Shared Flashcard Set

Details

Anti-seizure drugs
Current drugs of choice
9
Medical
Professional
11/07/2008

Additional Medical Flashcards

 


 

Cards

Term
Phenytoin
Definition
  • blocks Na+ channels
  • tx of partial & tonic-clonic (generalized) seizures
  • P450 inducer; incr dose gradually
  • toxicity: nystagmus early, dose-limiting diplopia and ataxia, gingival hyperplasia & hirsutism (long-term use)
Term
Carbamazepine
Definition
  • ticyclic cpd
  • tx for partial & tonic-clonic (generalized) seizures; also tx bipolar disorder & trigem neuralgia
  • may exacerbate myoclonic & absence seizures
  • Na+ channel blocker
  • P450 inducer; adjust dose, avoid DDI's
  • toxicity: nystagmus early, dose-limiting diplopia & ataxia
  • Stevens-Johnson syndrome, 10X risk in asians
Term
Valproic acid
Definition
  • tx partial seizures, tonic-clonic, myotonic, atonic, absence & combination seizures; also bipolar
  • multiple MOA: block Na+ channels, potentiate GABA, inhibit histone deacetylase, etc.
  • severe idiosyncratic hepatotoxicity
Term

Which AED causes severe idiosyncratic hepatotoxicity and has broad specificity thought to be due to multiple MOA?

Definition
Valproic acid
Term
What are the drugs of choice to treat partial and tonic-clonic (generalized) seizures?
Definition
Phenytoin, Carbamazepine, Valproic acid
Term
What are the drugs of choice for treating absence (generalized) seizures?
Definition
Ethosuximide, Valproic acid, Clonazepam
Term
Ethosuximide
Definition
  • first line for absence seizures only
  • MOA: inhibits T-type Ca++ channel
  • well absorbed
  • toxicity: well tolerated; dose-related gastric distress
Term

Clonazepam

Definition
  • tx for absence seizures (also infantile spasms plus some myoclonic & atonic seizures)
  • benzodiazepine class
  • use limited by sedation, tolerance dev, withdrawal
Term
What is the treatment for generalized tonic-clonic status epilepticus?
Definition
  •  medical emergency!
  • give IV diazepam (or lorazepam) followed by IV fosphenytoin or phenobarbital
  • beware synergistic CNS depression
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