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Pharm 2.2

QuestionAnswer
GABA slows your brian by blocking specific signals in the CNS
Anticonvulsants administration, tips Take at same time of day in the same way each day. Only take in pregnancy if benefits outweigh risks.
Phenytoin MOA Decreases voltage gated NA+ channels, decreasing excitation
Phenytoin misc Can cause fetal hydantoin syndrome gingival hyperplasia, ataxia, slurred speech, nystagmus. 10-20 mcg/mL. Can not be mixed with D5W, causes purple glove via IV. No tube feedings 2 hrs before and after. May discolor urine.
Valproate(Depakote) MOA , complications side effects. Decreases voltage gated NA+ channels and increases GABA. FIRST line use for general seizures and absence/complex seizures. 50-100mcg/mL. Do not mix with carb beverages. Use cautiously in children under 2.
Side effects of valproate Spna bifida, pancreatitis, anemia, hepatotoxicity, muscle wekness, and weight gain.
Gabapentin (Neurontin) Adjust dosage in renal patients. Increases production of GABA. Dont take antacid within 2 hrs, not metabolized in the liver so is safe in liver disease.
Levetiracetam (Keppra) Adjunctive therapy for partial onset myoclonic, or tonic-clonic seizures. MOA unknown. Can cause SJS and angioedema. irritability treated by B6. Do not give in patients with renal or hepatic impairment.
Lamotrigine (Lamictal) Uses- Mgmt of seizures, bipolar disorders. APpears to inhibit release of excitatory neurotransmitters via voltage sensitive sodium channels.
 



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