Seizure/Epilepsy Pharm Flashcards
What is the drug of choice for absence seizures?
Ethosuximide
What AED enhances slow inactivation of Na+ channels?
Lacosamide (Partial onset seizures)
Which AED’s enhance fast inactivation of Na+ channels?
Phenytoin, Carbamezepine, lamotrigine, oxycarbazepine
What channels are involved in absence seizures?
VSCC, T-Type Ca++ channels that mediate activity in the thalamus
What type of seizures can Valproate be used for? Side effects?
Broad spectrum-> all seizure types
Side effects-> weight gain, hair loss, lethargy, neural tube defects in pregnancy
What is the MOA of Lamotrigine? Used for what?
Acts on VGSC, N and P-type Ca++ channels, and K current
Broad spectrum seizure drug
What does Tiagabine act on? Used for what type of seizure?
Inhibits GABA re-uptake-> increased GABA outside cell
Used for partial onset seizures
What does Vigabatrin act on? Used for what type of seizure?
Inhibits GABA metabolism-> increased GABA in vesicles
Used for partial onset seizures
Where/how do benzodiazepines act?
Bind to post-synaptic GABA receptors-> potentiate GABA binding-> Cl- channel opens
Where does phenobarbital act?
Acts on post-synaptic GABA receptors-> can act independently of GABA in high doses-> toxicity
What is the standard tx for status epileptics?
1st-> IV lorazepam/diazepam, if seizure is not stopped in 5 mins-> give Fosphenytoin IV
What is the drug of choice for myoclonic seizures?
Clonazepam
What are the actions of Topirimate? Used for what seizure type?
Is a AMPA receptor antagonist (blocks glutamate receptor), acts on ligand-gated ion channels, and a GABA receptor agonist. Used for all seizure types
What is the MOA of Levitiracetam? Used for what seizure type?
Binds to SV2A (synaptic vesicle protein) and prents fusion with membrane and glutamate release. Broad spectrum drug
What are the complications of phenytoin?
Zero-order pharmacokinetics, induces Hepatic CYP450 enzymes, causes gingival hyperplasia, osteoporosis.
