Antiseizure Drugs Flashcards Preview

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Flashcards in Antiseizure Drugs Deck (33):
1

the oldest organic antiseizure drug; GABA agonist; use for partial and generalized tonic-clonic; may worsen symptoms of absence, atonic attacks, and infantile spasms

phenobarbital

2

benzodiazepine; generalized tonic-clonic status epilepticus; tolerance after repeated use

diazepam

3

benzodiazepine; more effective and longer lasting vs. diazepam; tolerance

lorazepam

4

benzodiazepine: effective against absence and myoclonic; long acting and highly potent; tolerance

clonazepam

5

benzodiazepine: add-on treatment of complex partial seizures in adults

clorazepate

6

1st non-sedative antiepileptic drug; prolongs the inactivated state of Na channels; partial and generalized tonic-clonic; highly bound to plasma protein

phenytoin

7

more soluble prodrug that is converted to phenytoin in the blood

fosphenytoin

8

elimination of low doses of phenytoin: ... order kinetic

1st

9

elimination of higher doses of phenytoin: ... order kinetic

zero

10

what drug displaces phenytoin from plasma proteins

valproic acid

11

side effects of which drug?: diplopia and ataxia; gingival hypertrophy; hirsutism; peripheral neuropathy; osteomalacia; teratogenicity (fetal hydantoin syndrome)

phenytoin

12

related to TCA; prolong the inactivated state of Na channels; partial and generalized tonic-clonic; not for absence and myoclonic seizures

carbamazepine

13

2 potentially fatal side effects of carbamazepine

aplastic anemia and agranulocytosis

14

analog of carbamazepine; less potent with improved toxicity profile

oxcarbazepine

15

enhances slow inactivation of Na channels; binds to collapsin-response mediator protein--> prevent excitatory axonal sprouting; partial with/without secondary generalization

lacosamide

16

enhances slow inactivation of Na channels; add-on treatment of Lennox-Gastaut syndrome

rufinamide

17

inhibition of GABA uptake (GAT-1); significant binding to plasma proteins; add-on treatment of partial seizures

tiagabine

18

an irreversible inhibitor of GABA aminotransferase; used for partial, infantile spasms, reserved for patients refractory to other drugs; side effect: permanent bilateral vision loss

vigabatrin

19

analog of GABA; add-on treatment of partial with or w/o secondarily generalized

pregabalin

20

analog of GABA; add-on treatment of partial and generalized tonic-clonic

gabapentin

21

prolong inactivated state of Na channels; inhibit voltage gated Ca channels; inhibit release of glutamate; add-on or monotherapy; used for partial, Lennox-Gastaut syndrome; side effect: Stevens-Johnson syndrome

lamotrigine

22

Lamotrigine is metabolized by ...

UGT

23

valproic acid ... UGT

inhibits

24

structurally different from all other antiseizure drugs; prolong inactivated state of Na channels; inhibit voltage gated Ca channels; agonist of GABA receptor; antagonist of kainate receptors; used for partial and generalized tonic-clonic and Lennox-Gastaut syndrome; its teratogenic

topiramate

25

"pure petit mal" drug; absence seizure; blocks T-current: inhibits 3-Hz activity; valproic acid decrease clearance; side effect of leukopenia

ethosuximide

26

blocks T-current; prolongs the inactivated state of Na channels; increase GABA levels; used for absence, myoclonic, partial and generalized tonic-clonic (broad spectrum)

valproic acid

27

primarily metabolized by UGT with significant binding to plasma proteins; inhibits metabolism of CYP3A, CYP2C9 and UGT

valproic acid

28

valproic acid displaces ... and ... from plasma proteins

phenytoin and lamotrigine

29

side effects of which drug?: severe hepatitis and pancreatitis; teratogenicity (spina bifida); inhibition of platelet aggregation w/ gingival bleeding

valproic acid

30

binds to synaptic vesicular protein SV2A and regulates release of glutamate and GABA; add-on therapy for partial, primary generalized tonic-clonic. myoclonic due to juvenile myoclonic epilepsy

levetiracetam

31

activation of voltage gated K channels; add on treatment for partial seizures in adults; causes psychosis in some pts

retigabine

32

non competitive antagonist of AMPA receptors; add on for partial

perampanel

33

Na channel blocker; analog of oxcarbazepine; add on for partial

eslicarbazepine