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Flashcards in AEDs Deck (27)
1

Treatment of seizures typically tries to affect what 2 transmitters?

decreased effectiveness of GLU

increase effectiveness of GABA

2

What is the mechanism of action for carbamazepine?

It stabilizes the "inactivated" state of VG Na+ channels to decrease repetitive firing

3

What is the main therpauetic use of carbamazepine?

grand mal seizures

4

What are some side effects of carbamazepine

1. diplopia
2. gait instability
3. inducer of cyp450

5

What is the mechanism of action for ethosuximide?

It blocks the T-type voltage gated calcium channels in postynaptic thalamic neurons

6

What is the main therapeutic use of ethosuximide?

absence seizures

7

What are the side effects of ethosuximide?

GI distress
fatigue
headache
dizziness

8

What is the mechanism of action for levetiracetam?

It affects synaptic vesicle protein (SV2A), resulting in decreased GLU release, but increased GABA release!

9

What is the main therapeutic use of leviteracitam

partial seizures

10

What is the kinetic order for levitiracetam?

zero order

11

What are some side effects of levetiracetam?

headache
somnolence
dizziness
asthenia

12

What is the mechanism of action for topiramate?

increased inactivation of VG Na+ channels
- blocks presynaptic type N and typ P/Q VG Ca2+ channels

13

What is the main therapeutic use for topiramate?

partial and generalized tonic-clonic seizures.

great for monotherapy

14

What are some side effects of topiramate?

parasthesias, anorexia, idiosyncratic glaucoma, stones, cognitive slowing

15

What is the mechanism of action for phenytoin?

It prolongs the inactivation of VG Na+ channels, preventing rapid firing of action potentials

16

What is the main therapeutic use for phenytoin?

Generalized tonic clonic seizures

status epilepticus

17

What is critical to know about the pharmacokinetics of phenytoin?

It has zero order kinetics, so when the metabolizing enzymes are saturated, even small dose changes will cause large changes in drug concentration, increasing toxicity without added benefit

so if phenytoin isn't working for someone, just switch them to a new drug - don't increase dose

18

What are some side effects of phenytoin?

nystagmus, diplopia
ataxia
sedation
induction of cyp450 and protein binding leads to drug interactions

19

What is the mechanism of action for tiagabine?

Inhibits reuptake of GABA via GAT1, thus increasing the amount of GABA available to postsynaptic neurons

20

What is the therapeutic use for tiagabine?

partial seizures

21

What are the size effects of tiagabine?

nervousness
dizziness
depression
seizures

22

What is the mechanism of action for valproic acid?

blocks VG Na+ channels, blocks NMDA receptors, decreases GABA reuptake

23

What is the main therapeutic use for valproic acid?

absence seizures - especially when combined with some generalized tonic/clonic

24

What are the main side effects of valproic acid?

GI upset
Drug interactions with other anticonvulsants because it decreases liver metabolism
Hepatotoxicity - can be fatal
Teratogenic (inhibits HDAC)

25

What is the mechanism of action for gabapentin?

It's a GABA analog, but blocks VG Ca2+ channels

26

What barbiturate is used to treat seizure?

phenobarbital

27

What benzodiazepines are used to treat seizures?

diazepam
lorazepam