushy beard”)

-phenytoin therapy during pregnancy may cause cleft palate
(“trucker’s cleft hat”)

-can decrease bone density
(“fractured osteoporotic towed car axle”)

Question 5

Carbamazepine and Phenytoin can both cause …

(“classic car and tow car”)

Answer 5

drug-induced Lupus

(“wolf between classic cars”)

Question 6

how should you treat Status Epilepticus

(“order status” sign)

Answer 6

-treat acutely with IV Benzodiazepines Diazepam, Lorazepam and Phenytoin (2nd line) for maintenance
(“Ben’s diner in the background behind cars”)

-if this treatment didn’t work IV Phenobarbital can be used to treat refractory seizures
(“barbershop in the background”)

Question 7

Gabapentin

(“Grab a pint! “ on ice-cream parlor)

Answer 7

-blocks voltage gated Ca+2 channels
(“closed Calci-YUM Ice cream cooler door”)

-useful for treatment of chronic pain
(“chronically frayed wire next to diasweeties machine”)

-can treat diabetic neuropathy
(“diasweeties machine “)

-useful for treatment of Fibromyalgia
(“fiber bars in 1st row of diasweeties machine”)

-useful in treatment of post-herpetic neuralgia
(“Zeus poppin from top of ice cream car”)

-can cause ataxia
(“unbalanced stack of ice cream balls”)

Question 8

Vigabatrin

(“raised V-Cab transmission”)

Answer 8

-irreversible inhibition of GABA-Transaminase → decrease GABA degradation

(“V-Cab _trans_mission”)

Question 9

Tiagabine

(“tied up cab driver”)

Answer 9

-inhibits GABA-Reuptake

(“tied up driver can’t be re-uptaken into cab”)