-
DOC of new- onest partial seizures
carbamazepine
-
drugs for absence seizure
- ehtosuximide
- valproic acid (if both generalized and absence)
-
tonic clonic generalized seizure drugs
monotherapy
- monotherapy:
- carbamazepine,
- phenobarbital
- phenytoin
- topiramate (>10yo)
-
drug for post traumatic epilepsy
phenytoin x7 d
-
for infantile spasms
- ACTH
- oral steroids
- vigabatrin
- valproic acid
-
catamenial epilepsy
what is it?
what drug is used?
- related with hormonal changes during menstruation
- acetazolamide
-
carbamazepine
indicated for?
- complex partial seizures
- mostgeneralized seizures
not absence or febrile seizures
-
SE of carbamazepine
- SIADH
- osteomalacia
- folate deficiency
- potentially fatal, severe dermatologic rxn (HLAB1502)
- aplastic anemia
- hepatotox
- suicidal
- preg D
-
carbamazepine trade name
- Carbatrol
- Equetro
- Epitol
- Tegretol
-
ethosuximide indications
- absence
- myoclonic seizures
-
ethosuximide trade name
Zarontin
-
long term SE of ethosuximide
- anorexia
- weight loss
- gum hypertrophy
-
felbamate indication
adjunctive only
-
felbamate SE
weight loss
- hepatotox
- aplastic anemia
- suicidal
-
fosphenytoin indication
short term IV/IM for generalized convulsive status epilepticus
-
reference range for phenytoin
10-20 mg/L
-
felbamate trade name
Felbatol
-
Fosphenytoin brand
Cerebyx
-
-
-
-
Divalproex sodium brand
Depakote
-
-
Oxcarbazepine brand
Trileptal
-
-
-
-
Zonisamide brand
Zonegran
QD
-
Gabapentin and pregabalin and tiagabine indication
adjunct for partial
-
lacosamide indication
- adjunctive for partial
- (>17y)
-
lamotrigine indications
adjunctive for partial, tonic-clonic, and Lennox-Gastaut syndrome
for conversion to monotherapy
and other seizures
-
black box of lamotrigine
toxic epidermal necrolysis (rash)
-
Levetiracetam indication
adjunct for partial, primary generalized, and myoclonic
-
oxcarbazepine indication
- for partial seizures
- monotherpy (>4yo) and adjunct (>2yo)
-
SE of oxcarbazepine
SIADH (more common than with carbamazepine)
antiepileptic drug hypersensitivity syndrome
-
patient counseling for oxcarbazepine
back up birth control
-
phenobarbital indications
- neonatal seizures
- generalized (except absence)
-
phenobarb reference range
15-40mg/L
-
SE of phenobarb
- hyperactive
- lowers IQ
- folate and vit. K deficiency
- liver failure
- stevens-johnson syndrome
Preg. category D
-
-
phenytoin indication
all seizures except absence and febrile
prevention of seizure following neurosurgery
-
SE of phenytoin
- peripheral neuropathy
- hydantoin facies (enlargement of nose and lips)
- acne, hirsutism, gingival hyperplasia
- osteomalacia
- vitamin K and folate deficiency
- hepatic failure
- steven-johnson syndrome
- preg. D
-
SE of pregabalin
angioedema
increased appetite and weight gain
-
primidone indication
- generalized tonic-clonic
- complex partial
- simple partial
-
reference range for primidone
5-12mg/L
-
SE of primidone
- malignant lymphoma-like syndrome
- megaloblastic anemia
- lupus like syndrome
-
primidone's metabolite
phenobarbital
-
topiramate indication
initial monotherapy (>10yo) for partial onset seizures, primary generalized tonic clonic
adjunct for (2-16 yo) with partial onset, or tonic lonic
Lennox-Gastaut
-
SE of topiramate
- hyperchloremic metabolic acidosis
- acute myopia/ closed angle glaucoma
- kidney stones
- paresthesia
- word finding difficulties and decreased cognition
- weight loss
*not sweat --> over heat
-
valproic acid indications
all generalized and partial
DOC for absence
rarely used in <2 yo
-
valproic acid range
50-150mg/L
-
SE of valproic acid!!
- increase LFT (hepatotox)
- weight gain
- alopecia
- thrombocytopenia
- tremorr
-
black box of valproic acid
- hepatotox
- hemmorhagic pancreatitis
- preg D
-
vigabatrin indication
infantile spasms
adjunct for complex partial
-
viagabatrin SE
peripheral vision loss
hyperactivity
-
zonisamide indication
partial seizures
-
SE of zonisamide
- kidney stones
- weight loss
- psychosis
- oligohidrosis (no sweat)
- metabolic acidosis (check bicarb)
-
ketogenic diet
high fat, adequate protein, low carb diet
-
max infusion rate for phenytoin
50mg/min
-
max fosphenytoin rate
150mg/min
-
phenytoin: fosphenytoin
1mg : 1.5 mg
-
how to induce coma?
- pentobarbital
- LD 20-40mg/kg over 1-2 hr
- continues 1-4mg/kg/hr
-
DOC for prolonged febrile seizure
rectal lorazepam or diazepam
(Diastat)
-
rash is associated with which anticonvulsants
- carbamazepine (HLAB*1502)
- oxcarbazepine
- ethosuximide?
- fosphenytoin and phenytoin(HLA-B*1502)
- lamotrigine (hold a dose)
- phenobarbital
-
anticonvulsants that causes kidney stones
-
pancreatitis causing anticonvulsant
valproic acid
-
which one causes weight gain?
which one causes weight loss?
valproic acid
topiramate
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