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Anti-epileptics

NameMOAUSESAE/BBContra/InterMonitor/Pearls
Phenobarbital GABA-a receptor agonist Barbituate 2nd line partial and GTC 1st line febrile seizures children drowsiness and cognitive slowing CYP450 (dec lvls of drugs) serum concentrations, LFTs, CBC
clonazepan (Klonopin) GABA-a receptor agonist BZD DOC myocloinc drowsiness/sedation Preg Cat D CYP34A inhibitors and inducers CBC, liver and renal function
diazepam (valium) GABA-a receptor agonist BZD DOC for Status Epilepticus too rapid = apnea and cardiac arrest preg cat D be aware of dependence
lorazepam (ativan) GABA-a receptor agonist BZD DOC for Status Epilepticus too rapid = apnea and cardiac arrest preg cat D
tiagabine (gabitril) inhibits GABA uptake in neurons and glia "adjunct agent" combo with older drugs to treat partial seizures increased risk of suicidal thoughts Preg cat C
gabapentin (neurontin) increases release of GABA all forms of partial seizures minimal, but can cause ataxia, dizziness increase interval in persons with renal insufficiency
vigabatrin (sabril) GABA transaminase inhibitor increases lvls of GABA partial, secondarily generalized *west's syndrome* psychiatric defects visual field preg cat C used in refractory bc of visual defects
ethosuximide (zarontin) blocks T-type Ca channesl absence seizures safe inc by vpa not effective in adults
topiramate (topamax) glutamate blocker (1) partial onset and secondarily GTC (2) primary GTC (3) Lennox Gastaut syndrome MC ataxia, cognitive sedation preg cat D
levetiracetam (keppra) binds to SV2A impedes neuronal firing adjunct for partial, juvenile myoclonic, primary GTC somnolence
zonisamide (zonegran) blocks Na+ channels blocks T-type Ca channels adjunct with older AED for partial dizziness, anorexia, HA, ataxia preg cat C serum bicarb before and after treatment
phenytoin (dilantin) Blocks Na+ channels first line for partial and GTC seizures Gingival Hyperplasia hirsutism preg cat D Benzos, PPI, & Itraxonazole INCREASES effects Carbemazepine & Barbituated DECREASE effects Non-linear kinetics
Carbamazepine (tegretol) Blocks Na+ channels first line for partial and GTC seizures DOC trigeminal neuralgia CNS=sedation, ataxia Eyes=diplopia GI=N/V Metabolic/endo=hyponatremia (SIADH in old) BB= SJS, agran CYP450 inducer and autoinduce
Lamotrigine (lamictal) Blocks Na+ channels adjucnt for partial SJS MC for prego
valporic acid (depakote/Depakene) Inibits Na+ channesl at HIGH concentrations DOC for generalized myoclonic seizures GI Preg cat D salicylates increase serum VA lvls LFTs baseline and 1st 6 months
Created by: duanea00