Pharmacology IV Flashcards
What additional four conditions is Gabapentin used to treat aside from its use as an anti-epileptic?
Peripheral neuropathy, postherpetic neuralgia, migraine prophylaxis, bipolar disorder (p.451)
Which two anti-epileptic drugs are also used to treat migraines?
Topiramate (migraine prevention); Gabapentin (migrains prophylaxis) (p.451)
Which drug is first line in treating children for simple and complex partial seizures and for tonic-clonic seizures?
Phenobarbital (p.451)
What antiepileptic drug can be used for to treat myoclonic seizures?
Valproic acid (p.451)
What antiepileptic drug class can be used for seizures of eclampsia?
Benzodiazapines (p.451)
What drug is first line for seizure of eclampsia?
MgSO4 (p.451)
What toxicities are associated with benzodiazapines?
Sedation, tolerance, dependence (p.452)
What toxicites are associated with Carbamazepine?
Diplopia, ataxia, blood dyscrasias (agranulocytosis, aplastic anemia), liver toxicity, teratogenesis, induction of cytochrome p450, SIADH, Stevens Johnson syndrome (p.452)
Which anti-epileptic drugs may cause Stephens-Johnson syndrome?
Ethosuxamide, Carbamazepine, Phenytoin, Lamotrigine (p.452)
What toxicities are associated with Ethosuxamide?
GI distress, fatigue, headache, urticaria, Stevens-Johnson syndrome (p.452)
What toxicities are associated with Phenobarbital?
Sedation, tolerance, dependence, induction of cytochrome P450 (p.452)
What toxicities are associated with Phenytoin?
Nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirtuitism, megaloblastic anemia (decreased folate absorption), teratogenesis (fetal hydantoin syndrome), SLE-like syndrome, induction of cytochrome p450, lymphadenopathy, Stevens-Johnson syndrome, osteopenia (p.452)
What toxicites are associated with Valproic Acid?
GI distress, rare but fatal hepatotoxicity (measure LFTs), neural tube defects in fetus (spina bifida), tremor, weight gain, contraindicated in pregnancy (p.452)
What labs are important to monitor in a patient taking Valproic acid and why?
LFTs for rare but fatal hepatotoxicity (p.452)
What major side effect is associated with Lamotrigine?
Stevens Johnson Syndrome (p.452)
What toxicites are associated with Gabapentin?
Sedation, ataxia (p.452)
What toxicites are associated with Topiramate?
Sedation, mental dulling, kidney stones, weight loss (p.452)
What is Stevens-Johnson syndrome?
Prodrome of malaise and fever followed by rapid onset of erythematous/ purpuric macules (oral, ocular, genital). Skin lesions progress to epidermal necrosis and sloughing (p.452)
Name four barbiturates.
Phenobarbital, pentobarbital, thiopental, secobarbital (p.452)
What is the mechanism of action of barbiturates in treatment of epilepsy?
To facilitate GABA(a) action by increasing DURATION of Cl- channel opening and decreasing neuronal firing (p.452)
What condition makes use of barbiturates contraindicated?
Porphyria (p.452)
What are barbiturates used for?
Sedative for anxiety, seizures, insomnia, induction of anesthesia (thiopental) (p.452)
Which barbiturate drug is most commonly used in induction of anesthesia?
Thiopental (p.452)
What toxicities are associated with barbiturates?
Respiratory and cardiovascular depression (can be fatal), CNS depression (can be exascerbated by EtOH use), dependence, drug interactions (induces p450) (p.452)
How is barbiturate toxicity treated?
Supportive therapy- assist respirations and maintain BP (p.452)
