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anti-epileptics
Question | Answer |
---|---|
drugs work on ____ channels, NOT ____ channels | inactivated, closed |
drugs that work on sodium channels | carbamazepine, lamotrigine, phenytoin, VPA |
drugs that work on GABA-A receptors | clonazepam, diazepam, lorazepam, phenobarbitol |
do not use ___ for absence seizures, instead use ____ | NO: benzos YES: ethosuximide and VPA |
used 2nd line for partial and generalized tonic-clonic | phenobarbital |
phenobarbital MOA | increases duration of opening for GABA-A receptor |
phenobarbital SE | sedation, toxicity, tolerance, CYP450 inducer |
first line for febrile seizures in children | phenobarbital |
used for partial/general tonic-clonic and status epilepticus | phenytoin |
MOA phenytoin | voltage-gated Na channels |
phenytoin SE | diplopia, ataxia, rashes, hisutism, gingival hyperplasia |
which drug has nonlinear kinetics that may result in rapid increases in serum concentration in response to small doses | phenytoin |
first line for partial and general tonic clonic | carbamazepine |
MOA carbamazepine | voltage gated Na channels |
SE carbamazepine | diplopia, ataxia |
used for trigeminal neuralgia | carbamazepine |
which drug may induce aplastic anemia and agranulocytosis | carbmazepine |
DOC for myoclonic...also used for absence, partial and general | VPA |
MOA for VPA | voltage gated Na channels, T-type ca channels (at higher concentrations) |
SE for VPA | hepatotox, developmental abnormalities for pregnant women |
monitoring for VPA | LFTs and pregnancy |
used for refractory partial seizures | lamotrigine |
lamotrigine MOA | voltage-gated Na channels |
SE for lamotrigine | SJS |
benzo used for absence and myoclonic seizures in children | clonazepam |
clonazepam MOA | increases frequency of opening for GABA-A receptors |
SE of clonazepam | low toxicity, drowsiness, fast tolerance |
benzos used IV for status epilepticus | diazepam, lorazepam |
MOA for diazepam, lorazepam | GABA-A |
SE for diazepam, lorazepam | sedation and tolerance |
used for partial and secondarily generalized seizures | vigabatrin |
vigabatrin MOA | irreversible inhibition of GABA transaminase, and blocks GABA transporter |
which drug is used for West syndrome, a rare infant epilepsy | vigabatrin |
SE for vigabatrin | visual field defects and psych problems |
DOC for uncomplicated absence | ethosuximide |
MOA for ethosuximide | T-type Ca channels |
what is the safest drug to use in absence? | ethosuximide |
monotherapy for partial/primary generalized seizures | topiramate |
adjunct therapy fro refractory lennox-gastaut | topiramate |
MOA for topiramate | voltage gated Na channels and glutamate receptor antagonist |
SE topiramate | kidney stones, cognitive defects, poor vision |
adjunct for refractory adult partial seizures | kepra |
MOA for kepra | SV2A protein in synaptic vesicle (binds to BOTOX) |
used for refractory partial seizures | neurontin |
well tolerated drug usually used for neuropathic pain | neurontin |
do not use neurontin if patient is ___ | bipolar |