(3.10) Pharmacology of anticonvulsant drugs & drugs used to tx all seizures

Question 1

What is the MOA of lamotrigine (lamictal)?

Answer 1

Inhibits Na and voltage gated Ca channels

Question 2

What are toxicities of lamotrigine (lamictal)?

Answer 2

Sedation, ataxia, serious skin rash (Steven-Johnson syndrome/toxic epidermal necrolysis)

Question 3

What are MOA of valproate (depaken)?

Answer 3

Inhibits Na and Ca channels

Question 4

What are drugs interactions of valproate (depaken)?

Answer 4

• Displaces phenytoin from plasma proteins
• Inhibits metabolism of phenytoin, carbamazepine, phenobarbital, lamotrigine

Question 5

What are toxicities of valproate (depaken)?

Answer 5

GI distress, hyperammonemia, hepatotoxicity (can be fatal - careful monitoring necessary)

Question 6

What is the MOA of levetiracetam (Keppra)?

Answer 6

• Binds the synaptic vesicular protein SV2A, and thus interferes w synaptic vesicle release and neurotransmission
• Also appears to interfere w Ca entry through Ca channels and w intraneuronal Ca singaling

Question 7

Due to its unique MOA, what is levetiracetam (keppra) a candidate for?

Answer 7

Candidate for tx of status epilepticus cases that are refractory to other therapies