CNS drugs 2: anti-seizures Flashcards
MOA of valproic acid
- reduces metabolism of GABA
2. Na channel blocker
Na channel blocker
Phenytoin Carbamazepine Valproic acid Lamotrigine Zonisamide
remarks on phentoin
Phenytoin
- preferred in prolonged therapy for status epi bec it is less sedating
- m/c s/e: diplopia, ataxia
- s/e: GINGIVAL HYPERPLASIA,fetal hydantoin syndrome (midfacial hypoplasia, hypoplasia of toenails and distal phalanges)
DOC for trigeminal neuralgia
CARBAMAZEPINE
- structurally similar to phenytoin
- m/c s/e: dipolpia, ataxia (just like phenytoin)
- other s/e: SJS, rash (m/c idiosyncratic rxn), SPINA BIFIDA
DOC for seizures in infants
phenobarbital (Katzung)
first line in neuropathic pain (postherpetic neuralgia)
GABAPENTIN
- GABA analogue
- acts presynaptically to promote GABA release
- blocks Ca++ channels
- decreases glutamate release
remarks on lamotrigine
s/e: SJS/TEN
remarks on LEVETIRACETAM
MOA
- selectively binds synaptic vesicular protein SV2A
- modifies synaptic release of glutamate and GABA
drug interactions are minimal (NEITHER AN INDUCER NOR AN INHIBITOR)
antiseizure drugs that are monosaccharide derivatives
topiramate
felbamate
topiramate? is the antiseizure drug with the greatest number of MOA
fetal hydantoin syndrome
teratogenic effect of phenytoin
- wide set eyes
- upturned nose
- mild midfacial hypoplasia
- broad mandible
- long upper lip with thin vermilion border
- lower distal digital hypoplasia
DOC for Generalized tonic-clonic
valproic acid
phenytoin
carbamazepine
DOC for partial seizures
carbamazepine
lamotrigine
phenytoin
DOC for absence seizures
Ethosuximide
valproic acid
DOC for myoclonic and atypical absence syndromes
valproic acid
DOC for status epilepticus
lorazepam
diazepam
phenytoin
phenobarbital
