Mod 3 Antiepileptic Drugs Flashcards Preview

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Flashcards in Mod 3 Antiepileptic Drugs Deck (8):


 Brief episode of abnormal electrical activity in the nerve cells of the brain
Involuntary spasmodic contractions of any or all voluntary
muscles throughout the body, including skeletal and facial
 Epilepsy
Chronic, recurrent pattern of seizures
Primary (idiopathic)
 Cause cannot be determined
 More than 50% of epilepsy cases
 Secondary
 Distinct cause identified
• Trauma, infection, cerebrovascular disorder


Classification of Epilepsy

Partial-onset seizures
 Simple (formerly known as petit mal seizures)
 Complex
 Secondary generalized tonic-clonic
 Generalized-onset seizures
 Formerly known as grand mal seizures
 Unclassified seizures
 Status epilepticus


Antiepileptic Drugs

Also known as anticonvulsants
 Goals of therapy
 To control or prevent seizures while maintaining a reasonable quality of life
To minimize adverse effects and drug-induced toxicity
 AED therapy is usually lifelong
 Combination of drugs may be used
Single-drug therapy started before
multiple-drug therapy is tried
 Serum drug concentrations must be
Therapeutic drug monitoring
 Patients who are seizure free for 1 to 2 yearsmay be able to discontinue antiepileptic


Mechanism of Action

AED therapy must:
 Prevent generation and spread of excessive
electrical discharge from abnormally functioning nerve cells
 Protect surrounding normal cells
AEDs thought to alter movement of sodium,
potassium, calcium or magnesium ions across nerve cells in the brain
 Reduce nerve’s ability to be stimulated
 Suppress transmission of impulses from one nerve to the next
Decrease speed of nerve impulse conduction within a neuron


Mechanism of Action (cont’d)

Overall effect
 Neurons are stabilized
 Neuron hyperexcitability is decreased
 Spread of excessive nerve impulses is decreased


Antiepileptic Drugs:

Prevention or control of seizure activity
Long-term maintenance therapy for chronic, recurring seizures
Acute treatment of convulsions and status


Antiepileptic Drugs

Adverse effects often necessitate a change in
medication Black box warning as of  Suicidal thoughts and behavior
Long-term therapy with phenytoin may cause gingival hyperplasia, acne, hirsutism, and Dilantin facies


Antiepileptic Drugs (cont’d)

phenobarbital (Solfoton)
 primidone
 carbamazepine (Tegretol)
 valproic acid (Depakote)
 phenytoin (Dilantin)
 fosphenytoin
succinimides, such as ethosuximide (Zarontin)
benzodiazepines (clonazepam and clorazepate)
gabapentin (Neurontin)
lamotrigine (Lamictal)
 pregabalin (Lyrica)
 levetiracetam (Keppra)
 topiramate (Topamax)
 tiagabine (Gabitril)