Seizure Medications

Question 1

Traditional Seizure Medications

Answer 1

Well established 
Less well tolerated 
More cplex pK
Drug interactions due to CYP450
Less safe in pregnancy but remember some of these benefits outweigh the risks

Question 2

New Generation Seizure Medications

Answer 2

Not as well established 
Well tolerated
Simpler PK
NO cyp450 interaction 
Safer in pregnacy

Question 3

Phenytoin

Answer 3

Prototype of the traditional seizure medications
MOA: -Selectively inhibits Na+
-Slows recovery from inactive
-Metabolizing enzymes in liver quickly become maxed out → narrow the dosing for this reason

Question 4

What are the adverse effects of phenytoin

Answer 4

HIGH TOXICITY RISK
CNS sedation
Insomnia, nystamias 
Gingival hyperplasia 
Measle like rash
Necrosis with the IV

Question 5

what types of drugs do you not want to take when on phenytoin

Answer 5

CYP450 inducers and inhibitors

Question 6

what drug has the same MOA as Phenytoin

Answer 6

Carbamazepine

Question 7

How is Carbamazepine different from Phenytoin

Answer 7

mainly in adverse effects: 
CNS depression 
Bone marrow suppression 
Increase in ADH suppression 
Derm rashes/ hypersensitive

Question 8

what is the MOA of valoprate

Answer 8

traditional antisizure medication

enhances GABA transmission and has similar NA+ blocking effects as phenytoin

Question 9

who should not take valoprate

Answer 9

pregnant women

Question 10

what are two unique side effects of valoprate

Answer 10

Life threatening pancreatitis

Rare fatal liver failure

Question 11

what is the unique MOA of Ethosuximide

Answer 11

Suppression of Ca++ channel in the thalamus

Question 12

what is unique about when you can take ethosuximide

Answer 12

Absence of seizure usage

Question 13

how does Phenobarbital work (MOA)

Answer 13

Potentiates effects of GABA used in anesthesia!!

Question 14

what metabolism is unique about Phenobarbital

Answer 14

VitD metabolism

Question 15

New generation anti-seizure medications

Answer 15

Not as well established 
Well tolerated
Simpler PK
NO cyp450 interaction 
Safer in pregnacy

Question 16

what is the prototype of new generation antiseizure medication

Answer 16

Oxcarbazepine

prototype

Question 17

what is Oxcarbazepine
(prototype)
a derivative of

Answer 17

Is a derivative of Carbamazepine which is a Na+ channel inactivation

Question 18

what do you want to be careful taking Oxcarbazepine with

Answer 18

Can induce CYP450
Avoid with other drugs that reduce Na+
Avoid alcohol

Question 19

how does Lamotrigine work (MOA)

Answer 19

New generation antiseizure medication

Na++ channel inactivation and Ca++ channel block

Question 20

what are the unusual effects of Lamotrigine

Answer 20

Unusual AE
Hypo NA+
Hypothyroidism

Question 21

what new generation antiseizure medication Decreases GABA reuptake

Answer 21

Tiagabine

Question 22

what is the MOA of Pregabalin

Answer 22

Binds Ca++ and inhibits glutamate, NE, sub P

Question 23

what new generation seizure medication can lead to euphoria

Answer 23

Pregabalin

Question 24

what new generation seizure medication can lead to decreased fertility

Answer 24

Pregabalin

Question 25

what is the new generation antiseizure medication Topiramate MOA

Answer 25

GABA potentiation

Na++ channel and Ca++ channel block

Question 26

what adverse effects does topiramate have

Answer 26

Metabolic acidosis

Possibly high SI

Question 27

Levetiracetam has….

Answer 27

no known MOA
Minimal adverse effects
no significant drug interactions

Question 28

Gabapentin

Answer 28

no known MOA, well tolerated