Antiepileptic Drugs Flashcards Preview

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Flashcards in Antiepileptic Drugs Deck (32):
1

mechanistically what triggers seizures

decrease in inhibitory synaptic activity or an increase in excitatory synaptic activity

2

what are the two main classes of anti epileptic drugs

-drugs that block voltage gated channel: Na and T type Ca
-drugs that affect synaptic transmission: GABA agonist or glutamate antagonist

3

what are the drugs that block Na voltage gated channels

PCOLZ PVT (not so sure about PVT)

-Phenytoin
-Carbamazepine
-Oxcarbazepine
-Lamotrigine
-Zonisamide

-Phenobarbital
-Valproate
-Topiramate

4

drugs that block T type Ca channels

Ethosuximide
Valproate

5

drugs that enhance GABA transmission postsynapticallly and their mechanism

Direct action on the GABA receptors

Benzos
Barbiturates
Topiramate

6

drugs that enhance GABA transmission pre-synaptically and their mechanism

-inhibit reuptake of GABA: Tiagabine

-inhibit degradation of GABA by irreversibly inhibiting GABA aminotransferase: Vigabatrin

7

drugs that inhibit glutamate neurotransmission pre-synaptically and their mechanism

-decrease glutamate release by blocking pre-synpatic voltage gated Ca channels: Gabapentin and Pregabalin


-binds to synaptic vesicle glycoprotein 2A (SV2A) : Levetiracetam

8

drugs that inhibit glutamate neurotransmission post synaptically and their mechanism

Phenobarbital and Topiramate: blocks glutamate receptors

9

drugs used for tonic-clonic seizures (generalized seizure)

COLT PV (Coach J)

Carbamazepine
Oxcarbazepine
Lamotrigine
Topiramate

Phenytoin
Valproate

10

drug of choice for absence seizures (generalized seizures)

Ethosuximide
Valproate

11

drug of choice if tonic-clonic seizures occur or emerge during absence seizures or preferred for atypical absence seizures

Valproate

12

drug of choice for myoclonic seizures (short episode of muscle contractions that may happen for several minutes) and drug used for adjunct therapy

Valproate

-Levetiracetam as adjunct therapy

13

drug of choice for atonic seizure (sudden loss of postural tone)

usually all drugs are refractory

Valproate and Lamotrigine may be beneficial

14

treatment of febrile seizures

-if less than 15 minutes, give supportive therapy

-if greater than 15 minutes, use diazepam IV or as rectal solution

15

first line treatment for status epilepticus (seizures lasting longer than 30 minutes -- life threatening)

IV Lorazepam

16

if seizures in status epilepticus continue after administration of IV lorazepam, what drug should be given

IV phenytoin or Fosphenytoin

17

in status epilepticus, if IV lorazepam and phenytoin fail, what should be given

Phenobarbital

18

Common complication of phenobarbital especially after giving lorazepam and phenytoin ...how should the complication be handled

Respiratory depression --> intubation and ventilation should be instituted

19

In status epilepticus, if lorazepam, phenytoin, and phenobarbital are not working, what should be done

general anesthesia with
Barbiturates (thiopental or pentobarbital)
Propofol
Midazolam

20

seizures due to drug overdose or poisoning in a non epileptic person should be treated how

local anesthesia such as
Diazepam
Lorazepam
Phenobarbital

all IV

21

drug used for breakthrough seizures (seizures in those on anti epileptic regimen)

Diazepam rectal gel

22

AE of phenytoin

Gingival Hyperplasia
Fetal Hydantoin Syndrome

23

AE of valproate

Hepatotoxicity
Spina Bifida

24

AE of lamotrigine and what should be done

Steven Johnson's rash - discontinue at first sign of rash

carries black box warning about rash

25

AE of carbamazepine

Aplastic anemia
Agranulocytosis

26

what occurs with overdose of anti epileptics

Respiratory Depression

27

AE of phenobarbital

Cardiac defects
Oral clefts

28

AE of Topiramate

Oral clefts

29

what are some supplements that are given to pregnant women on anti epileptics drugs

first off, they should be avoided if possible especially ones like Valproate and Phenytoin

-supplement folate to prevent spina bifida
-supplement vitamin K especially in final months of pregnancy and in newborn to prevent Newborn Hemorrhagic Disease

30

first line for essential tremor and also used as an anti epileptic

Primidone

31

used for trigeminal and post herpetic neuralgia

Trigeminal Neuralgia: Carbamazepine
Post Herpetic Neuralgia: Gabapentin and Pregabalin

32

non pharmacological treatment of seizures

Vagus Nerve Stimulation
Surgery
Ketogenic Diet

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