Seizure Meds Flashcards

1
Q

Carbamezepine

A
  • Blocks high-frequency firing of neurons through action on VG Na+ channels; decreases synaptic release of glutamate
  • Well absorbed orally, with peak levels in 6-8 h; 8-12 half life
  • Generalized tonic-clonic seizures, partial seizures
  • Nausea, diplopia, ataxia, hyponatremia, headache
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2
Q

Ethosuximide

A
  • Reduces low threshold Ca++ currents (T-type)
  • Well absorbed orally, peak levels in 3-7 hr; 40 h 1/2 life
  • ABSENCE SEIZURES (generalized, non-convulsant); think KIDS
  • Nausea, headache, dizziness, hyperactivity
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3
Q

Levetiracetam

A
  • Action on synaptic protein SV2A
  • Well absorbed orally, metabolized to 3 inactive metabolites; half life 6-11 hrs
  • Generalized tonic-clonic seizures, partial seizures, generalized seizures
  • Nervousness, dizziness, depression, seizures
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4
Q

Phenytoin

A
  • Block high frequency firing of neurons through action on voltage gate Na+ channels; decreases synaptic release of glutamate
  • Dose dependent elimination, half life 12-36 h, highly bound to plasma proteins
  • *Induces drug metabolizing enzymes
  • Diplopia, ataxia, gingival hyperplasia, hirsutism, neuropathy
  • *ZERO ORDER KINETICS, increasing dose doesn’t do much already maxed out blood concentration, switch drugs if not working!!!
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5
Q

Tiagabine

A
  • Blocks GABA reuptake in forebrain by selective blockade of GAT-1
  • Well absorbed; highly bound; half life 4-8 hr
  • Partial seizures
  • Nervousness, dizziness, depression, seizures
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6
Q

Topiramate

A
  • Multiple actions on synaptic function, probably via actions on phosphorylation
  • Well absorbed; not bound to PP; 40% excreted unchanged in urine; half life 20 hr, decreases with concomitant drugs
  • Generalized tonic-clonic seizures, partial seizures, generalized seizures, absence seizures, migrain
  • Somnolence, cognitive slowing, confusion, paresthesias
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7
Q

Valproic acid

A
  • Many different mechanisms of action; inhibits HDAC

- Nausea, vomiting, and GI complaints, teratogen (spina bifida)

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8
Q

Complex focal

A

Complex (loss of consciousness); focal (can point to lesion)

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9
Q

Absence seizures

A

generalized + non-convulsant

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