Pharm 8 Anticonvulsants Flashcards Preview

Test 7 > Pharm 8 Anticonvulsants > Flashcards

Flashcards in Pharm 8 Anticonvulsants Deck (31):
1

Boobs

BOOBS

2

Group 1 mechanism

Enhance GABA

3

Group 2 mechanism

Inhibit Glutamate

4

Group 3 mechanism

Ion channel blocker
Reduce neuronal excitability

5

Theory behind most seizure control

-Decrease Na conductance (prolong refractory period)
-Facilitate GABA

6

Absence seizure Tx theory

-Reduce Ca current
-Other drugs might exacerbate

7

-Phenytoin-
MOA

Prolong Na channel inactivation, reduce neuronal firing

8

-Phenytoin-
Metabolism
Serum levels
Interactions

-Liver
-Slow unless IV, doesn't work IM
-Oral contraceptives

9

-Phenytoin-
Toxicity (acute, chronic, IV)

Acute - Nystagmus, Diplopia, Ataxia
- Cerebellar atrophy sometimes
Chronic - Gingival hyperplasia & hirsutism
- Agranulocytosis, Rash
IV - arrhythmia, CNS depression

10

-Phenytoin-
Good aspects
Alternative

-Minimal sedation
-Fosphenytoin (pro-drug)

11

-Carbamazepine-
MOA

Non-sedating Tricyclic
Prolong Na channel inactivation

12

-Carbamazepine-
Metabolism

-Induces microsomal enzymes -> enhances metabolism of other anti-convulsants
-Active metabolite

13

-Carbamazepine-
Toxicity

Acute - Stupor, Coma, Convulsion, Rash
Chronic - Diplopia, Ataxia
- Agranulocytosis
- Stevens-Johnson in Asians (test)

14

-Phenobarbitol-
Indication
MOA

-Young children, Status Epilepticus
-Na inactivation, GABA stimulation

15

-Phenobarbitol-
SE

-Sedation, Respiratory depression, Tolerance

16

-Lamotrigine-

-Adjunct
-May cause life threatening rash in children

17

-Feldamine-

-Adjunct
-Severe hepatitis and Aplastic Anemia

18

-Gabapentin-

-Adjunct (GABA)
-May exacerbate myoclonic seizures

19

-Topiramate-

-Adjunct
-Typical mental SE

20

-Tiagabine-

-Adjunct (GABA)
-Typical mental SE

21

-Pregabalin-

-Adjunct (GABA)
-Good for neuropathic pain
-Euphoria SE

22

-Ethosuximide-
Indication
MOA

-Absence seizures
-Ca channel inhibition (thalamic)

23

-Ethosuximide-
Metabolism

Liver

24

-Ethosuximide-
SE
Toxicity

-GI side effects
-Rash and bone marrow depletion

25

-Valproic Acid-
Indication
MOA

-Absence seizures, Generalized Tonic-Clonic
-Inhibit Na and Ca channels and GABA

26

-Valproic Acid-
Metabolism
Interactions

-Liver
-Blocks metabolism of other anti-convulsants (phenytoin, carbamazepine, phenobarbital)

27

-Valproic Acid-
SE
Toxicity

-GI side effects, birth defects
-Hepatotoxicity in infants and patients on too many medications

28

-Diazepam-
Indication
MOA

-Status Epilepticus
-Benzo

29

-Clonazepam-
Indication
MOA

-Infantile spasms, Absence/myclonic seizures

30

Anticonvulsant interaction with:
Oral contraceptives
Pregnancy

-Reduce efficacy (phenytoin, carbamazepine, phenobarbital)
-Vitamin K deficiency -> Coagulation problems

31

Most teratogenic anticonvulsant

Valproic acid