Seizure meds

Question 1

Ethosuximide

Answer 1

Absence seizures
Blocks thalamic T-type calcium channels
Fatigue, GI distress, headache, itching, SJS

Question 2

Benzos- diazepam, lorazepam, midalozam

Answer 2

Status epilepticus
GABA (A) action (increases)
SFX: sedation, tolerance, resp depression

Question 3

Phenobarbital

Answer 3

Partial/ focal & tonic clonic (1st line in neonates)
Increases GABA (A) action
Sedation, tolerance,
dependence, induction
of cytochrome P-450,
cardiorespiratory depression

Question 4

Phenytoin,
fosphenytoin

Answer 4

Partial/focal, tonic clonic, status epilepticus
Blocks sodium channels, zeros order kinetics
eurologic: nystagmus, diplopia, ataxia, sedation, peripheral
neuropathy. Dermatologic: hirsutism, Stevens-Johnson
syndrome, gingival hyperplasia, DRESS syndrome.
Musculoskeletal: osteopenia, SLE-like syndrome. Hematologic:
megaloblastic anemia. Reproductive: teratogenesis (fetal
hydantoin syndrome). Other: cytochrome P-450 induction

Question 5

Carbamazapine

Answer 5

Partial/focal, tonic clonic, trigeminal neuralgia
Blocks sodium channels
diplopia, ataxia, blood
dyscrasias (agranulocytosis,
aplastic anemia), liver
toxicity, teratogenesis,
induction of cytochrome
P-450, SIADH, StevensJohnson syndrome

Question 6

Valproic acid

Answer 6

partial/focal, tonic clonic, absence
increases Na+ channel inactivation,
increases GABA concentration
by inhibiting GABA
transaminase
GI distress, rare but fatal
hepatotoxicity (measure
LFTs), pancreatitis, neural
tube defects, tremor, weight
gain, contraindicated in
pregnancy

Question 7

Vigabatrin

Answer 7

Partial/focal
Increases GABA by irreversibly inhibiting GABA transaminase
Permenent visual loss

Question 8

Gabapentin

Answer 8

Partial/focal
Primarily inhibits high-voltageactivated Ca2+ channels;
designed as GABA analog
Sedation, ataxia

Question 9

Topiramate

Answer 9

focal/partial, tonic clonic
blocks sodium channels, increases GABA action
Sedation, mental dulling,
kidney stones, weight loss,
glaucoma

Question 10

Lamotrigine

Answer 10

Partial//focal, tonic-clonic, absence
Blocks voltage-gated Na+
channels, inhibits the release
of glutamate
SJS

Question 11

Levetiracetam

Answer 11

parrtial/focal, tonic clonic
SVA2 antagonist
Fatigue, drowsiness,
headache, neuropsychiatric
symptoms (eg, personality
changes