Pharmacology of Epilepsy Flashcards
Benzodiazepines: MOA
Increases GABA-A action
Benzodiazepines: side-effects
Sedation, tolerance, dependence and respiratory depression
Carbamazepine: MOA
Blockage of Na+ channels
Carbamazepine: side-effects
Diploplia, ataxia, agranulocytosis/anemia, teratogenesis, SIADH, SJS
*CYP-450 induction
Ethosuxamide: MOA
Bockage of thalamic T-type Ca++ channels
Ethosuxamide: side-effects
EFGHIJ
“Ethosuzamide causes Fatigue, GI distress, HA, Itching and SJS”
Gabapentin: side-effects
Sedation, ataxia
Lamotrigine: MOA
Blockage of votlage-gated Na+ channels
Levetiracetam: MOA
SV2A blocker (inhibition of glutamate release)
Phenobarbital: MOA
Increase GABA-A action
Phenobarbital: side-effects
Sedation, osteoporosis, respiratory depression, CYP-450 induction
Phenytoin: MOA
Blockage of Na+ channels (0-order kinetics)
Penytoin: side-effects
PHENYTOIN P-450 induction Hirsutism Enlarged gums Nystagmus Yellow-brown skin Teratogenicity Osteopenia* Inhibition of folate absorption Neuropathy
Vigabatrin: MOA
Irreversible GABA-T inhibitor
Vigabatrin: side-effects
Complete vision loss
Which 2 drugs inhibit conjugation of other drugs by glucuronosyltransferases (UGT) causing accumulation of parent drug?
Valproic acid + Lamotrigine
Chronic usage of which 4 drugs are associated with osteopenia/osteoporosis?
Carbamazepine
Phenytoin
Phenobarbital
Valproic acid
-> induce vitamin D catabolism
Which 3 drugs are known CYP-450 inducers?
Carbamazepine
Phenytoin
Phenobarbital
What are the 3 consequences associated with CYP-450 inhibition in a patient on AEDs?
- OCP: increased clearance of OCPs; 2-4x increased risk for unplanned pregnancy.
- Anticoagulants: increased clearance of Warfarin; poor anticoagulations, leading to risk of thrombus/embolus.
- Antivirals: increased clearance of HIV meds; elevated risk for HIV replication.
Which drug is commonly used for partial seizures?
Carbamazepine*
Which drug is commonly used for absence seizures?
Ethosuximide
Which drugs are used for status epilepticus? (2)
Benzodiazepines (acute)
Phenytoin (chronic)
MOA: blockage of VG-Ca++ channels via ad1 (2)
Pregabalin - via ad1
Gabapentin - via ad1
MOA: blockage of VG T-type Ca++ channels (3)
Zonisamide
Ethosuxamide
Valproic acid
MOA: inhibition of glutamate release/SVA2 blocker (1)
Levetiracetam
MOA: irreversible inhibition of GABA-T (2)
Vigabatrin
Valproic acid
MOA: NMDA receptor blocker
Felbamate
MOA: K+ channel blocker
Ezogabine
Valproic acid 3 MOAs
Blockage of VG T-type Ca++
Inhibition of GABA-T
Blockage of VG Na+ channels
Topiramate 3 MOAs
Blockage of VG Na+ channels
AMPA blocker
Post-synaptic GABA agonist
