10. Antiepileptics used in partial seizures and generalized tonic-clonic seizures except for the “broad spectrum” agents Flashcards Preview

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1

Antiepileptics used in partial seizures and generalized tonic-clonic seizures

drugs that ...
acting on the voltage-gated Na+ channel
acting on the GABA system
acting on the glutamate system
and some others and newer drugs

2

drugs acting on the voltage-gated Na+ channel

Carbamazepine
Oxcarbazepine
Phenytoin
Fosphenytoin

3

drugs acting on the GABA system

Phenobarbital
Primidone
Vigabatrin
Tiagabine

4

drugs acting on the glutamate system

Gabapentin
Pregabalin
Felbamate

5

Carbamazepine & Oxcarbazepine

First line
AE: neurological prob., leukopenia
For trigeminal neuralgia!!!, neuropathy
influences ADH

Oxcarbazepine is a prodrug of Carbamazepine

6

Phenytoin

zero order pharmacokinetics

AE: teratogenic, gingival hyperplasia

Anti-arrhythmic

7

Fosphenytoin

for acute seizures
given IV

8

Phenobarbital

2nd / 3rd line due to AE
cuss Dependence
acts on GABAA receptors & also blocks Na+ channels

9

Primidone

prodrug
for tremors

10

Vigabatrin

selective, irreversible GABA-transaminase inhibitor (presynaptic)
AE: might provoke psychosis

11

Tiagabine

Inhibitor of GABA uptake

12

Gabapentin & Pregabalin

inhibiting presynaptic N-type calcium channels
AE: obesity and ataxia
used as adjuvan

13

Felbamate

Inhibits postsynaptic NMDA receptors
used as last resort drugs

14

newer drugs

Zonisamide
Lacosamide
Rufinamide
Levetiracetam
Retigabine

15

Zonisamide

Carboanhydrase inhibitor, Inhibition of Na+ and Ca++ channels, Might have GABAergic and glutamatergic effects
AD: kidney stones

16

Lacosamide

Inhibition of Na+ channels

17

Rufinamide

Inhibition of Na+ channels
for Lennox-Gastaut syndrome

18

Levetiracetam

Inhibits N-type calcium channels
Also used as nootropic drug

19

Acetazolamide

part of the other sub group
Carboanhydrase inhibitor
can enter CNS

20

partial seizures

involve one part of the brain

3 types
simple - no loss of consciousness
complex - consciousness altered
simple followed by generalized (seconderly generalized)

21

generalized tonic-clonic seizures

involves the entire body
loss of consciousness followed by tonic & clonic phases