Pharm II test II AED

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204386
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Pharm II test II AED
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2013-03-06 23:27:31
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Pharm II test AED
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Pharm II test II AED
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  1. Enhances GABA Cl influx & glutamate block
    may worsen absence
    long half life (50hr)
    osteomalacia
    hypothombinemia
    main SE is occular, nystagmus, diplopia and ataxia in high doses
    phenobarbital
  2. 2 active metabolites Pb PEMA
    sedation
    blood dyscrasias 
    primidone
  3.  absorption depends on dose form 
    capacity of liver to  metabolize is very limited
    highly protein bound
    common SE   
       gingival hyperplasia  
       hirsutism  
       skin reactions
    phenytoin
  4. absence
    ineffective for other seizures and may worsen grand mal
    not protein bound
    CNS SE  
      sedation
      hiccough  
      cough   
      photophobia  
      behavioral changes with history of    psychiatric disturbances
    ethosuximide - zarontin
  5.  absence refractory to ethosuximide
    CNS SE  
      sedation  
      hemeralopia  
      may precipitate seizures in petit mal       assoc. with grand mal  
    blood dyscrasias - 20%  
      hepatitis and neprhosis, more than etho
    trimethadone - tridione
  6. DOC in partial (complex and simple)
    very effective against generalized tonic clonic
    trigeminal and glossopharyngeal neuralgias
    bipolar affective disorder
    induces microsomal enzymes
    CNS SE   
        start low dose and largest part at hs   hyponatremia  
      skin reactions - increased in asians (HLA-B1502 allele)  
    weight gain - 20-30%
    carbamazepine - tegretol
  7. similar to carbamazepine with fewer side effects - doesn't induce microsomal enz.
    more hyponatremia
    oxcarbazepine - trileptal
  8. absence and mixed seizures
    bipolar affective disorder
    first broad spectrum AED
    CNS SE  
       Hyperammonemic encephalopathy w/ defective urea metabolism  
      Hepatotoxicity - rare, but potentially fatal - greater if < 2yo  
      alopecia and blood dyscrasias
    valproic acid - depakote
  9. adjunct for partial, maybe be as effective against partial and tonic clonic
    lennos-gastaut
    CNS SE  
      skin rash - SJ  
      blood dyscrasias
    lamotrigine - lamictal
  10. prodrud of phenytoin
    IV & IM
    DOC in SE 
    fosphenytoin - cerebyx
  11. reserved for pts. who don't have efficacy towards other AED
    AE  
      aplastic anemia  
      acute hepatic liver failure
    felbamate - felbatol
  12. FDA approved as adjunctive >12yo with partial seizures
    AE   some tolerate well but some discontinue
    CI - psychosis
    elimination via feces - 65%
    tiagabine - gabitril
  13. adjunct for partial and generalized tonic-clonic > 2 yo
    LG and West's syndrome in kids
    AE  
      myopia  
      glaucoma  
      urolithiasis
    dose related SE and highest in first 4 wks    fatigue  
    drowsiness  
    dizziness
    topiramate - topamax  
  14. not metabolized by CYP
    adjunct for partial seizures
    well tolerated
    levetiracetam - keppra
  15. benzodiazepines used as AED 2
    • diazepam (valium) - Status epilepticus
    •    chronic use limited due to tolerance(6MO)
    • clonazepam - klonopin - absence and akiniteic and myoclonic seizures
  16. only approved for partial but broad spectrum
    sulfonamide
    zonisamide - zonegran
  17. partial seizures and infantile spasms
    visual field loss
    vigabatrin - sabril
  18. Tx of neuropathic pain - fibromyalgia
    pregabalin - lyrica
  19. FDA approved as add-on in adults with partial seizures
    ADR - euphoria (schedule V)
    lacosamide - vimpat
  20. lennox-gastau
    tQT shortening
    rufinamide - banzel
  21. adjunct in Tx partial seizures
    ADR - bladder dysfunction (8-9%)
    ezogabine - potiga
  22. adjunct in Tx of partial seizures
    ADR - mood changes (aggression/anger/anxiety)
    perampanel - fycompa
  23. orphan drug Tx of myoclonic epilepsy in infancy (SMEI (dravet's syndrome))
    useful in reduction of pharmacoresistant seizures
    stiripentol - diacomit
  24. adjunct in petit mal
    inhibits carbonic anhydrase
    acetazolamide - diamox
  25. convulsions due to hypomagnesiumia
    severe pre-eclampsia
    magnesium sulfate

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