Anti-seizure medications - French

Question 1

Which antiseizure drugs block Nav channels?

Answer 1

Phenytoin, carbamazepine, lamotrigine

Question 2

Which antiseizure medications enhance GABA function?

Answer 2

BDZ, phenobarbital, GABApentin

Valproate (partly)

Question 3

Which antiseizure drug blocks T-type Ca channels?

Answer 3

Ethosuximide

Question 4

Which antiseizure drug inhibits function of synaptic vesicle protein SV2A (Blocking Ca++ mediated neurotransmitter release)?

Answer 4

levetiracetam

Question 5

What antiseizure drug inhibits the VSCC?

Answer 5

Lamotrigine (Lamictal®)

Question 6

What drugs can be used to treat tonic-clonic seizures?

Answer 6

Valproate, Levetiracetam, Lamotrigine

Question 7

What drugs can be used to treat partial seizures?

Answer 7

Carbemazepine, Levetiracetam, Lamotrigine

Question 8

1st line in treatment of generalized tonic-clonic seizures

Answer 8

Levetiracetam

Somnolence, asthenia, dizziness
Low incidence of cognitive effects
No CYP450 metabolism - minimal DDIs

Question 9

1st line for partial or generalized seizures?

Answer 9

Lamotrigine (Lamictal®)

better tolerated than phenytoin or carbamazepine (ADR: low incidence of diplopia, ataxia, dizziness, skin rashes, sedation)

Effects on VSSCs (suppress repetitive APs) and VSCCs ( Glu release)

Question 10

Notable characteristics/ADRs of valproate?

Answer 10

TERATOGENIC (neural tube defects)
Weight gain common

Inhibits metabolism of other AEDs: phenytoin, lamotrigine, carbamazepine, phenobarbital, ethosuximide

Hepatic failure –>deaths [increased risk

Question 11

What is status epilepticus?

Answer 11

Recurrent major motor seizures between which patient does not regain consciousness

Mortality of 20-25% - death can occur from respiratory arrest or circulatory collapse

Question 12

To treat status epilepticus:
1st:
2nd:
3rd:
4th:

Answer 12

1st: Diazepam, Lorazepam, Midazolam
2nd: Phenytoin or phosphenytoin
3rd: Phenobarbital
4th: Phenobarbital + propofol + pressor support

Question 13

A pregnant woman on your service has multiple seizures per day. What is the risk to the fetus?

Which drugs are safest?

Which are least safe?

Answer 13

Seizures may be more dangerous to the fetus than teratogenic effects. But,

Risk of birth defects 2-3-fold higher if mother on AEDs
Cleft palates, skeletal abnormalities, CNS-cardiac problems
Most (> 90%) deliver normal babies

Treat with monotherapy if possible. Multiple drugs = bad

Carbamazepine, phenytoin, lamotrigine - lower rates

Valproate and phenobarbital–>highest risk

**also administer vitamin K for bleeding pre-delivery (1 month)

Question 14

3 antiseizure meds that are classic inducers?

Answer 14

Phenytoin, carbamazepine, phenobarbital