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