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chronic neurological disorder char. by recurrent seizures.
Epilepsy
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Episodes of sudden, transient distrubances in cerebral excitation.
seizures
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Involuntary, paroxsmal skeletal muscle contraction seen during certain seizures.
Convulsions
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propoposed classification scheme of epileptic sezures.
International league against epilepsy
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Effective in generalized tonic-clonic and simple and complex partial siezures.
Barbiturates- phenobarbital and mephobarbital (Mebaral)
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Barbituturates MOA?
A.R?
- Increses inhibitory effects of GABA.
- Inhibits Calcium entry in presynaptic terminals (which decreases glutamate release)
AR- safe, but use limited b/c of sedation effect
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Used to Rx staus epilepticus
- Benzodiazipines-
- Diazepam (Valium) and Lorazepam (Ativan)
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Treats absence seizures
Benzodiazipine- Clonazepam (klonopin)
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Benzodiazipines MOA?
A.R.?
- Potentiates GABA
- AR-Sedation ataxia and behavioral changes
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Effective in treating partial and generalized tonic clonic seizures.
Hydantoin- Phenytoin (Dilantin)
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Hydantoins MOA?
AR.-? (5)
- MOA- decreases excitability by decreasing sodium entry into rapidly firing neurons.
- AR- GI irritation, confusion, sedation, dizziness, head ache
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1. Effective in treating all epilepsy except absence seizures.
2. Primary agent for treating partial and tonic-clonic seizures.
Iminostilbenes- Carbazepine (Tegretol); equivalent to phenytoin.
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Iminostilbenes MOA?
AR-?
- MOA- decreases excitability by decreasing sodium entry into rapidly firing neurons.
- also inhibits presynaptic uptake and relase of norepi.
- AR-water retention
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Primary agent in treatment of Absence seizures.
Succinimides- Ethosuximide (Zarontin)
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1. Increases seizure threshold and limits spreads of electrical activity in brain.
2. May decrase calcium influx.
Succinimides
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1. Classified as Carboxylic acid
2. treats absence seizures and bipolar disorder.
Valproic Acid- Depakote
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MOA of Valproic acid?
AR-?
- Increases Gaba levels in the brain
- May increase K+ and efflux (hyperpolarizes, thus decreasing excitability).
- May limit Na+ entry into rapidly firing Neurons.
- AR- Hair loss, GI distress- weight gain/loss
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Felbamate used for?
MOA?
AR-?
- Parital seizures in adults and children; absence seizures in children
- MOA- blocks effects of excitatory aa's in brain
- AR- aplastic anemia and liver failure
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Gabapentin (Neurontin) is used for?
GABA agonist or antagonist?
- Parital seizures in adults and children
- GABA Agonist
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Lamotrigine (Lamictal) is used for?
MOA?
- Partial siezures
- MOA- Stabalizes Na+ entry in rapidly firing neurons.
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Levetiracetam (Keppra) is used for?
MOA?
AR-?
- Partial seizures
- MOA- Unknown
- AR- Sedation, dizziness, and weakness
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Tiagabine (Gabitril) is used for?
MOA?
AR-
- Parital seizures
- Inhibits reuptake of GABA (stays in cleft longer)
- AR- psychiatric distrubances
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Topiramate (Topamax) is used for?
MOA? (3)
- Parital Seizures
- inhibits NA+ channel opening
- blocks excitatory aa receptors,
- stimulates GABA receptors
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Zonisamide (Zonegran) is used for?
MOA?
AR?
- Partial seizures
- Stabalizes Na+ channels (limits Na+ entry into rapidly firing neurons)
- AR- loss of appetitie
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Gabapentin aka?
Neurontin
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Lamotrigine aka?
Lamictal
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Levetiracetam aka?
Keppra
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