Epilepsy- nueropsych drugs

Card Set Information

Author:
Jjanggoo83
ID:
244999
Filename:
Epilepsy- nueropsych drugs
Updated:
2013-11-04 17:08:36
Tags:
epilepsy drugs AE
Folders:

Description:
adverse effect and drug
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user Jjanggoo83 on FreezingBlue Flashcards. What would you like to do?


  1. Carbamazepine 

    brand name? 
    CIs?
    Active metabolite? (enzyme? effect?)
    Labeled use and off label use?
    Dose?
    tegretol

    • CI: MAO inhiitor use within last 14 days or w/ use. 
    • concomitant nafazodone, hx of BM depression, hypersensitivites to TCA** 
    • concomitant delarirdine or NNRTIs
    • 10,11 epoxide are active metabolites and metabolized by epoxide hydrolase -> can get serum concentration
    • carbamazepine metabolized by Cyp 3A4
    • to its metabolites

    can exacerbate absence seizure and primary GTC

    • Equetro: acute mania, mixed episodes w/ bipolar 1 disorder
    • Carbatrol, tegretol and tegretal XR : mixed seizure patterns, trigeminal neuralgia, glossopharyngeal neuralgia

    • Off label use: restless leg syndrome, PTSD
    • 200mg BID
  2. Carbamazepine Acute, idiosyncratic, chronic 
    AE
    acute: CNS effects (diplopia, dizziness, ataxia, drowsiness, lethargy )

    • idiosyncratic: Blood dycrasis ** (BBW)
    • leukopenia - dc if WBC <2500 &ANC <1000

    Rash (BBW)- asian, 1502 allele (TEN/SJS)

    • Chronic: hyponatremia ( elderly, thiazide diuretic users at risk)
    • osteopathy
  3. Ethosuximide 
    brand?
    AE? 
    use?
    • 1st line in absence. & only for absence
    • brand: zarontin

    • acute: ataxia
    • GI upset N/V (alleviate w/ lower dose commonly)
    • hiccups 

    • idiosyncratic : blood dyscrasias, rash
    • chronic behavioral changes, HA
  4. Felbamate
    brand? 
    CI ?
    • felbatol
    • patient should sign a consent form to use
    • CI in hepatic disease and hx of blood dyscrasis
    • acute: anorexia n/v insomnia
    • Idiosyncratic: Aplastic anemia (BBW) 
    • Acute hepatic failure (BBW) 
    • chronic : osteopathy
  5. Ezogabine
    brand? 
    MOA?
    metabolite?
    • potiga
    • 1st in class 
    • MOA: K channel opener
    • active metabolite- NAMR
    • schedule 5 

    • Acute: confsional state, psychotic symptoms 
    • hallucinations (all 3 concentration dependent )

    somnolence, dizziness, vertigo, abnl coordination attention disturbance, memory impair 

    • idiosyncratic: QT prolongation 
    • Chronic: urinary retention(if w/ anticholinergic drug, worry)
    •  blue skin, retinal abnormalities (if turning blue, stop. not sure if reversible )
  6. gabapentin
    • enurontin
    • (never mono or 1st line) not effective 
    • off label: neuropathic pain, diabetic peripheral neuropathy , fibromyalgia, postoperative pain, restless leg syndrome, vasomotor symptoms

    acute: dizziness, fatigue, ataxia, aggressive behavior in children 

    • idiosyncratic: peripheral edema 
    • chronic: wt gain, abrupt discontinuation cause w/d syndrome (anxiety, insomnia, sweating)
  7. lacosamide
    vimpat, schedule v

    acute: dizziness, HA, N/V, ataxia,  QT prolongation (EKG prior, if cardiac issue, not CI but cautious)
  8. Lamotrigine 
    brnad? use? 
    dose?
    • other label: maintenance tx bipolar 1 disorder
    • dose 25mg daily,
    • 25mg every other day w/ VPA, 50mg  w/ inducers 
    • all for 1-2 wks and specific guideline after. 

    • acute : ataxia, dizziness, diplopia, HA 
    • idiosyncratic: Rash (BBW), aseptic miningitis


  9. Levetriacetam
    • Keppra, 
    • FDA approved adjunctive, but always mono therapy especially for hepatic dysfunction 


    • acute: dizzy, drowsiness, 
    • idiosyncratic: behavioral disturbances/psychosis (if become agressive, take off!)
  10. Clobazam
    • onfil
    • schedule 4
    • active metabolite:
    • n- desmethylclobazam. 
    • can be used for pron in refractory patients. 
    • all benzos are antiseizure but not used for out pts as scheduled meds.

    • Actue: CNS depression, somnolence, lethargy
    • ataxia, drooling constipation

    idiosyncratic: anterograde amnesia

    chronic: physical and psychological dependence w/d symptoms (seizure, psychosis, hallucination,, etc) 
  11. Phenytoin
    dose, formulation 
    brand name (AE for other slide)
    • IV in NS 
    • 40% propylene glycol - hypotension and cardiac arrhythmias 
    • iv : phlebitis, extravasation of tissue
    • contraindication: delavirdine, other NNRTIS,
    • IV phenytoin: sinus bradycardia, sinoatrial block , adams strokes syndrome

    • dose: loading: 15-20mg/kg  followed by maintenance dose 100mg TID (q8h)
    • IV max : 50mg/min
    • ER capsules used for once a day (this is the formulation typically used)
    • IR IV: given TID
    • suspension: interact w/ tube feeding

What would you like to do?

Home > Flashcards > Print Preview