Anticonvulsants Flashcards
(43 cards)
Seizure (convulsion)
Clinical manifestation of abnormal activity in the brain
Epilepsy
Multiple seizures over a long period of time
Status epilepticus
Seizure lasting at least 5 minutes or 2+ discrete seizures without full recovery of consciousness between seizures
Primary cause of seizures
Idiopathic epilepsy
Secondary cause of seizures
Distemper, head injury, encephalitis
Reactive cause of seizures
Fever/heatstroke, poisoning
At home treatment of seizures
Diazepam 1-2mg/kg via rectum up to 3x/24hrs
In hospital treatment of seizures
Diazepam 5-10mg IV to effect
Diazepam 1-2mg/kg rectal if no IV access
0.5mg/kg/hr CRI if seizures reoccur after Diazepam bolus
Lorazepam, Midazolam, Clonazepam, Chlorazepate
Phenobarbital (10-20mg/kg IV increments to effect)
If no response - general anesthesia
When do you start treatment when diagnosed with epilepsy?
More than 1 seizure per month, seizure within 1 week of head injury, or when brain lesion is ID’s
Drugs to avoid
Phenothiazines
Butyrophenones
Opioid agonists
Fluoroquinolones (+NSAIDs) - lower seizure threshold
Where do Benzodiazepines act?
GABA agonist
Where does Phenobarbital act?
GABA agonist
Where does Gabapentin act?
Block Ca2+ channels
Where does Felbamate act?
GABA agonist
NMDA antagonist
Block Na+ channels
Where does Valproate act?
GABA agonist
Block Ca2+ channels
Clinical uses for Benzodiazepines
Emergency anticonvulsant
Clinical uses for Phenobarbital
Initial therapy (drug of choice in cats and dogs)
Clinical uses for Bromide
Add-on to Phenobarbital or initial therapy
Clinical uses for Levetiracetam
Mono therapy or as an add-on to Phenobarbital
Clinical uses for Valproate
Add-on to Phenobarbital
Clinical uses for Zonisamide
Add-on to Phenobarbital or mono therapy
Clinical uses for Gabapentin
Add-on with Phenobarbital and/or Bromide
Clinical uses for Felbamate
Add-on to Phenobarbital or mono therapy
Side effects of Benzodiazepines
Enzyme induction (will effect PK of other drugs)
