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Neuro 2 > Pharm 4 Anticonvulsants > Flashcards

Pharm 4 Anticonvulsants Flashcards

1
Q

3 MOAs of anticonvulsants

A
  1. Block voltage gated Na channels (AP gen)
  2. Block voltage gated Ca channels (t type, neuronal AP pacemaking)
  3. Potentiate GABA
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2
Q

Common AE

A

suicidal ideation 1-24 weeks post initiation

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3
Q

How to administer anticonvulsants

A 
start with one
switch to another if needed
polypharmacy
then consider for surgery
or vagal nerve stimulation
**make sure to taper drug**
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4
Q

HLAB1502

A

more common in Asians

inc. risk of SJS/TEN

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5
Q

Phenytoin

A
  • prodrug = Fosphenytoin
  • Na channel blocker
  • high protein binding
  • zero order: kinetics are independent of drug concentration
  • eliminated in stool at constant rate
  • AE: gingival hyperplasia, SJS/TEN, Fetal Hydantoin syndrome (Cat D)
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6
Q

Topiramate

A
  • Na channel blocker
  • inc. K efflux
  • inc. GABA
  • dec. glutamate
  • weak CA inhibition (can cause acidosis)
  • AE: parasthesia, vision, psychomotor slowing
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7
Q

Valproate

A
  • Na channel blocker
  • dec. GABA metab
  • high protein binding
  • AE: bleeding, thrombocytopenia, SJS, TEN, hepatotoxic in kids (Cat X)
  • DOC: absence, tonic-clonic, myoclonic, atonic
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8
Q

Carbamezapine

A
  • Na channel blocker
  • upregulates its own metabolism (CYP activity)
  • BBW: agranulocytosis
  • AE: dry mouth, SJS/TEN, fetal hyantoin syndrome (Cat D)
  • DOC: partial/secondary generalized
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9
Q

Lacosamide

A
  • Na channel blocker

- dizzy, diplopia, HA, N/V

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10
Q

Lamotrigine

A
  • Na channel blocker
  • no CYPs
  • DOC: partial/secondary generalized, tonic-clonic, myoclonic, atonic
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11
Q

Oxcarbamezapine

A
  • Na channel blocker
  • maybe inc. K efflux and block Ca channels
  • diplopia
  • DOC: partial/secondary generalized
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12
Q

Zonisamide

A
  • Na channel blocker
  • also blocks Ca channels
  • accumulates in RBCs
  • weak CA inhibition (can cause acidosis)
  • AE: anorexia
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13
Q

Clonazepam

A
  • GABA potentiator (Benzo)
  • DOC for Status Epilepticus
  • Somnolence, Cat D
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14
Q

Lorazepam

A
  • GABA potentiator (Benzo)
  • given as IV
  • DOC for status epilepticus
  • somnolence, Cat D
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15
Q

Phenobarbital

A
  • GABA potentiator (Barbiturate)
  • can cause Fetal Hydantoin syndrome
  • induces CYPs
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16
Q

Felbamate

A
  • GABA potentiator
  • blocks NMDA
  • BBW: anemia, hepatic dz
17
Q

Ethosuxamide

A
  • Ca channel blocker
  • AE: somnolence, GI
  • DOC: absence seizures
18
Q

Pregabalin

A
  • Ca channel blocker
  • blocks alpha2delta1 subunit
  • not metabolized, no CYPs
  • AE: edema
19
Q

Gabapentin

A
  • Ca channel blocker
  • blocks alpha2delta1 subunit
  • no CYPs
20
Q

Levitiracetam

A
  • unknown MOA
  • no CYPs
  • URTI
    DOC: partial/secondary generalized, tonic-clonic, myoclonic, atonic

Neuro 2 (6 decks)

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