Seizures/Epilepsy Flashcards
Define focal seizures
start on one side of the brain but can spread to the other side
Define generalized seizures
start on both sides of the brain
define tonic movements
rigid or tense muscles
Define status epilepticus
seizure lasting longer than 5 minutes
Define how ketogenic diet helps
for refractory seizures
4:1 ratio of fat to carb
ketosis leads to a reduction in seizure frequency
Ethosuximide is used primarily for what type of seizure
absence seizures
BZD MOA
increase GABA
VPA MOA
increase GABA
phenobarbital MOA
enhance potentiate GABA effect
Levetiracetam MOA
CCB and increase GABA
Ethosuximide MOA
T-type CCB
pregabalin/gabapentin MOA
CCB
Carbamazepine MOA
Na channel blocker
Phenytoin MOA
Na channel blocker
Lamotrigine boxed warning
SJS
SE of lamotrigine
alopecia
-supplement with selenium and zinc
VPA and lamotrigine DDI
VPA increases lamotrigine levels
OC and lamotrigine DDI
OC decrease lamotrigine
-specifically the estrogen
Levetiracetam IV:PO ratio
1:1
Topiramate warning and SE
metabolic acidosis oligohidrosis nephrolithiasis glaucoma hyperammoniemia fetal harm somnolence memory problems weight loss
topiramate and OC
decrease OC with dose > 200 mg/day
VPA therapeutic range
50-100 mcg/mL
Boxed warning for VPA
hepatic failure
fetal harm
pancreatitis
Warning and SE of VPA
hyperammonemia-treat with carnitine
thrombocytopenia (inc bleeding risk)
alopecia-treat with selenium and zinc
weight gain
Carbamazepine brand name
Tegretol
therapeutic range for CBZ
4-12 mcg/mL
Boxed warning for CBZ
SJS
HLA-B*1502
aplastic anemia
agranulocytosis
CI for CBZ
myelosupression
Warning and SE of CBZ
hyponatremia (SIADH)
fetal harm
lacosamide brand name
vimpat
lacosamide warning
prolong PR interval-risk for arrhythmias
oxcarbazepine brand name
trileptal
oxcarbazepine warning and SE
SJS
HLA-B*1502
hyponatremia
phenobarbital therapeutic range
20-40 mcg/mL
phenobarbital SE
habit forming
respiratory depression
fetal harm
phenobarbital and OC
decrease OC levels
Phenytoin brand name
Dilantin
Fosphenytoin brand name
Cerebyx
phenytoin IV:PO ratio
1:1
SE of phenytoin
gingival hyperplasia
hair growth
heptatoxcity
Gabapentin warnings and SE
peripheral edema
somnolence
weight gain
what is the prodrug of phenobarbital
primidone
Vigabatrin boxed warning
> 30% of patients have permanent vision loss
CI to zonisamide
allergy to sulfonamides
phenytoin correction calculation
total phenytoin measured / [(0.2 x albumin) + 0.1]
All patients on AEDs should be supplemented with?
Ca and Vit D b/c of bone loss
