Pharmacology of Anti-Seizure Drugs Flashcards
What drugs are used as rescue drugs for status epilepticus and may be administered nasally?
Diazepam, Lorazepam, Clonazepam
This drug is second-line for status elepticus.
Fosphenytoin
What ASMs are broad spectrum enzyme inducers?
Phenytoin, Carbamazepine, Phenobarbital
True/False. There is no drug to treat epilepsy.
True. Current drugs treat active seizures and manage symptoms, but cannot cure epilepsy.
What ASM blocks NMDA receptors?
Felbamate
What ASM is associated with anger and irritability?
Levetiracetam
What is the MOA of Tiagabine?
Inhibits pre-synaptic GABA uptake
What ASM is associated with weight loss?
Topiramate
This drug may be used to treat focal seizures in children and adults, but is not a first line option.
Phenytoin
Diplopia and ataxia are ADRs most commonly associated with what ASM?
Carbamazepine
What ASM has zero-order kinetics?
Phenytoin
ASMs that target Na+ channels should be closely monitored in what patient population?
Patients over 60yo or with cardiac issues
Topiramate is used for the treatment of what seizure types?
Monotherapy for focal and generalized seizures and migranes
What ASMs act by inhibiting Na+ channels?
Phenytoin, Carbamazepine, Lamotrigine, Topiramate, VPA
What is the MOA of Valproate/Valproic Acid?
Blocks Na+ channels and increases K+ permeability
What is the first line therapy for absence epilepsy in adults?
Ethosuximide
What is the use for Tiagabine?
Adjunct therapy for focal seizures
What ASM may exacerbate myoclonic and abscene seizures, if prescribed?
Carbamazepine
Infantile spasms and tuberous sclerosis can be treated with what ASM?
Vigabatrin
What Na+ channel-targeting ASMs are broad spectrum?
Lamotrigine, Valproate, Topiramate,
What is the MOA of Carbamazepine?
Binds to inactivated Na+ channels
Benzodiazepines & barbituates both bind the GABAa receptor to enhance Cl- channel function. How do their MOAs differ?
Benzodiazepines increase the duration of channel opening. Barbituates increase the frequency of channel opening. Both cause hyperpolariztion.
These ASMs are good for adjunct therapy, but are not used first line for any epilepsy.
Gabapentin, Pregabalin
What ASM is a first-line therapy for seizures in neonates?
Phenobarbital
Vigabtrin is associated with what irreversible ADR?
Vision deficits and retinopathy
What ASM is associated with weight loss?
Ethosuximide & Topiramate
How is Levetircetam used in adults?
Adjunct therapy for focal seizures
What is the MOA of Levetircetam?
Binds the synaptic vesicle to modify neurotransmitter release
What ASMs are associated with behavioral changes?
Levetircetam, Perampanel
What ADRs are most associated with Valproate/Valproic Acid?
GI disturbances
What ASM can be added as an adjunct therapy to treat generalized tonic-clonic seizures in children?
Levetircetam
What serious ADRs are associated with phenytoin?
SJS/TEN, gingival hyperplasia
What is the MOA of Lamotrigine?
Bind inactivated Na+ channels
What rare ADR is unique to Lamotrigine?
Hemophagocytic Lymphohistiocytosis (HLH)
What ASM is contraindicated during pregnancy?
Valproate/Valproic Acid
What is the MOA of gabapentin & pregabalin?
Bind Ca2+ channels to decrease Ca2+ influx and thus glutamate release
What ASM irreversible inhibits the GABA aminotransferase to prevent degradation of GABA?
Vigabatrin
Dependence and tolerance are commonly associated with what class of ASMs?
Benzodiazepines (Diazepam, Lorazepam, Clonazepam)
How do ASMs inhibit Na+ channels?
They bind to Na+ channels in the inactivated state to extend the refractory period
When is the MOA of Phenytoin and Fosphenytoin?
Bind inactivated Na+ channels
Juvenile Myoclonic Epilepsy is effectively treated with this ASM.
Valproate/Valproic Acid
What is the most common drug to treat focal seizures?
Carbamazepine
What is the first line therapy for absence epilepsy in children?
Ethosuximide
What is the MOA of Carbamazepine?
Bind inactivated Na+ channels
In utero cardiac malformations are associated with which ASM?
Phenobarbital
How does Fosphenytoin differ from Phenytoin?
Fosphenytoin is a phenytoin derivate that may be administered via IM or IV
Most ASMs are broad inducers of enzymes. What ASM is a broad INHIBITOR?
Valproate/Valproic Acid
What ASM acts on Ca2+ channels on thalamic neurons?
Ethosuximide
Cannabidol has been approved for treatment of what seizure disorders?
Lennox-Gastaut Syndrome, Dravet Syndrome, Tuberous Sclerosis
What serious ADRs are associated with Felbamate?
Liver failure, aplastic anemia
Cognitive slowing is associated with what ASM?
Topiramate