Question | Answer |
4 AEDs that act on Na+ channel inhibition | phenytoin, carbamazepine, lamotrigine, valproic acid |
AEDs that enhance Na+ channel inhibition are good drugs for | partial seizures and secondary generalized seizures |
Na+ channel blocker AEDS function in what manner? | use dependent manner |
MOA of Phenytoin | slows channel recover between inactivated to closed |
Phenytoin is a major drug choice for what types of seizures? | Partial and Tonic-Clonic (secondary generalized) seizures |
AED that when used with phenytoin can greatly decrease phenytoin levels | carbamazepine |
Pt with seizures that takes phenytoin might be switched to this drug if they need medications for other medical problems | Carbamazepine |
MOA of Carbamazepine | slows recovery of Na+ channel from inactivated to closed |
3rd line DOC for atypical absence seizures | lamotrigine |
AEDs that block T-type calcium channels are used for what | absence seizures |
1st line therapy for uncomplicated absence seizures | ethosuxamide |
2nd line AED for absence seizures not responding to ethosuxamide | valproic acid |
Partial seizures not responding to phenytoin or carbamazepine are usually treated with | Valproic acid |
MOA of Valproic Acid | affects Na+ channels, at slightly higher concentration inhibits T-type Ca++ channel, and also stimulates GABA synthesis and inhibits it’s degradation |
Pt has a generalized epileptic syndrome with mixed seizure types. DOC? | Valproic acid |
DOC for idiopathic generalized seizures | Valproic acid |
MOA: Gabapentin | increases GABA but major action is inhibiting HVA Ca++ channels |
4th DOC for absence seizures | clonazepam |
MOA of benzodiazepines | increase affinity for GABAa receptors; increase Cl- influx through GABAa receptor |
MOA that makes clonazepam special from other benzos | inhibit T-type Ca++ channels in the thalamus, “turning off” the reticular nucleus |
Benzo’s are used in what mode for seizure Tx | used to ablate partial and tonic-clonic seizures |
Don’t give phenobarbital with this type of seizure because it might exacerbate it | absence seizures |
Used in extreme refractory epilepsy b/c can cause fatal aplastic anemia | felbamate |
Used in ventricular arrhythmias that don’t respond to lidocaine or procainamide | Phenytoin |
MOA for benzodiazepines | increase the FREQUENCY of GABA-mediated chloride ion channel opening |
Benzodiazepine that has efficacy against absence seizures and in anxiety states, such as agoraphobia | clonazepam |
DOC for status epilepticus | Diazepam |
2 AEDs used for treatment of Bipolar Affective Disorder | Carbamazepine, lamotrigine |
If Pt is being treated for partial or tonic-clonic seizures with multiple drugs and drops dead, suspect this drug | tiagabine |
Adjunct therapy for partial seizures that may cause anemia or leukopenia | levetiracetam |