Rapid - Antiepileptics Flashcards Preview

M2 - Pharm Rapid > Rapid - Antiepileptics > Flashcards

Flashcards in Rapid - Antiepileptics Deck (25):
1

Status Epilepticus

  • Continuous or recurring seizures > 10-30 min
  • May result in brain injury
  • Rx: Benzos, Phenytoin

2

Seizures

Synchronized, high frequency neuronal firing + reduced threshold

3

Epilepsy

D/o of recurrent non-febrile seizures

4

Partial Seizure

  • usually focal in medial temporal lobe and may generalize
  • possible aura
  • Rx: Carbamazepine

5

Simple Partial Seizure

  • no loss of consciousness
  • motor, sensory, autonomic, psychic

6

Complex Partial Seizure

+ loss of consciousness

7

Generalized Seizure

diffuse

8

Absence Seizure

  • Generalized
  • "petit mal"
  • 3 Hz
  • no postictal confusion
  • blank stare
  • Rx: Ethosuxamide

9

Myoclonic Seizure

  • Generalized
  • Quick, repetitive jerks

10

Tonic-Clonic Seizure

  • Generalized
  • "grand mal"
  • alternating stiffening and movement
  • Rx: phenytoin, carbamazepine, valproic acid

11

Tonic Seizure

  • Generalized
  • Stiffening

12

Atonic Seizure

  • Generalized
  • "Drop" → fall to floor
  • Commonly mistaken for fainting

13

Ethosuxamide

  • Anti-epileptic
  • Blocks T-type Ca2+ channels in thalamic neurons
  • Use: absence seizures
  • S/E:
    • Fatigue
    • GI distress
    • HA
    • Itching
    • SJS

14

Eclampsia Seizures Rx

  • 1st line: MgSO4
  • 2nd line: Benzos

15

Phenytoin

  • Anti-epileptic
  • Increases Na+ channel inactivation in cortical neurons
  • Zero-order kinetics
  • Use:
    • Status epilepticus (prophylaxis)
    • Tonic-clonic seizures (1st line)
    • Simple and complex partial seizures
  • S/E:
    • Nystagmus
    • Gingival hyperplasia (increased PDGF)
    • Peripheral neuropathy
    • Megaloblastic anemia (vit def)
    • SLE-like syndrome
    • SJS
    • Osteopenia
    • Teratogenesis (cleft palate, heart defects, phalanx hypoplasia)
  • P450 inducer

16

Carbamazepine

  • Anti-epileptic
  • Increases Na+ channel inactivation in cortical neurons
  • Undergoes autoinduction (t1/2 decreases) → slowly increase dose to keep therapeutic
  • Use:
    • Trigeminal neuralgia (1st line)
    • Simple and Complex Partial Seizures (1st line)
    • Tonic-Clonic Seizures (1st line)
  • S/E:
    • Blood dyscrasias
    • Liver toxicity
    • SIADH
    • SJS
    • Hyponatremia
    • Diplopia
    • Ataxia
    • Teratogenesis
  • P450 inducer

17

Trigeminal neuralgia

  • extreme, sporadic, sudden burning or shock-like facial pain in CN5 distribution
  • lasts from a few seconds to as long as two minutes per episode

18

Valproic Acid

  • Anti-epileptic
    • Increases Na+ channel inactivation
    • Inhibits GABA transaminase → increases GABA concentration
  • Use:
    • Tonic-Clonic Seizures (1st line)
    • Simple and Complex Partial Seizures
    • Absence Seizures
    • Myoclonic Seizures
    • Bipolar D/O maintenance
  • S/E:
    • BM suppression
    • Teratogenesis: Neural tube defects
    • GI distress
    • Hepatotoxicity (can be fatal)
    • Tremor
    • Weight gain
    • Alopecia

19

Gabapentin

  • Anti-epileptic
  • Designed as GABA analog
  • Inhibits voltage-activated Ca2+ channels
  • Use:
    • Simple and Complex Partial Seizures
    • Peripheral neuropathy
    • Posteherpetic neuralgia
  • S/E:
    • Sedation
    • Confusion
    • Ataxia

20

Topiramate

  • Anti-epileptic
  • Blocks Na+ channels
  • Increases GABA action
  • Use:
    • Simple and Complex Partial Seizures
    • Tonic-Clonic Seizures
    • Migraine Prophylaxis
    • Neuropathic Pain
  • S/E:
    • Sedation / Mental dullness
    • Parasthesias
    • Kidney stones
    • Weight loss
    • Hyperthermia (decreased sweating)

21

Lamotrigine

  • Anti-epileptic
  • Blocks voltage-gated Na+ channels
  • Use:
    • Simple and Complex Partial Seizures
    • Tonic-Clonic Seizures
    • Absence Seizures
    • Bipolar d/o maintenance (dec risk depressive episode)
  • S/E:
    • SJS
    • Aseptic meningitis

22

Levetiracetam

  • Anti-epileptic
  • May modulate GABA and Glu release
  • Use:
    • Simple and Complex Partial Seizures
    • Tonic-Clonic Seizures

23

Tiagabine

  • Anti-epileptic
  • Inhibits GABA reuptake
  • Use: Simple and Complex Partial Seizures

24

Vigabatrin

  • Anti-epileptic
  • Irreversibly inhibits GABA transaminase
  • Use: Simple and Complex Partial Seizures

25

Anti-Epileptic Drugs

  • Ethosuxamide
  • Benzodiazepines
  • Phenytoin
  • Carbamazepine
  • Valproic Acid
  • Gabapentin
  • Pregabalin
  • Phenobarbital
  • Topiramate
  • Lamotrigine
  • Levetiracetam
  • Tiagabine
  • Vigabatrin