Drugs used for generalized absence, myoclonic or atonic seizures
Ethosuximide
Clonazepam
Ethosuximide - MOA
Blocks T-type calcium channels in thalamic neurons. Inhibits the low-threshold 3-Hz (three cycles per second) spike-and dome depolarizations seen in absence seizures.
Ethosuximide - indications
DOC for generalized absence seizures in children. (not very effective in adults or other types of seizures)
Ethosuximide - adverse effects
Drowsiness, dizziness, gastric distress, lethargy, nausea
Ethosuximide - interactions
Decreased met by: valproate. With haloperidol: altered seizure pattern
Clonazepam - MOA
Enhances GABA-mediated chloride influx
Clonazepam - indications
Absence, myoclonic and atonic seizures
Clonazepam - contraindications
Acute angle-closure glaucoma, hypersensitivity, severe liver disease
Clonazepam - interactions
Decreased met by: Cimetidine and disulfiram. Increased met by: rifampin.
Clonazepam increases CNS depression with alcohol.
Clonazepam - adverse effects
Arrhythmia, CNS depression, drug dependence, hypotension, mild
respiratory depression
Clonazepam - safety in pregnancy
Category C: apnea in newborns, defects.
Drugs for status epilepticus
Diazepam, lorazepam
phenobarbital, Phenytoin
Diazepam, lorazepam - contraindications
Acute angle-closure glaucoma, hypersensitivity, severe liver disease
Diazepam, lorazepam - adverse effects
Arrhythmia, CNS depression, drug dependence, hypotension, mild respiratory depression
Diazepam - interactions
Decreased met by: Cimetidine and disulfiram. Increased met by: rifampin. Clonazepam increases CNS depression with alcohol.
Diazepam - safety in pregnancy
Cat D: increased risk of birth defects
Lorazepam - interactions
Increased met by rifampin. Increased CNS depression with alcohol
Lorazepam - safety in pregnancy
Cat D: increased risk of birth defects
