Neuro Drugs 1 - Epilepsy Drugs Flashcards

1
Q

Clinical use: Tiagabine

A

Focal

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2
Q

Mechanism: Phenobarbital

A

Facilitate GABAA action by increasing duration of Cl- channel opening, thus decreasing neuron diring

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3
Q

Mechanism: Vigabatrin

A

Increase GABA by irreversibly inhibiting GABA transaminase

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4
Q

Clinical use: BDZs

Diazepam

Lorazepam

Midazolam

A

Status epilepticus (1st line for acute)

Eclampsia seizures (2nd line; 1st line is magnesium sulfate)

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5
Q

Clinical use: Topiramate

A

Focal

Tonic-clonic

Migraine prophylaxis

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6
Q

Adverse effects: Phenobarbital

A
  1. Sedation
  2. Tolerance
  3. Dependence
  4. Cardiorespiratory depression
  5. P-450 induction
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7
Q

Clinical use: Levatiracetam

A

Focal

Tonic-clonic

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8
Q

Mechanism: Lamotrigine

A

Blocks voltage-gated Na+ channels

Inhibits release of glutamate

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9
Q

Adverse effects: Phenytoin, Fosphenytoin

A
  1. Neuro: Nystagmus, diplopia, ataxia, sedation, peripheral neuropathy
  2. Hirsutism
  3. Stevens-Johnson syndrome
  4. Gingival hyperplasia
  5. DRESS syndrome
  6. MSK: Osteopenia, SLE-like syndrome
  7. Heme: Megaloblastic anemia
  8. Teratogen (fetal hydantoin syndrome)
  9. P-450 induction
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10
Q

Clinical use: Lamotrigine

A

Focal

Tonic-clonic

Absence

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11
Q

Clinical use: Gabapentin

A

Focal

Peripheral neuropathy (e.g., DM)

Postherpatic neuralgia

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12
Q

Adverse effects: Lamotrigine

A
  1. Stevens-Johnson syndrome (must titrate slowly)
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13
Q

Adverse effects: BDZs

Diazepam

Lorazepam

Midazolam

A
  1. Sedation
  2. Tolerance
  3. Dependence
  4. Respiratory depression
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14
Q

Clinical use: Valproic acid

A

Focal

Tonic-clonic (1st line; phenytoin also 1st line)

Absence (combo tonic-clonic + absence)

Myoclonic seizures

Bipolar disorder

Migraine prophylaxis

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15
Q

Clinical use: Carbamazepine

A

Focal (1st line)

Tonic-clonic

Trigeminal neuralgia (1st line)

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16
Q

Mechanism: Levatiracetam

A

Unknown

May modulate GABA and glutamate release

17
Q

Clinical use: Ethosuximide

A

Absence (1st line)

18
Q

Mechanism: Ethosuximide

A

Blocks thalamic T-type Ca2+ channels

19
Q

Adverse effects: Carbamazepine

A
  1. SIADH
  2. Steven-Johnson syndrome
  3. Diplopia
  4. Ataxia
  5. Blood dyscrasias - agranulocytosis, aplastic anemia
  6. Hepatoxicity
  7. Teratogenesis
  8. P-450 induction
20
Q

Mechanism: Gabapentin

A

Designed as GABA analog:

Primarily inhibits high-voltage-activated Ca2+ channels (essentialy for fusion/release of NT)

21
Q

Mechanism: Valproic acid

A

Increase Na+ channel inactivation

Increase GABA concentration by inhibiting GABA transaminase

22
Q

Clinical use: Vigabatrin

A

Focal

23
Q

Adverse effects: Topiramate

A
  1. Sedation
  2. Mental dulling
  3. Kidney stones
  4. Weight loss
  5. Glaucoma
24
Q

Adverse effects: Gabapentin

A
  1. Sedation
  2. Ataxia
25
Q

Adverse effects: Ethosuximide

A
  1. Stevens-Johnson syndrome
  2. Itching and urticaria
  3. Fatigue
  4. GI distress
  5. Headache
26
Q

Adverse effects: Vigabatrin

A
  1. Permanent visual loss (black box warning)
27
Q

Adverse effects: Valproic acid

A
  1. Weight gain
  2. Hepatotoxicity (measure LFTs)
  3. Neural tube defects (contraindicated in pregnancy)
  4. Pancreatitis
  5. GI distress
  6. Tremor
28
Q

Mechanism: BDZs

A

Facilitate GABAA action by increasing frequency of Cl- channel opening, thus decreasing neuron firing

29
Q

Mechanism: Phenytoin, Fosphenytoin

A

Blocks Na+ channels

(zero-order kinetics)

30
Q

Clinical use: Phenobarbital

A

Focal

Tonic-clonic

(1st line in neonates)

31
Q

Mechanism: Tiagabine

A

Increase GABA by inhibiting reuptake

32
Q

Mechanism: Carbamazepine

A

Blocks Na+ channels

33
Q

Clinical use: Phenytoin, Fosphenytoin

A

Focal

Tonic-clonic (1st line; valproic acid also 1st line)

Status epilepticus (1st line prophylaxis)

34
Q

Mechanism: Topiramate

A

Blocks Na+ channels

Increases GABA action

35
Q

Adverse effects: Levetiracetam

A
  1. Fatigue
  2. Drowsiness
  3. Headache
  4. Neuropsychiatric symptoms (e.g., personality changes)