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Pharm test 4 > Seizure Meds > Flashcards

Seizure Meds Flashcards

1
Q

Phenytoin -uses

A

all forms of seizures except absence

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2
Q

Phenytoin - things to know

A

most widely used, a drug of 1st choice
narrow TI
Teratogenic

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3
Q

Phenytoin - AE

A
  • mild CNS effects, nystagmus
  • gingival hyperplasia (folic acid can help)
  • SJS, DRESS, TEN (with genetic defect - mostly Asians)
  • If given IV push, hypotension and dysrhythmias
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4
Q

Phenytoin - drug interactions

A
  • CYP, esp. birth control, warfarin, and glucocorticoids
  • drugs that increase levels - diazepam, cimetidone, alcohol (acutely), and valproic acid
  • drugs that decrease levels - carbamazepine, phenobarb, alcohol (chronically)
  • enteral tube feeds
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5
Q

carbamazepine - uses

A
  • tonic-clonic and partial
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6
Q

carbamazepine - things to know

A
  • half life decrease as therapy progresses
  • teratogenic
  • check CBC at baseline, DO NOT give in pts with hemolytic abnormalities
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7
Q

carbamazepine - AE

A
  • neuro - visual disturbance, ataxia, vertigo, HA
  • leukopenia, thrombocytopenia (rare)
  • fatal aplastic anemia (very rare)
  • SJS, TEN, DRESS (see in 2-4 weeks)
  • hyponatremia
  • hepatic and renal failure
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8
Q

carbamazepine - interactions

A
  • inactivates birth control and warfarin

- grapefruit juice

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9
Q

Valproic Acid - uses

A

1st line for all partial and generalized

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10
Q

Valproic Acid - AE

A
  • minimal cognitive impairment or sedation
  • N/V/indigestion (take with food)
  • hepatotoxicity - BBW
  • pancreatitis - BBW
  • teratogenic
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11
Q

Valproic Acid- Interactions

A
  • increases levels of phenobarb
  • topiramate -> hyperammonemia -> encephalopathy
  • carbapenem abx
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12
Q

Ethosuzimide (Zarontin) - uses

A

1st choice for absence seizures

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13
Q

Ethosuzimide (Zarontin)- AE

A
  • initially drowsiness, dizziness, lethargy
  • N/V - take with food
  • RARE: lupus, leukopenia, aplastic anemia, SJS
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14
Q

Phenobarbital - uses

A

partial and tonic clonic

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15
Q

Phenobarbital - AE

A
  • drowsiness (decreased over time)
  • cognitive deficits in kids
  • depression
  • agitation and confusion in older adults
  • acute intermittent porphyria
  • resp depression
  • disrupt metab of vit D and K (patient should eat food high in those and calcium)
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16
Q

Phenobarbital - interactions

A
  • CYP - birth control and warfarin

- valproic acid

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17
Q

Primidone (mysoline) - uses

A
  • tonic clonic, partial, not absence
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18
Q

Primidone (mysoline) - AE

A
  • initially, sedation
  • confusion in older adults
  • paradoxical effects in kids
  • acute intermittent porphyria
  • RARE: psychosis, leukopenia, thrombocytopenia, lupus
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19
Q

Primidone (mysoline) - Interactions

A

birth control, warfarin

20
Q

Oxcarbazepine (Trileptal) - uses

A

partial seizures - mono >4, adjunct >2

21
Q

Oxcarbazepine (Trileptal) - AE

A
  • CNS effects (improve over time)
  • hyponatremia
  • SJs, TEN
  • hemolytic effects (rare)
  • multi organ hypersensitivity
  • decreased bone density
22
Q

Oxcarbazepine (Trileptal) - interactions

A
  • phenytoin
  • perampanel, phenobarab, valproic acid
  • eslicarbazepine
  • birth control
  • Na depleting drugs
23
Q

Lamotrigine (Lamicatal) - uses

A

adjunct for partial, lennox gasteau, and tonic clonic

mono for partial >16yo

24
Q

Lamotrigine (Lamicatal) - AE

A
  • dizziness, diplopia, blurred vision, N/V, HA
  • SJS, TEN, DResS (valproic acid increases that risk)
  • hypersensitivity
  • aseptic meningitis (very rare)
  • suicidal thoughts
25
Q

Lamotrigine (Lamicatal) - interactions

A
  • affected by drugs that induce or inhibit hepatic metabolism
  • birth control
26
Q

Gabapentin (Neurontin) - uses

A

adjunct for partial

27
Q

Gabapentin (Neurontin) - AE

A
  • well tolerated

- somnolence, dizziness, ataxia, fatigue, nastigmus, and peripheral edema (decreases over time)

28
Q

Gabapentin (Neurontin) - Interactions

A

none

29
Q

Pregabalin (Lyrica) - uses

A

adjunct for partial

30
Q

Pregabalin (Lyrica) - AE

A 
dizziness and somnolence (doesn't go away)
blurred vision (goes away)
- weight gain
- cognitive issues, HA, edema
- hypersensitivity (angioedema)
- potential for abuse (withdraw slowly)
- reproductive risks for men and women
31
Q

Pregabalin (Lyrica) - Interactions

A

opioids, benzos

32
Q

Levetiracetam (Keppra) - uses

A

adjunct for myoclonic (>12), partial (>4), tonic clonic (>6)

33
Q

Levetiracetam (Keppra) - AE

A

possible renal failure

drowsiness, weakness,suicide

34
Q

Levetiracetam (Keppra) - interactions

A

none

35
Q

Topiramate (Topomax) - uses

A

adjunct >2 partial, tonic clonic, and LG

mono >10 tonic clonic

36
Q

Topiramate (Topomax) - AE

A

wt loss, dizziness, solomnence ataxia, congnitive issues
metabolic acidosis 9at risk: keto, renal dz, resp disorders, and diarrhea
hypohydriasis, closed angle glaucoma, suicide

37
Q

Topiramate (Topomax) - interactions

A

phenytoic, carbamazepine, valproic acid

38
Q

Tiagabine (Gabitril) - uses

A

adjunct for partial >12

39
Q

Tiagabine (Gabitril) - ae

A

dizziness, somnolence, nervousness

40
Q

Tiagabine (Gabitril) - Imnteractions

A

decreased by phenytoin, phenobarb, and carbamen

41
Q

zonisamide (Zonegran) - uses

A

adjunct for partial in adults

42
Q

zonisamide (Zonegran) - AE

A 
drowsiness, dizziness, anorexia, HA, N
metabolic acidosis
cognitive effects
- suicide
SJS, TEN
- kidney stones
- rarely hypohidrosis
43
Q

zonisamide (Zonegran) - Interactions

A

CYP3A4, grapefruit juice

44
Q

Felbamate (Felbatol) - uses

A

adjunct or mono in adults with partial

adjunct in kids with LG

45
Q

Felbamate (Felbatol) - AE

A

aplastic anemia, liver damage, GI disturbance

46
Q

Felbamate (Felbatol) - Interactions

A

phytoin, valproic acid, carbamen

Pharm test 4 (5 decks)

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