Neuro: Pharm - Epilepsy drugs

Question 1

Drugs for Absence seizures:

Answer 1

Ethosuximide, Valproic Acid, Lamotrigine

Question 2

Drugs for Status Epilepticus:

Answer 2

Benzodiazepines (diazepam, lorazepam), phenytoin

Question 3

Ethosuximide: MOA

Answer 3

blocks thalamic T-type Ca2+ channels
absence seizures (Sux to have Silent (absence) Seizures)

Question 4

Ethosuximide: SE

Answer 4

GI, fatigue, headache, urticaria, Steven-Johnson syndrome.

EFGHIJ - Ethosuximide causes Fatigue, GI issues, Headache, Itching, and stevens-Johnson syndrome

Question 5

Benzodiazepines: MOA and use

Answer 5

First line for acute status epilepticus

Increases GABA A action

Question 6

Benzodiazepines: SE

Answer 6

Sedation, tolerance, dependence, respiratory depression

Question 7

Tx for Eclampsia Seizures:

Answer 7

1st line: MgSO4

also Benzos

Question 8

Phenytoin: uses

Answer 8

simple, complex, tonic-clonic, and status epilepticus
First line for tonic-clonic
First line for prophylaxis of status epilepticus

Question 9

Phenytoin: MOA

Answer 9

Increases Na+ channel inactivation; zero-order kinetics

Question 10

Phenytoin: SE

Answer 10

Nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, peripheral neuropathy, megaloblastic anemia, teratogenesis (fetal hydantoin syndrome), SLE-like syndrome, induction of cytochrome P-450, lymphadenopathy, Stevens-Johnson syndrome, osteopenia

Question 11

Parenteral use of phenytoin:

Answer 11

Fosphenytoin

Question 12

Carbemazepine: uses

Answer 12

First-line drug for simple, complex, and tonic-clonic seizures

Question 13

Carbemazepine: MOA

Answer 13

increased Na+ channel inactivation

Question 14

Carbemazepine: SE

Answer 14

Diplopia, ataxia, blood dyscrasias (agranulocytosis, aplastic anemia), liver toxicity, teratogenesis, induction of cytochrome P-450, SIADH, Stevens-Johnson Syndrome

Question 15

First line drug for trigeminal neuralgia:

Answer 15

Carbemazepine

Question 16

Valproic Acid: uses

Answer 16

simple, complex, tonic-clonic, and absence seizures
First line for tonic-clonic seizures
Myoclonic seizures
Bipolar disorder

Question 17

Valproic Acid: MOA

Answer 17

increased Na+ channel inactivation, increased GABA concentration by inhibiting GABA transaminase

Question 18

Valproic Acid: SE

Answer 18

GI, distress, rare but fatal hepatotoxicity (measure LFTs), neural tube defects in fetus (spina bifida), tremor, weight gain, contraindicated in pregnancy

Question 19

Gabapentin: Uses

Answer 19

simple, complex, and tonic-clonic seizures
peripheral neuropathy
postherpetic neuralgia
migraine prophylaxis
bipolar disorder

Question 20

Gabapentin: MOA

Answer 20

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

Question 21

Gabapentin: SE

Answer 21

sedation, ataxia

Question 22

Phenobarbital: uses

Answer 22

simple, complex, and tonic-clonic seizures

First line in neonates

Question 23

Phenobarbital: MOA

Answer 23

increased GABA A action

Question 24

Phenobarbital: SE

Answer 24

sedation, tolerance, dependence, induction of cytochrome P-450, cardiorespiratory depression

Question 25

First line seizure med in neonates:

Answer 25

Phenobarbital

Question 26

Topiramate: Uses

Answer 26

simple, complex, and tonic-clonic seizures
migraine prevention
Tx for increased ICP

Question 27

Topiramate: MOA

Answer 27

blocks Na+ channels, increases GABA action

Question 28

Topiramate: SE

Answer 28

sedation, mental dulling, kidney stones, weight loss

Question 29

Lamotrigine: Uses

Answer 29

simple, complex, tonic-clonic, absence seizures

Question 30

Lamotrigine: MOA

Answer 30

blocks voltage-gated Na+ channels

Question 31

Lamotrigine: SE

Answer 31

SJS (must be titrated slowly)

Question 32

Levetiracetam: uses

Answer 32

simple, complex, and tonic-clonic seizures

Question 33

Levetiracetam: MOA

Answer 33

unknown; may modulate GABA and glutamate release

Question 34

Tiagabine: uses

Answer 34

simple and complex seizures

Question 35

Tiagabine: MOA

Answer 35

increased GABA by inhibiting reuptake

Question 36

Vigabatrin: uses

Answer 36

simple and complex seizures

Question 37

Vigabatrin: MOA

Answer 37

increased GABA by irreversibly inhibiting GABA transaminase

Question 38

Stevens-Johnson Syndrome:

Answer 38

Prodrome of malaise and fever followed by rapid onset of erythematous/pupuric macules (oral, ocular, genital). Skin lesions progress to epidermal necrosis and sloughing.