click below
click below
Normal Size Small Size show me how
Anti-epileptics
Name | MOA | USES | AE/BB | Contra/Inter | Monitor/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 |