Seizure meds Flashcards
Ethosuximide
Absence seizures
Blocks thalamic T-type calcium channels
Fatigue, GI distress, headache, itching, SJS
Benzos- diazepam, lorazepam, midalozam
Status epilepticus
GABA (A) action (increases)
SFX: sedation, tolerance, resp depression
Phenobarbital
Partial/ focal & tonic clonic (1st line in neonates)
Increases GABA (A) action
Sedation, tolerance,
dependence, induction
of cytochrome P-450,
cardiorespiratory depression
Phenytoin,
fosphenytoin
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
Carbamazapine
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
Valproic acid
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
Vigabatrin
Infantile spasms, refractory partial/focal -use as second line or adjuncts because f the risk of vision loss
Increases GABA by irreversibly inhibiting GABA transaminase
SX: Permenent visual loss, drowsy, dizzy, wt gain, behavioural changes
Gabapentin
Partial/focal
Primarily inhibits high-voltageactivated Ca2+ channels;
designed as GABA analog
Sedation, ataxia
Topiramate
focal/partial, tonic clonic
blocks sodium channels, increases GABA action
Sedation, mental dulling,
kidney stones, weight loss,
glaucoma
Lamotrigine
Partial//focal, tonic-clonic, absence
Blocks voltage-gated Na+
channels, inhibits the release
of glutamate
SJS
Levetiracetam
parrtial/focal, tonic clonic
SVA2 antagonist
Fatigue, drowsiness,
headache, neuropsychiatric
symptoms (eg, personality
changes
