Seizure Meds Flashcards
1
Q
Carbamezepine
A
- Blocks high-frequency firing of neurons through action on VG Na+ channels; decreases synaptic release of glutamate
- Well absorbed orally, with peak levels in 6-8 h; 8-12 half life
- Generalized tonic-clonic seizures, partial seizures
- Nausea, diplopia, ataxia, hyponatremia, headache
2
Q
Ethosuximide
A
- Reduces low threshold Ca++ currents (T-type)
- Well absorbed orally, peak levels in 3-7 hr; 40 h 1/2 life
- ABSENCE SEIZURES (generalized, non-convulsant); think KIDS
- Nausea, headache, dizziness, hyperactivity
3
Q
Levetiracetam
A
- Action on synaptic protein SV2A
- Well absorbed orally, metabolized to 3 inactive metabolites; half life 6-11 hrs
- Generalized tonic-clonic seizures, partial seizures, generalized seizures
- Nervousness, dizziness, depression, seizures
4
Q
Phenytoin
A
- Block high frequency firing of neurons through action on voltage gate Na+ channels; decreases synaptic release of glutamate
- Dose dependent elimination, half life 12-36 h, highly bound to plasma proteins
- *Induces drug metabolizing enzymes
- Diplopia, ataxia, gingival hyperplasia, hirsutism, neuropathy
- *ZERO ORDER KINETICS, increasing dose doesn’t do much already maxed out blood concentration, switch drugs if not working!!!
5
Q
Tiagabine
A
- Blocks GABA reuptake in forebrain by selective blockade of GAT-1
- Well absorbed; highly bound; half life 4-8 hr
- Partial seizures
- Nervousness, dizziness, depression, seizures
6
Q
Topiramate
A
- Multiple actions on synaptic function, probably via actions on phosphorylation
- Well absorbed; not bound to PP; 40% excreted unchanged in urine; half life 20 hr, decreases with concomitant drugs
- Generalized tonic-clonic seizures, partial seizures, generalized seizures, absence seizures, migrain
- Somnolence, cognitive slowing, confusion, paresthesias
7
Q
Valproic acid
A
- Many different mechanisms of action; inhibits HDAC
- Nausea, vomiting, and GI complaints, teratogen (spina bifida)
8
Q
Complex focal
A
Complex (loss of consciousness); focal (can point to lesion)
9
Q
Absence seizures
A
generalized + non-convulsant
