Exam 1: Anti - Seizure meds (partial summary of key stuff! not enough time to do all the info) Flashcards

1
Q

First choice drugs for:

Tonic-clonic seizures

A

Carbamazepine, Valproic acid, Phenytoin, Lamotigrine

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2
Q

First choice drugs for:

Simple partial seizures

A

Carbamazepine, Phenytoin, Valproic acid, Lamotigrine

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3
Q

First choice drugs for:

Complex partial seizures

A

Carbamazepine, Phenytoin, Valproic acid, Lamotigrine

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4
Q

First choice drugs for:

Absence seizures

aka petite mal

A

Ethosuximide, Valproic acid

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5
Q

First choice drugs for:

Myoclonic and Atonic seizures

A

Valproic acid, Clonazepam

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6
Q

First choice drugs for:

Status Epilepticus seizures

A

Diazepam (1), Lorazepam (1)

Phenytoin (2)

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7
Q

First choice drugs for:

Infantile spasms

A

ACTH, Corticosteroids

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8
Q

First choice drugs for:

Lennox Gastaut syndrome

A

Clonazepam, Lamotigrine

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9
Q

First choice drugs for:

Febrile seizures

A

Diazepam

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10
Q

Drugs for the chemical class:

Hydantoins

A

Phenytoin

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11
Q

Drugs for the chemical class:

Tricyclics

A

Carbamazepine

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12
Q

Drugs for the chemical class:

Barbiturates

A

Phenobarbital

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13
Q

Drugs for the chemical class:

Valproates

A

Valproic acid, Valproate sodium

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14
Q

Drugs for the chemical class:

Succinimides

A

Ethosuximide

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15
Q

Drugs for the chemical class:

Benzodiazepines

A

Clonazepam, diazepam, lorazepam

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16
Q

Drugs for the chemical class:

GABAergic drugs

A

Gabapentin

17
Q

Drugs for the chemical class:

Others

A

Lamotrigine, topiramate

18
Q

Efficacy of birth control pills is _____ due to seizure medications inducing _____ enzyme.

If a medication must be given during pregnancy, _____ and _____is the safest

A

Efficacy of birth control pills is decreased due to seizure medications inducing CYP 450 enzyme.

If a medication must be given during pregnancy, phenobarbital and lamotrigine is the safest

19
Q

Phenytoin Side Effects:

A

Side Effects

Nystagmus (rhythmic, oscillating eye movement)

Diplopia (double vision) DOSE-RELATED

Ataxia (loss of coordination of voluntary muscles) DOSE –RELATED

Gingival hyperplasia (overgrowth of gum tissues in the mouth)

Hirsutism (excessive hair growth of face or body in women)

Sedation (CNS depression)

Coarsening of facial features (occurs with long-term therapy)

Mild peripheral neuropathy (diminished deep tendon reflexes) (occurs with long-term therapy)

Abnormalities in Vitamin D metabolism with osteomalacia (occurs with long-term therapy)

Megaloblastic anemia (decreased folate levels)

Aplastic anemia

Teratogenicity (Pregnancy Category D)

Fetal hydantoin syndrome (increased risk of congenital malformations like cleft lip and palate)

20
Q

Valproic acid/Valproate BLACK BOX WARNING OF SIDE EFFECTS:

A

BLACK BOX WARNING OF SIDE EFFECTS

Hepatotoxicity →higher risk in patients <2 years old and on multiple medications

Oral or Intravenous L-carnitine may help reduce hepatotoxicity

Teratogenicity → spina bifida (Pregnancy Category D)

Pancreatitis

21
Q

Lamotrigine BLACK BOX WARNING OF SIDE EFFECTS:

A

BLACK BOX WARNING OF SIDE EFFECTS

Skin rashes like Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

22
Q

MOA for:

Phenytoin

A

Blocks Axonal Na+ channels in their native state

inhibit generation of rapidly repetitive action potentials

increases GABA-mediated inhibition

Decreases Ca+ influx

23
Q

MOA for:

Carbamazepine

A

Blocks Na+ channels

24
Q

MOA for:

Phenobarbital

A

Potentiates GABA mediated inhibitoy stimuli in the presence of GABA by prolonging the opening of Cl- channels

Inhibits Na+ Channels and Ca+ channels

Blocks excitaroty AMPA recpetors

Directly opens GABA-A recpetors

25
Q

MOA for:

Ethosuximide

A

Blocks T-Type Ca++ Channels in thalamic neurons

26
Q

MOA for:

Valproic Acid/ Valproate

A

Blocks Na+ channels

Enhances GABA Mediated inhibition

Increases K+ Currents

Blocks T-Type Ca++ Channels

Blocks Excitatory NMDA recptor-mediated excitation

27
Q

MOA for:

Lamotrigine

A

Blocks Na+ channels

28
Q

MOA for:

Gabapentin

A

Unclear

29
Q

MOA for:

Topiramate

A

Blocks Na+ channels

Augments the action of GABA at GABA-A recpetors

Antagonizes glutamate recptors

inhibits carbonic anhydrase

30
Q

MOA for:

Felbamate

A

Blocks Na+ channels

31
Q

MOA for:

Clonazepam (Benzodiazepine)

A

Benzodiazepine that facilitiates actions of GABA

32
Q

MOA for:

Lorazepam (Benzodiazepine)

A

Benzodiazepine that facilitiates actions of GABA

33
Q

MOA for:

Diazepam (Benzodaizepine)

A

Benzodiazepine that acts on parts of the limbic system, thalamus, and hypothalamus and induces calming effects