Seizure Tx: AED Meds

Question 1

Carbamazepine

Answer 1

TN: Tegretol
MOA: Na Channel
AE: Ataxia, diplopia, sedation, nausea, dizziness, rash, hyponatremia, leukopenia, Pg D
Half Life: M 12 hr; Co 5-14 hr
TR: 4-12 mcg/ml
Drug Intx: CYP2C8, 3A3/4 substrate, CYP1A2, 2C, 3A3/4 induer (Auto-induction: drug induces itself; needs longer titration time than normal)

Question 2

Felbamate

Answer 2

Not used often: for hard to treat SD

AE: anorexia, N/V, insomnia, HA, aplastic anemia, hepatic failure (taper off slowly or can lead to death)

Question 3

Gabapentin

Answer 3

TN: Neurontin
MOA: Increase GABA-ergic inhibition; Decrease glu?
AE: sedation, dizziness, atazia, weight gain, behavior changes in children
HL: 5-40 hrs because renally eliminated
TR: Not defined; Est 10-20mcg/ml
Drug Intx: Renally eliminated, no intx

Question 4

Lamotrigine

Answer 4

TN: Lamictal
MOA: Na channel, Decreases glutamate
AE: rash (MC if on VA or if too high dose to start), ataxia, tremor, sedation, N/V, weight gain
HL: M 25 hr
TR: 10-20 mcg/ml
Drug Intx: CYP substrate, inducer and inhibitor

Question 5

Phenobarbital

Answer 5

TN: NA
MOA: Increase GABA-ergic inhibition
AE: Sedation, irritability, confusion, decreased cognition and motor skills, aggression, hyperactivity esp in kids
HL: A 48-136 hr; C 37-73 hr
TR: 20-40 mcg/ml
Drug Intx: Inducer