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Pnt exam 3 > Seizures > Flashcards

Seizures Flashcards

1
Q

Carbamazepine brand name

A

Tegretol

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2
Q

Carbamazepine MOA

A

limits influx of Na+ ions across cell membrane, stimulates release of ADH

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3
Q

Carbamazepine dosing

A

2 divided doses
initial 400 mg/day
max 1600 mg/day

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4
Q

Precautions of carbamazepine

A

caution in hepatic

renal adjust to 75% of dose when CrCl < 10

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5
Q

Carbamazepine levels

A

4-12 mcg/mL

toxic > 15

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6
Q

Black box warning for carbamazepine

A

dermatologic reactions

aplastic anemia/ agranulocytosis

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7
Q

carbamazepine preg cat

A

D

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8
Q

Clobazam brand name

A

Onfi

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9
Q

Clobazam MOA

A

BZD binds to postsynaptic GABA neuron; enhances GABA -> hyperpolarization

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10
Q

Clobazam dosing

A

5 mg BID x 1 week -> 10 BID x 1 week -> 20 mg BID

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11
Q

Clobazam drug interactions to avoid

A 
CNS depressants
strong CYP 2C19 inhibitors
CYP3A4 inducers
estrogen contraceptives
other BZDs
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12
Q

Precautions with clobazam

A

CrCl<30

caution in severe hepatic impairment

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13
Q

schedule of clobazam

A

IV

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14
Q

safety alert for clobazam

A

SJS

TEN

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15
Q

Clobazam in pregnancy

A

1st trimester avoid

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16
Q

Clonazepam MOA

A

enhances GABA, suppresses spike and wave discharge by depressing nerve transmission

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17
Q

Clonazepam dosing

A

2-8 mg QD in 1-2 divided doses

max 20 mg daily

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18
Q

Clonazepam preg cat

A

D

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19
Q

Eslicarbazepine brand name

A

Aptiom

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20
Q

Eslicarbazepine MOA

A

inhibit voltage gated sodium channels

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21
Q

Eslicarbazepine brand name

A

400 mg daily x 1 week -> 800 mg daily

max 1200 mg daily

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22
Q

Avoid eslicarbazepine with what

A

strong 3A4 inducers

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23
Q

Eslicarbazepine induces what

A

2C19

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24
Q

Precautions with eslicarbazepine

A

renally dose

avoid in severe hepatic impairment

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25
Q

dose dependent AEs with eslicarbazepine

A

CNS related - dizziness, drowsiness, HA

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26
Q

Eslicarbazepine preg cat

A

C

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27
Q

Ethosuximide brand name

A

Zarontin

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28
Q

ethosuximide MOA

A

diminish T-type calcium currents in thalamic neurons

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29
Q

Ethosuximide dose

A

500 mg/day increase 250 mg x 4-7 days up to 1500 mg/day in divided doses

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30
Q

Therapeutic level of ethosuximide

A

40-100 mcg/mL

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31
Q

AEs of ethosuximide

A

N/V
sleep disturbances
drowsiness
hyperactivity

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32
Q

Ezogabine brand name

A

Potiga

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33
Q

Ezogabine MOA

A

voltage gated potassium channels -> stabilization -> regulated excitability

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34
Q

Ezogabine dosing

A

100 mg TID increase weekly by 150 mg to 200-400 mg TID

max 1200 mg/day

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35
Q

precautions with ezogabine

A

renally dose
hepatic dose for moderate-severe
QT prolongation

36
Q

ezogabine drug interactions to avoid

A

QTC prolonging

37
Q

ezogabine black box warning

A

retinal abnormalities

potential vision loss

38
Q

Felbamate brand name

A

Felbatol

39
Q

Felbamate MOA

A

inhibitory effects GABA receptor binding and BZD receptor binding

40
Q

Felbamate dosing as monotherapy

A

1200 mg/day in divided doses 3-4 x/day increase by 600 mg x 2 weeks to 2400 mg/day
max 3600 mg/day

41
Q

felbamate dosing as adjunct

A

incremental increase is by 1200 mg

42
Q

avoid felbamate with what

A

drugs metabolized by CYP3A4

43
Q

Precautions with felbamate

A 
transaminase and hematologic 
renally dose (50%) 
Avoid in hepatic impairment
44
Q

Felbamate black box warning

A

aplastic anemia

hepatic failure

45
Q

Felbamate preg cat

A

C

46
Q

Fosphenytoin brand name

A

Cerebryx

47
Q

Fosphenytoin MOA

A

increased efflux or decreased influx of sodium ions

48
Q

Fosphenytoin interactions by strongly inducing

A 
CYP2B6
CYP2C19
CYP2C8 
CYP3A4
p-glycoprotein
49
Q

fosphenytoin black box warning

A

CV risk with rapid infusion (>150 PE/min)

50
Q

fosphenytoin preg cat

A

D

51
Q

fosphenytoin therapeutic level

A

10-20 mcg/mL
toxic >30
lethal > 100

52
Q

fosphenytoin precautions

A 
dermatologic reactions
local toxicity (purple glove)
53
Q

Gabapentin brand name

A

neurontin

54
Q

gabapentin MOA

A

voltage gated calcium channels

55
Q

gabapentin dosing

A

300 mg TID up to 1800 mg/day

56
Q

avoid gabapentin with what

A

CNS depressants

57
Q

gabapentin precautions

A

renally dose

58
Q

gabapentin preg cat

A

C

59
Q

AEs of gabapentin

A

dizziness
drowsiness
fatigue

60
Q

Lacosamide brand name

A

Vimpat

61
Q

Lacosamide MOA

A

slow inactivation of sodium channels

62
Q

lacosamide dosing monotherapy

A

100 mg BID increase weekly by 50 mg BID

63
Q

lacosamide dosing adjunct

A

50 mg BID

64
Q

lacosamide precautions

A

prolong PR interval

65
Q

lacosamide interactions

A

CYP3A4 inhibitors may decrease elimination

66
Q

lacosamide preg cat

A

C

67
Q

Lacosamide AEs

A

dizziness
ataxia
fatigue
HA

68
Q

Lamotrigine brand name

A

Lamictal

69
Q

Lamotrigine MOA

A

inhibits release of glutamate, inhibits voltage sensitive sodium channels

70
Q

Lamotrigine precautions

A

renal dosing, hepatic dosing for moderate/severe +/- ascites

71
Q

Lamotrigine black box warning

A

dermatologic rashes - SJS

72
Q

Lamotrigine Preg Cat

A

C

73
Q

Lamotrigine AE

A

nausea

74
Q

Levetiracetam brand name

A

Keppra

75
Q

Levetiracetam MOA

A

voltage dependent N type calcium channels an facilitate GABA inhibition and reduce potassium current

76
Q

Levetiracetam dosing

A

500 mg BID + 500 mg x 2 weeks to 1500 mg BID

77
Q

Levetiracetam preg cat

A

C

78
Q

Oxcarbazepine brand name

A

Trileptal

79
Q

Oxcarbazepine MOA

A

blocks voltage sensitive sodium channels and increase potassium conduction
modulate high voltage calcium channels

80
Q

oxcarbazepine dosing

A

600 mg daily in 2 divided doses + 600 mg/day x week to 1200 mg/day
max 2400 mg/day

81
Q

oxcarbazepine strongly induces

A

CYP3A4

82
Q

AEs of oxcarbazepine

A

hyponatemia
CNS effects
blood dyscrasias

83
Q

oxcarbazepine preg cat

A

C

84
Q

oxcarbazepine precautions

A

renally dose

85
Q

Perampanel brand name

A

Fycompa

Pnt exam 3 (8 decks)

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