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Module 4 > UNIT 2 SEIZURE AND EPILEPSY DRUGS > Flashcards

UNIT 2 SEIZURE AND EPILEPSY DRUGS Flashcards

1
Q

What is the most widely used traditional AED?

A
  1. Phenytoin
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2
Q

What is the MOA of phenytoin?

A
  1. Causes selective inhabitation of sodium channel.
  2. It is the 1st to suppress seizures without depressing CNS
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3
Q

Phenytoin is active against which types of seizures?

A
  1. Partial and generalized tonic-clonic seizures
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4
Q

What are the adverse effects of phenytoin?

A
  1. Effects the CNS
    -Nystagmus, sedation, ataxia, diplopia, cognitive impairment
  2. Gingival hyperplasia
    -Severe cases require surgical removal of gum tissues– oral care important
  3. Dermatologic effects
    -Morbilliform (measle like rash)
  4. Effects pregnancy
  5. Cardiovascular effects
    -Cardiac dysrhythmia and hypotension
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5
Q

What are some phenytoin drug interactions?

A
  1. Decrease effect of oral contraceptives, warfarin, glucocorticoids
  2. Increase Dilantin levels: diazepam, isoniazid cimetidine, acute alcohol, valproic acid
  3. Decrease Dilantin levels: Carbamazepine, phenobarbital, chronic alcohol
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6
Q

True or false: Phenytoin dosing is highly individualized?

A

True

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7
Q

True or false: Do not administer phenytoin with food?

A

False

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8
Q

What is the MOA of Carbamazepine (tegretol)

A

Same as phenytoin but minimal effects on cognitive function

causes selective inhabitation of sodium channels

also used for bipolar disorder and trigeminal neuralgia

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9
Q

What is the MOA for valproic acid (depakene, depakote)?

A
  1. Same as phenytoin but with minimal effects on cognitive function– causes selective inhabitation of sodium channels
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10
Q

What are the adverse effects of carbamazepine?

A

Bone marrow suppression

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11
Q

True or false: Valproic acid (depakene, depakote) is the 1st line drug for all patients & generalized seizures?

A

True

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12
Q

What is the adverse effects of valproic acid (depakene, depakote)

A

Hepatoxicity and pancreatitis.

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13
Q

What is the MOA of Phenobarbital?

A

Reduce seizure without causing sedation.

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14
Q

What are the adverse effects of phenobarbital?

A
  1. Drowsiness
  2. Interferes w/metabolism of vitamin D and K
  3. Toxicity- nystagmus and Ataxia
  4. Can cause physical dependance (belongs to barbiturate family)
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15
Q

What is the MOA of Oxcarbazepine (trileptal) (newer AED)

A

Blockage of voltage sensitive sodium channels

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16
Q

Oxcarbazepine (trileptal) (newer AED) is used in the management of what types of seizures?

A

Partial

17
Q

What else should we know about oxcarbazepine (trileptal) newer AED

A
  1. Can be used with adults and children and is a derivative of carbamazepine
18
Q

What are the adverse effects of Oxycarbazepine (trileptal) (newer AED)

A
  1. Dizziness, drowsiness, avoid driving and other hazardous activities
19
Q

What should we know about lamotrigine (lamictal) (newer AED)

A
  1. Broad spectrum or antiseizure activity
  2. Used also with bipolor disorder
20
Q

What is the MOA of lamotrigine (Lamictal) Newer AED

A
  1. Block sodium and calcium channels
21
Q

What are the adverse effects of Lamotrigine (Lamictal) newer AED?

A
  1. Life threatening rash
  2. Risk for suicide– will not be given to patients who have a history of suicide.
22
Q

What should we know about gabapentin (neurotin) (newer AED)?

A
  1. Adjunct therapy for partial seizure therapy
  2. Off label uses for this drug include: neuropathic pain, prophylaxis of migraine, fibromyalgia and post-menopausal hot flashes
  3. very well tolerated
  4. NOT USUALLY GIVEN FOR SEIZURES BY ITSELF TYPICALLY PAIRED WITH A PRIMARY AED
23
Q

What are common side effects of Gabapentin

A
  1. Somnolence, dizziness, ataxia, fatigue, nystagmus, peripheral edema
24
Q

What should we know about pregabalin (lyrica) (newer AED)

A
  1. Useful for neuropathic pain, postherpetic neuralgia
  2. is regulated under the controlled substance act
  3. Adjunct therapy for partial seizures
25
Q

What is a major side effect of pregabalin (lyrica) new AED?

A
  1. Can cause life threatening angioedema
26
Q

What should we know about Levetiracetam (Keppra)? a newer AED

A
  1. Does not interact with other AED’s
  2. MOA: unkown
27
Q

What should we know about Toprimate (topamax)?

A
  1. Broad-spectrum antiseizure meds
  2. Migraine treatment.

Module 4 (29 decks)

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