LECOM Pharm Ch 14 AED seizure drugs
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| 4 AEDs that act on Na+ channel inhibition | phenytoin, carbamazepine, lamotrigine, valproic acid
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| AEDs that enhance Na+ channel inhibition are good drugs for | partial seizures and secondary generalized seizures
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| Na+ channel blocker AEDS function in what manner? | use dependent manner
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| MOA of Phenytoin | slows channel recover between inactivated to closed
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| Phenytoin is a major drug choice for what types of seizures? | Partial and Tonic-Clonic (secondary generalized) seizures
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| AED that when used with phenytoin can greatly decrease phenytoin levels | carbamazepine
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| Pt with seizures that takes phenytoin might be switched to this drug if they need medications for other medical problems | Carbamazepine
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| MOA of Carbamazepine | slows recovery of Na+ channel from inactivated to closed
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| 3rd line DOC for atypical absence seizures | lamotrigine
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| AEDs that block T-type calcium channels are used for what | absence seizures
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| 1st line therapy for uncomplicated absence seizures | ethosuxamide
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| 2nd line AED for absence seizures not responding to ethosuxamide | valproic acid
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| Partial seizures not responding to phenytoin or carbamazepine are usually treated with | Valproic acid
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| MOA of Valproic Acid | affects Na+ channels, at slightly higher concentration inhibits T-type Ca++ channel, and also stimulates GABA synthesis and inhibits it’s degradation
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| Pt has a generalized epileptic syndrome with mixed seizure types. DOC? | Valproic acid
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| DOC for idiopathic generalized seizures | Valproic acid
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| MOA: Gabapentin | increases GABA but major action is inhibiting HVA Ca++ channels
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| 4th DOC for absence seizures | clonazepam
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| MOA of benzodiazepines | increase affinity for GABAa receptors; increase Cl- influx through GABAa receptor
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| MOA that makes clonazepam special from other benzos | inhibit T-type Ca++ channels in the thalamus, “turning off” the reticular nucleus
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| Benzo’s are used in what mode for seizure Tx | used to ablate partial and tonic-clonic seizures
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| Don’t give phenobarbital with this type of seizure because it might exacerbate it | absence seizures
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| Used in extreme refractory epilepsy b/c can cause fatal aplastic anemia | felbamate
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| Used in ventricular arrhythmias that don’t respond to lidocaine or procainamide | Phenytoin
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| MOA for benzodiazepines | increase the FREQUENCY of GABA-mediated chloride ion channel opening
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| Benzodiazepine that has efficacy against absence seizures and in anxiety states, such as agoraphobia | clonazepam
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| DOC for status epilepticus | Diazepam
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| 2 AEDs used for treatment of Bipolar Affective Disorder | Carbamazepine, lamotrigine
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| If Pt is being treated for partial or tonic-clonic seizures with multiple drugs and drops dead, suspect this drug | tiagabine
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| Adjunct therapy for partial seizures that may cause anemia or leukopenia | levetiracetam
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