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Pharm 24: Antiseizure drugs
pharmacology of antiseizure drugs
105
Pharmacology
Professional
02/18/2012

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Term
Benzos: tox?
Definition
sedation, tolerance, dependence
Term
sedation, tolerance, dependence - tox of which drugs?
Definition
benzos
Term
Carbamazepine: tox?
Definition
diplopia, ataxia, blood dyscrasias, liver tox, teratogenesis, induction of CYP, SIADH, SJ syndrome
Term
tox: diplopia, ataxia, blood dyscrasias, liver tox, teratogenesis, induction of CYP, SIADH, SJ syndrome. NAME THE DRUG.
Definition
carbamazepine
Term
Ethosuximide: tox?
Definition
fatigue, GI, headache, urticaria, SJ syndrome
Term
tox: fatigue, GI, headache, urticaria, SJ syndrome. NAME THE DRUG.
Definition
ethosuximide
Term
Phenobarbital: tox?
Definition
sedation, tolerance, dependence, induction of CYP450
Term
tox: sedation, tolerance, dependence, induction of CYP450. NAME THE DRUG.
Definition
phenobarbital
Term
Phenytoin: tox?
Definition
nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, megaloblastic anemia, teratogenesis (fetal hydantoin syn), SLE-like syndrome, induction of CYP
Term
Tox: nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, megaloblastic anemia, teratogenesis (fetal hydantoin syn), SLE-like syndrome, induction of CYP. NAME THE DRUG.
Definition
phenytoin
Term
Valproic acid: tox?
Definition
GI distress, rare but fatal hepatotoxicity (measure LFTs), neural tube defects, tremor, weight gain. Contraindicated in pregnancy.
Term
Tox: GI distress, rare but fatal hepatotoxicity (measure LFTs), neural tube defects, tremor, weight gain. Contraindicated in pregnancy. NAME THE DRUG.
Definition
valproic acid
Term
Lamotrigine: Tox?
Definition
SJ syndrome
Term
Gabapentin - tox?
Definition
sedation, ataxia.
Term
Tox: sedation, ataxia. NAME THE DRUG.
Definition
gabapentin
Term
Topiramate: tox?
Definition
sedation, mental dulling, kidney stones, weight loss
Term
tox: sedation, mental dulling, kidney stones, weight loss. NAME THE DRUG
Definition
topiramate
Term
SJ syndrome - skin CELs come off. Which drugs cause it?
Definition
Carbamazepine, Ethosuximide, Lamotrigine
Term
Phenytoin: MOA?
Definition
use-dependent blockade of Na channels, ^ refract period, inh of glutamate release from excitatory presyn neuron
Term
MOA: use-dependent blockade of Na channels, ^ refract period, inh of glutamate release from excitatory presyn neuron. NAME THE DRUG.
Definition
phenytoin
Term
what is phenytoin used for besides seizures?
Definition
it's a class IB antiarrhythmic
Term
Chronic use of phenytoin produces...
Definition
gingival hyperplasia in kids, peripheral neuropathy, hirsutism, megaloblastic anemia
Term
Which drugs are NOT used for simple or complex partial seizures?
Definition
ethosuximide, benzos
Term
ethosuximide, benzos have no use in...
Definition
partial seizures
Term
What are first-line agents for generalized tonic-clonic seizures?
Definition
Phenytoin, carbamazepine, valproic
Term
Phenytoin, carbamazepine, valproic - 1st line agents for...
Definition
generalized tonic-clonic seizures
Term
Which drugs are NOT used for generalized tonic-clonic seizures?
Definition
ethosux, benzos, tiagabine, vigabatrin
Term
ethosux, benzos, tiagabine, vigabatrin - NOT used for...
Definition
generalized tonic-clonic seizures
Term
What's the 1st line drug for absence seizures? What else can be used?
Definition
ethosux, valproic
Term
Ethosux is first line and valproic is backup drug for...
Definition
absence seizures
Term
What's the 1st line drug for PROPHYLAXIS of status epilepticus? What's the 1st line for ACUTE TREATMENT?
Definition
phenytoin for prophylaxis, diazepam or lorazepam for acute
Term
What is phenytoin good for?
Definition
Partial, tonic clonic (1st), prophylaxis of status epilepticus (1st)
Term
______ is good for partial, tonic clonic, prophylaxis of status epilepticus
Definition
phenytoin
Term
What is carbamazepine good for?
Definition
partial, tonic clonic (1st)
Term
________ is good for partial, tonic clonic (1st)
Definition
carbamazepine
Term
What is lamotrigine good for?
Definition
partial, tonic clonic
Term
What is topiramate good for?
Definition
partial, tonic clonic
Term
What is gabapentin good for?
Definition
partial, tonic clonic
Term
What is phenobarbital good for?
Definition
partial, tonic clonic
Term
What is levetiracetam good for?
Definition
partial, tonic clonic
Term
What are the drugs that are ONLY used in partial and tonic-clonic seizures, not as 1st line?
Definition
lamotrigine, gabapentin, topiramate, phenobarbital, levetiracetam
Term
lamotrigine, gabapentin, topiramate, phenobarbital, levetiracetam -- these drugs are not 1st line agents, and they are only used in...
Definition
partial and tonic clonic
Term
What is ethosux good for?
Definition
1st line for absence
Term
Which drug is only good for absence?
Definition
ethosux
Term
What are benzos good for?
Definition
1st line for acute status
Term
Which drugs are only good for acute status (1st line)?
Definition
benzos
Term
What is tiagabine good for?
Definition
partial seizures
Term
what is vigabatrin good for?
Definition
partial seizures
Term
Which drugs are used ONLY in partial seizures?
Definition
tiagabine and vigabatrin
Term
tiagabine and vigabatrin are used ONLY in...
Definition
partial seizures
Term
Which drugs ^ Na+ channel inactivation?
Definition
phenytoin and carbamazepine
Term
Which drugs work by ^ Na+ channel inactivation?
Definition
phenytoin, carbamazepine
Term
What is used for parenteral phenytoin administration?
Definition
fosphenytoin
Term
Which drug is 1st line for trigeminal neuralgia?
Definition
carbamazepine
Term
Lamotrigine: MOA?
Definition
blocks voltage-gated Na+ channels
Term
Which drug blocks voltage-gated Na+ channels?
Definition
lamotrigine
Term
Gabapentin: MOA?
Definition
designed as GABA analog, but primarily inhibits HVA Ca+ channels
Term
Which drug was designed as GABA analog, but primarily inhibits HVA Ca+ channels?
Definition
gabapentin
Term
Which drug is also used for peripheral neuropathy and bipolar disorder?
Definition
gabapentin
Term
gabapentin is also used for...
Definition
peripheral neuropathy and bipolar
Term
Which drug blocks Na+ channels and increases action of GABA?
Definition
topiramate
Term
topiramate: MOA?
Definition
blocks Na+ channels and increases action of GABA
Term
Which drugs ^ GABA-a action?
Definition
benzos and barbs
Term
Which drug is the first line in pregnant women and children?
Definition
phenobarbital
Term
phenobarbital is 1st line in...
Definition
pregnant women and children
Term
Which drug ^ Na+ channel inactivation AND ^ GABA concentration?
Definition
valproic acid
Term
valproic acid: MOA?
Definition
^Na+ channel inactivation and ^ GABA concentration
Term
Which drug is also used for myoclonic seizures?
Definition
valproic
Term
valproic is also used for...
Definition
myoclonic seizures
Term
which drug blocks thalamic T-type Ca2+ channels?
Definition
ethosuximide
Term
ethosux: MOA?
Definition
blocks T-type thalamic Ca2+ channels
Term
which drug is also used for seizures of eclampsia?
Definition
benzos
Term
benzos are also used for seizures of...
Definition
eclampsia
Term
what is the first line agent to prevent seizures of eclampsia?
Definition
MgSO4
Term
What's MgSO4 good for?
Definition
1st line agent to prevent seizures of eclampsia
Term
which drug inhibits GABA reuptake?
Definition
tiagabine
Term
tiagabine: MOA?
Definition
inhibits GABA reuptake
Term
Which drug irreversibly inhibits GABA transaminase to increase GABA?
Definition
vigabatrin
Term
vigabatrin: MOA?
Definition
irreversibly inhibits GABA transaminase to increase GABA
Term
Which drug has an unknown mechanism but may modulate GABA and glutamate release?
Definition
levetiracetam
Term
levetiracetam: MOA?
Definition
unknown, may modulate GABA and glutamate release
Term
Most frequent route of metabolism
Definition
hepatic enzymes
Term
Mechanisms of action for Phenytoin, Carbamazepine, Lamotrigine
Definition
Sodium blockade
Term
MOA for Valproic acid at high doses
Definition
Affect calcium, potassium, and sodium channels
Term
Drugs of choice for generalized tonic-clonic and partial seizures
Definition
Valproic acid and Phenytoin
Term
DOC for febrile seizures
Definition
Phenobarbital
Term
Drugs of choice for absence seizures
Definition
Ethosuximide and valproic acid
Term
Drug of choice for myoclonic seizures
Definition
Valproic acid
Term
Drugs that can be used for infantile spasms
Definition
Corticosteroids
Term
Anti-seizure drugs used also for bipolar affective disorder (BAD)
Definition
Valproic acid, carbamazepine, phenytoin and gabapentin
Term
Anti-seizure drugs used also for Trigeminal neuralgia
Definition
Carbamazepine
Term
Anti-seizure drugs used also for pain of neuropathic orgin
Definition
Gabapentin
Term
Anti-seizure agent that exhibits non-linear metabolism, highly protein bound, causes fetal hydantoin syndrome, and stimulates hepatic metabolism
Definition
Phenytoin
Term
SE of phenytoin
Definition
Gingival hyperplasia, nystagmus, diplopia and ataxia
Term
Anti-seizure agent that induces formation of liver drug-metabolism enzymes, is teratogen and can cause craniofacial anomalies and spina bifida
Definition
Carbamazepine
Term
Agent that inhibits hepatic metabolism, is hepatotoxic and teratogen that can cause neural tube defects and gastrointestinal distress
Definition
Valproic acid
Term
Laboratory value required to be monitored for patients on valproic acid
Definition
Serum ammonia and LFT's
Term
SE for Felbamate
Definition
Aplastic anemia and acute hepatic failure
Term
Anti-seizure medication also used in the prevention of migraines
Definition
Valproic acid
Term
Anti-seizure drugs used as alternative drugs for mood stabilization
Definition
Carbamazepine, gabapentin, lamotrigine, and valproic acid
Term
Which drugs INDUCE hepatic enzymes?
Definition
barbs, carbamazepine, phenytoin
Term
Which drug INHIBITS hepatic enzyme metabolism?
Definition
valproic acid
Term
Long term use of _____ is assoc with visual field defects
Definition
vigabatrin
Term
Withdrawal is most difficult for which drugs?
Definition
barbs and benzos
Term
sulfonamides can displace _____ from its binding sites
Definition
phenytoin
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