Seizure medications

Question 1

List of anti-epileptic medications used in hospitals

Answer 1

Question 3

Adverse effects of diazepam, lorazepam, midazolam

Answer 3

Affects the heart and lungs; arrhythmias, hypotension, mild respiratory depression.

Also; cns depression and drug dependency.

Question 4

Lorazepam

Answer 4

IV only. Indicated for status epilepticus.

Question 5

MOA of diazepam, lorazepam and midazolam

Answer 5

Facilitate GABA transmission that counteracts the excessive excitatory neurotransmission. (i.e. neural inhibiton)

“enhances GABA-mediated chloride flux”

Question 6

Contraindications of diazepam, lorazepam, midazolam

Answer 6

• acute angle-closure glaucoma
• hypersensitivity
• severe liver disease

Question 7

Which drugs (3) could you use for partial seizures and generalized tonic-clonic seizures?

Answer 7

Carbamazepine

Phenytoin

Valproic acid

(these are the first line drugs)

Question 8

What do these drugs have in common?

carbamazepine

lamotrigine

phenytoin

topiramate

Answer 8

Delay action potential by prolonging the time the sodium channel’s gate remains closed.

Question 9

What do valproate and ethosuximide have in common?

Answer 9

They both block T-type CALCIUM channels.

Both are used to treat absence seizures (ethosuximide is used for children)

Question 10

Which anticonvulsant drug is used to treat trigeminal neuralgia? (cranial nerve V)

Answer 10

carbamazepine

Question 11

Gabapentin

MOA

uses

Answer 11

Gabapentin is a GABA analogue that increases the releaese of GABA from centrol neurons.

Effective when used to combination with other drugs to treat all forms of partial seizures.

Question 12

What is an effective drug for treating partial seizures in adults and children?

Answer 12

Lamotrigine

Question 13

Lamotrigine is used for partial seizures; what else is it indicated for?

Answer 13

generalized tonic-clonic seizures

atonic

absence seizures

LGS

+ manic phase of bipolar disorder

Question 14

What are the primary side effects of lamotrigine?

Answer 14

cerebellar dysfunction

drowiness

rash - can progress to Stevens-Johnson Syndrome (esp. if lamotrigine is combined with valproate)

Question 15

What is topiramate indicated for?

Answer 15

partial seizures; as an adjunct treatment.

Studies showed a 50% reduction in seizure frequency when topiramate is added to treatment regimen.

** preg cat D due to increased risk of cleft palate in babies **

Question 16

What is the big risk of status epilepticus?

Answer 16

severe brain damage due to prolonged hypoxia

Question 17

Why is fosphenytoin given for status epilepticus?

Answer 17

IV. Gives a longer duration of seizure control than is provided by initial benzodiazepine (diazepam or lorazepam)

Question 18

Which are the two adjunct medications for partial seizures?

Answer 18

lamotrigine

topiramate

Question 19

Absence seizures - which drug

(a) Children
(b) adults

Answer 19

children - ethosuximide

adults - valproate

Question 20

What is the drug of choice for generalized myoclonic and atonic seizures?

Answer 20

Valproate