Neuro - Pharm Flashcards
(11 cards)
1
Q
Levetiracetam: MoA, PP
A
- Binds to synaptic vesicular protein (SV2A) - inhibits Ca currents
- Use: ?first line in women. Can be used in focal/generalised as add on
- Renally excreted, so doesn’t interact
- Mild toxicities but CNS/mood (SUICIDE), thrombocytopenia, fatigue, visio
- ok in preg
2
Q
All AED hepatically excreted except:
A
LEVETIRACETAM
GABAPENTIN
Dual excretion:
- Topiramate
- Phenobarbituate
3
Q
All AEDs linear kinetics except:
A
- Phenytoin
- Gabapentin
4
Q
AED w/ active metabolites
A
- CBZ
- Diazepam, Clobazam, Clonazepam
5
Q
AED - drug monitoring useful in
A
- Phenytoin
- Valproate
- Lamotrigine
- Phenobarbituate
- ?Levetriracteam
6
Q
AED that are CYP inhibitor/inducer
A
Inducer:
- CBZ
- Phenyoin
- (topiramate - weak)
Inhibitor; Valproate
7
Q
Lamotrigine - MoA, PP
A
- Sodium channel blocker
- Generalised & focal as early add on
- Interacts w/ CBZ via glucoronidation & Valproate (halve Lam dose)
- ?OCP reduces seizure control
- BEST IN PREG but still monitor & increase dose
8
Q
Gabapentin - MoA
A
Binds to α2δ subunit on Ca channel
(GABA receptors EtOH, BZD)
9
Q
Choice of AED
A
- Valproate usu choice (avoid in hepatic dis)
- Levetiracetam for young women (2* preg risks) but discuss as not as good
- Absence (pure): Ethosuximide
- Focal: CBZ > Lamotrigine > Levetiracetam
- Clonazepam - myoclonus (avoid Na channel blockers & LTG)
10
Q
Choice of AED if behavioural/mood
A
VPA
LTG
(avoid LEV)
11
Q
Choice of AED in DM
A
TPM
(Val)
