Term
| What are the four mechanisms of action of anti-seizure medications? |
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Definition
*Acting on ion channels
*Enhancing inhibitory neurotransmitters
*Inhibiting neuroexcitatory transmitters
*Acting at specific receptors in the brain |
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Term
| What is the MOA of anti-seizure medications that act on ion channels? |
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Definition
*Promotes inactivated state of sodium channels
*Cellular excitability is decreased, and propagation of nerve impulses or action potentials is diminished
*Neuron's ability to fire at high frequencies is either reduced or stopped
*Reduction of current through T-Type Calcium Channels
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Term
| What is the MOA of seizure medications that work by enhancing inhibitory neurotransmitters? |
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Definition
*GABA synapses are the most prevalent inhibitory synapses in the cerebrum.
*Reduces the metabolism of GABA and others act on GABA receptors
*Enhancing chloride influx in response to GABA |
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Term
| What is the MOA of anti-seizure drugs that act by inhibiting neuroexcitatory transmitters? |
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Definition
*Channel blockage of the N-methyl-D-aspartic acid (NMDA)- activated glutamate receptor
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Term
| What is the MOA of antiseizure drugs that act at specific receptors in teh brain? |
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Definition
| *Acts at dopaminergic or serotonergic receptors |
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Term
| What 3 anti-seizure meds are enzyme inducers? |
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Definition
*Phenobarbital
*Phenytoin (Dilantin)
*Carbamazepine (Tegretol)
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Term
| What two anti-seizure medications are enzyme inhibitors? |
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Definition
*Valproic acid (Depakene, Depakote)
*Topiramate (Topimax) |
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Term
| What is an important side effect of phenobarbital (Luminal)? |
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Definition
*Potent Hepatic Enzyme Inducer
*Potent inducer of hepatic microsomal drug metabolizing enzymes |
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Term
| What is the Dosing protocol for Phenytoin (Dilantin)? |
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Definition
| *1gm Dilantin IV over 1 hour |
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Term
| What is the Half life both orally and IV of Dilantin? |
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Definition
*Oral half life: 7-42 hours
*IV half life 10-15 hours |
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Term
| What can rapid IV infusion of Dilantin lead to? |
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Definition
*Hypotension
*Respiratory Depression
*Cardiac Toxicity- manifested by arrhythmias and hypotension
*CNS depression
*Must be given slow IV drip not a bolus |
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Term
| What does Dilantin do to metabolism? |
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Definition
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Term
| What does Carbamazepine (Tegretol) do to metabolism? |
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Definition
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Term
| What does Valproic Acid (Depakene, Depakote) do to metabolism? |
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Definition
| *Hepatic Enzyme Inhibitor |
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Term
| What drug is that drug of choice for status epileptacus? |
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Definition
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Term
| What class of drugs are effective for all seizure types in the acute setting? |
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Definition
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Term
| What does Topiramate (Topamax) do for metabolism? |
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Definition
| *It is an enzyme inhibitor |
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