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Epilepsy Drugs II by Mind Map: Epilepsy Drugs II
0.0 stars - reviews range from 0 to 5

Epilepsy Drugs II

Felbamate

Use

Partial seizures in adults, Both of the are very serious seizures

Lennox-Gastaut Syndrome in kids

SE

High incidence of aplastic anemia and liver failure, Only used on "compassionate use" basis

Vigabatrin

MOA

Inhibits GABA degradation (GABA transaminase) and reuptake, Increases GABA-mediated inhibition

Use

DLR for infantile spasms and refractory complex partial seizures, CP seizures are notoriously hard to control

SE

30% of pts have vision loss

headache, somnolence fatigue, dizziness

Rufinamide

Use

Lennox-Gastaut syndrome

MOA

acts on Na channels

SE

somnolence, vomiting

Adjunct drugs (for parital seizures)

Lamotrigen

Use, Partial seizures, Neuropathic pain

MOA, Slows recovery in Na channels, Inhibits V-G Ca channels, Inhibits Glutamate release

SE, Most common: weakness, diplopia, ataxia, N, irritability, SJS, Teratogen: increase risk of cleft palate, DDI, Inhibits carbarmazepine metab

Gabapentin

Use, Partial seizures, Neuropathic pain

MOA, Acts as a subunit of V-G Ca channels to decrease depolarization-induce Ca influx, decreases release of glutatmate (excitatory NT)

SE, somnolence, dizziness, ataxia, fatigue, wt gain, nystagmus, DDI, No major problems!

Topiramate

Use, Partial seizures, Tremors, Migraine prevention

MOA, Blocks Na channels & AMPA/Kainate receptors

SE, Difficulty concentrating, drowsiness, dizziness, ataxia, Wt loss!!!, Increased risk of kidney stones, Inhibits carbonic anhydrase, Measure serum bicarb before starting, Metabolic acidosis may result

Pregabalin

SE, somnolence, dry mouth, blurred vision, peripheral edeam, wt gain, Euphoria - Schedule V

Practical aspects of Drug Tx

Status epilepticus

State of continuous seizure activity

Generalized T/C type is 10% fatal

Usually d/t sudden withdrawal of CNS depressants or drug poisoning

Tx, Supportive care, Electrolytes, cardiac arrhythmia, ABCs, Drug, 1) IV diazepam or lorazepam, 2) Maintenance Tx of slow IV phenytoin of PBB infusion, Can't use 1st to prevent CV and CNS collapse

Monotherapy

Multiple drug Tx only used if:, >1 seizure type is present, single drug fails to provide adequate control near toxic levels

Remember therapeutic concentration is close to toxic levels for most drugs, watch for signs of toxicity

Pregnancy

Use lowest dose that will control seizures

Teratogenic, but uncontrolled seizure also unsafe for fetus

Supplement w/ Vit K and folic acid

Seizure Tx

Grand Mal (Primary generalized Tonic-clonic)

Valproate OR carbamazepine OR phenytoin

Partial (including secondarily generalized)

Valproate OR carbamazepine OR phenytoin

Absence (Petit mal)

Ethosuximide OR Valproate

Atypical absence, myoclonic, atonic

Valproate