Week 2 - Drugs Flashcards
(19 cards)
Mechanisms of anti-seizure drugs
Strategy= decrease excessive discharge rates and prevent propagation of activity
- modify ion-channels
- Increase GABA
- Block Glutamate
Phenytoin
anti-seizure (generalized tonic-clonic and partial, NOT absence)
use dependent effect on Na channels
inhibits generation of repetitive act pot
changes from 1st order to 0-order kinetics as dose increases, also varies by person
sides: CNS (nausea, anorexia, apathy, sedation)
gingival hyperplasia, hirsuitism, teratogen
Carbamazepine
anti-seizure similar to phenytoin unpredictable absorption choice for partial seizures sides: diplopia, ataxia, teratogen Oxcarbazepine= newer and better analog
Ethosuximide
anti-seizure (1st line absence seizures)
reduces T-type Ca currents in thalamic neurons
sides: GI, lethargy
Valproic acid
anti-seizure (Absence mostly, others too)
blocks repetitive neuron firing, reduces T-type Ca currents, increases GABA
sides: GI, weight gain, hepatotoxicity, spina bifida
Felbamate
anti-seizure (refractory partial seizures)
antagonist of NMDA receptor at glycine site, potentiates GABA
sides: aplastic anemia and hepatic failure
Gabapentin
anti-seizure (adjunct for partial seizures)
analog, but not agonist of GABA
also used for neuropathic pain and ALS
Pregabalin
anti-seizure (adjunctive for partial seizures)
similar and more potent to Gabapentin
also used for neuropathic pain, NO abuse potential
Lamotrigine
anti-seizure (partial, gen tonic-clonic, and absence)
blocks repetitive action potentials
also used for bipolar disorder
sides: serious rash, Stevens-Johnson syndrome
Topiramate
anti-seizure (add-on for partial seizures)
inhibits kainate/AMPA glutamate receptor
also used to prevent migraine and weight loss
Tiagabine
anti-seizure (add-on for partial seizures)
inhibits GABA GAT1 reuptake transporter
Levetiracetam
anti-seizure (adjunct for partial seizures)
mechanism unknown
sides: somnolence, dizzyness
Zonisamide
anti-seizure (adjunct for partial seizures)
acts on Na and Ca channels, stops spread
has CNS adverse rxns
Vigabatrin
anti-seizure (adjunct for refractory complex partial and infantile spasms)
irreversible GABA metabolism inhibitor
sides: possible permanent effect on vision
Clobazam
anti-seizure (adjunct for Lennox-Gastaut syndrome)
blocks v-gated Na and Ca channels
Lacosamide
anti-seizure (adjunct for partial)
enhances slow activation of Na channels
Drugs for Partial, secondarily generalized seizure
carbamazepine
gabapentin (not so much anymore)
oxcarbazepine
phenytoin
Drugs for all but absence seizures
valproic acid lamotrigine topiramate zonisamide levetiracetam felbamate
Drugs for absence seizures
ethosuximide
valproic acid
lamotrigine
