Seizure/Epilepsy Pharm Flashcards Preview

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Flashcards in Seizure/Epilepsy Pharm Deck (24):
1

What is the drug of choice for absence seizures?

Ethosuximide

2

What AED enhances slow inactivation of Na+ channels?

Lacosamide (Partial onset seizures)

3

Which AED's enhance fast inactivation of Na+ channels?

Phenytoin, Carbamezepine, lamotrigine, oxycarbazepine

4

What channels are involved in absence seizures?

VSCC, T-Type Ca++ channels that mediate activity in the thalamus

5

What type of seizures can Valproate be used for? Side effects?

Broad spectrum-> all seizure types
Side effects-> weight gain, hair loss, lethargy, neural tube defects in pregnancy

6

What is the MOA of Lamotrigine? Used for what?

Acts on VGSC, N and P-type Ca++ channels, and K current
Broad spectrum seizure drug

7

What does Tiagabine act on? Used for what type of seizure?

Inhibits GABA re-uptake-> increased GABA outside cell
Used for partial onset seizures

8

What does Vigabatrin act on? Used for what type of seizure?

Inhibits GABA metabolism-> increased GABA in vesicles
Used for partial onset seizures

9

Where/how do benzodiazepines act?

Bind to post-synaptic GABA receptors-> potentiate GABA binding-> Cl- channel opens

10

Where does phenobarbital act?

Acts on post-synaptic GABA receptors-> can act independently of GABA in high doses-> toxicity

11

What is the standard tx for status epileptics?

1st-> IV lorazepam/diazepam, if seizure is not stopped in 5 mins-> give Fosphenytoin IV

12

What is the drug of choice for myoclonic seizures?

Clonazepam

13

What are the actions of Topirimate? Used for what seizure type?

Is a AMPA receptor antagonist (blocks glutamate receptor), acts on ligand-gated ion channels, and a GABA receptor agonist. Used for all seizure types

14

What is the MOA of Levitiracetam? Used for what seizure type?

Binds to SV2A (synaptic vesicle protein) and prents fusion with membrane and glutamate release. Broad spectrum drug

15

What are the complications of phenytoin?

Zero-order pharmacokinetics, induces Hepatic CYP450 enzymes, causes gingival hyperplasia, osteoporosis.

16

What are the complications of carbamazepine?

Induces Hepatic CYP450 enzymes, can have Aplastic Anemia, osteoporosis, increased clearance of OC/warfarin

17

What drug induces its own metabolism via CYP450 and must be monitored closely?

Carbamazepine

18

What AED's have mixed renal-hepatic clearance?

Topiramate, oxycarbazepine, levetiracetum, zonisamide

19

What drugs are associated with hyponatremia?

Oxycarbazepine and carbamazepine (SIADH)

20

What AED's have 100% renal clearance?

Gabapentin, Pregabalin

21

What is Stevens-Johson syndrome? What causes it?

Rash
Lamotrigine

22

What drugs inhibit conjugation of drugs via UGT enzymes?

Valproate and Lamotrigine

23

What is a serious adverse effect of Topiramate?

Nephrolithiasis

24

What AED's are class D Teratogens?

Valproic acid, Carbamazepine, Phenytoin