seizure drug confusion Flashcards
four drugs used to tx partial seizures? (COLL)
carbamazepine(decrease Na+ channels)
Oxacarbezepine (decrease Na+ channels and CA2+ effects; increase K+)
Lamotirgine (decrease Na+ channels)
levetiracetam (UNKNOWN)
drugs used to treat BOTH GRAND MAL(tonic clonic seizures) and Atypical absence atopic seizures?
3 (VLL)
Valproate (increase GABA activity; decrease Na+ channels)
Lamotrigine(decrease Na+ channels)
Levetiracetam (UNKNOWN)
2 drugs used to tx Absence seizures (EV)
Ethosuximide (decrease T-type ca2+ channels)
Valproate (decrease Na+channels and increase GABA)
which drug is the DOC for the Tx of status epilepticus and WHY?
IV lorazepam b/c benzodiazepines can be given via RAPID IV (unlike phenytoin or valproate)
TERATOGENS:
which drugs is only Cat C
the 5 CATD drugs:(3 major CYP inducers(CPP), a benzo w/a C and a Tdrug )
the one Cat X drug:
cat C: lamotrigine
Cat D: Carbamazepine, Clonazepam, Phenobarbital + Topiramate
Cat X: valproate
jacksonian march characteristic of which type of seizure?
simple partial
the 3Hz spike wave is characteristic of which seizures?
ABSENCE
does valproate inhibit drug metabolism?
yes- major inhibitor
peripheral neuropathy including diminished deep tendon reflexes in the lower extremities = ADE of which drug?
PHENYTOIN
GI distress, hepatotoxicity, weight gain and CATX labelling = ADE of which drug?
valproic acid
kinetics of pheytoin
zero-order so must monitor plasmsa concentration
t/f. b/c of zero order kinetics, (dose-dependent elimination), some toxicities of phenytoin may occur only with a small increment in dose
true
which allele predisposes Asians to SJS?
which two drugs is SJS not reported with?
Asians - HLA-B*1502
SJS NOT WITH: CLONAZEPAM and LACOSAMIDE
which 3 drugs have blood toxicities (CFV)?
carbamazepoine
felbamate
valproate
which drug is first line for Status epilepticus?
Lorazepam IV
three MOA’s of AED drugs?
- work on Na+ channel
- Ca2+ T-type channel
- Reinforce GABA’s actions
major BBW for these all AED drugs?
increased suicidial ideation
which two AEDs have extensive protein binding?
pheytoin and valproate
which drug accumulates in erythrocytes?
Zonisamide
t/f/ drugs to tx AEDs have long serum t1/2.
true
must monior serum drug levels for which three drugs?
carbamazpein(induces own metabolism), phenytoin(zero-order), valproate
what are two eak carbonic anyhydrase inhibitors tat promote renal bicarbonate loss–>stone formation by reducing urinary citrate excretion and by increaing urinary pH therefore MUST monitor serum bicarb levels
topiramate(inhibits Na+ and glutamate channels; increases K+ and GABA)/zonisamide (decreases Na+ and T-type Ca2+)
why would you not discontinue AEDs drugs quickly
discontineu –> status epilepticus
MC ADE for phenytoin
NYSTAGMUS
other prominent: gingivial hyperplasia and Hypertrichosis or hirsuitis. (also, headache, ataxia and incooridation)
BBW for carbamazepine?
AGRANULOCYTOSIS
CNS
which drug (s) would you sue HLA-B 1502 genotyping to determine risk of developing SJS or TEN?
CARBAMAZEPINE
pheytoin, fosphenytoin
BBW = aplastic anemia, BM suppression, hepatic disease
felbamate (decrease NMDA and increase GABA)
BBW = serious rash (TEN/SJS)
lamotrigine
