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IOS 8 exam 3-seizure
seizure meds
| Question | Answer |
|---|---|
| Enzyme inducers | Phenobarbital, phenytoin, primidone, carbamazepine(auto), Felbamate, topiramate, oxcarbamazepine |
| Enzyme inhucers and inhibitors | Topiramate, Felbamate, Oxacarbazepine |
| Phase II metabolized | Lamotrigine, Tiagabine |
| Black Na channels | Phenyotin, carbamazepine, valprotae, lamatrigine, primidone, topiramate,oxacarbamazepine, Zonisamide |
| Block Ca channels-absence seizures | Ethosuximide, valproate, zonisamide (reduce T-type), Topimate (L-type), pregabalin (alpha 2), gabapentin (alpha 2) |
| Block glutamate | Felbamate (NMDA), topiramate(Kainate), lamotrigine(Glutamate), pregabalin(alpha 2) |
| Broad spectrum blockers | Valproate, zonisamide, pregabalin, levetiracetam,topiramate, felbamate, lamotrigine |
| Hypersensitivity reaction;AED | patient has inability to metabolize aromatic ring due to lack of epioxide hydroxlyase |
| AED with aromatic ring & cross sensitivity | Phenytoin, carbamazepine, phenobarbital,oxacarbamazepine, lamotrigine |
| Phenobarbital indication | status epileptus |
| Phenobarbital MOA | Gabaergic |
| Phenobarbital SE | aggression(elderly), hepatotoxcity, osteoperosis, sexual disfunction |
| Phenobarbital DI | birth control pills and cyclosporine |
| Phenytoin MOA | Na channel blocker |
| Phenytoin administration | rate NTE 50mg/min (propylene glycol crystals) |
| Phenytoin SE | Osteroperosis, gingival hyperplasia, hirtutism, venous irritation, sexual dysfunction |
| Phosphenytoin SE | cause groin itch (lower rate) |
| Phosphenytoin administration | rate at least 150mg/min monitor 2 hours after iv |
| Ethosuximide MOA | T-type ca channelinhibitor |
| Ethosuximide SE | Nightmares (children), hiccups |
| Carbamazepine MOA | Sodium channel blocker |
| Carbamazepine Dose | 400-600mg QD (TID) |
| Phenytoin serum level | 10-20mcg/L |
| Carbamazepine SE | Feel drunk, dizziness, visual disturbances, SIADH, sexual dusfunction, osteoperosis |
| Carbatrol | 3 beads of delayed release carbmazepine |
| valproate dose | 500TID |
| Valproate serum level | 50-150mcg/mL |
| Valproate SE | Hepatotoxcity, Tremor, hair changes, weight gain, osterperosis, polycystic ovarian syndrome (fat) |
| Require Ca supplements | Phenytoin, carbamazepine, phenobarbital, primidone, felbamate, valproate |
| Felbamate indication | 3rd line-lennox gastreau (various seizures) |
| Felbamate SE | aplastic anemia, hepatic failure in 6-12 months!!! CBC 2-4 times /week for 6-12 month |
| Lamotrigine | Months to get to therapeutic dose |
| Lamotrigine DI | (valproate-increases)SJS, and carbamazepine (decreases dose) |
| Lamotrigine SE | drunk feeling, SJS rash, |
| Gabapentin MOA | Gaba ergic |
| Gabapentin SE | sedation (synergisitc) |
| Topiramate | >200mg becomes inducer |
| Topiramate SE | parathesia, loss of cognition (high dose), kidney stones, weight loss |
| Tiagabine SE | Fast withdraw will cause status epilepticus, GERD, sedation, confusion |
| Levetiracetam | Immediate therapeutic level 500mg TID |
| OXacarbamazepine monitor | monohydroxy derrivative (dose 1.2 times carb dose) |
| Zonisamide | Therapeutic in week |
| Zonisamide SE | parathesia, kidney stones |
| Pregabalin MEtabolism | renal |
| Sulfa moiety drugs | Zonisamide, Topiramate |
| Oxacarbamazepine SE | SIADH (more than carb), dizziness, fatigue |
Created by:
liza001
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