Anti Epileptic Drugs

cubonula's version from 2016-02-05 02:26


Drug Name and Action
Drug NameDrug Action
Phenytoin (Dilantin)Na+ channel blocker
Carbamazepine (Tegretol)Na+ channel blocker
OxcarbamazepineNa+ channel blocker
PrimidoneNa+ channel blocker
FelbamateNa+ channel blocker and NMDA receptor antagonist
TopiramateNa+ channel blocker
ZonisamideNa+ channel blocker and reduces Ca++ current in T-type channels
PhenobarbitalProlongs GABA-gated Cl- channel opening
ClonazepamProlongs GABA-gated Cl- channel opening
Diazepam/lorazepam (Valium/Ativan)Prolongs GABA-gated Cl- channel opening
Valproate (Depakote)inhibits GABA breakdown
Vigabatrininhibits GABA breakdown
EthosuximideReduces Ca++ current in T-type channels
TiagabineGABA reuptake inhibitor
GabapentinBinds to alpha2delta subunit of Ca++ channel
PregabalinBinds to alpha2delta subunit of Ca++ channel
Levetiracetam (Keppra)Inhibits SNARE protein


Carbamazepine with Phenytoinincreased metabolism of CBZ
Carbamazepine with phenobarbitalincreased toxic metabolite - increased aplastic anemia
Phenytoin with primidoneincreased conversion to phenobarbital - greater sedation
Valproic acid with phenobarbitaldecreased metabolism, increased toxicity
Valproic acid with phenytoindisplacement from binding, increased toxicity


Drug Characteristics
Phenytointeratogen, Na+ channel blocker, non-sedative, zero order kinetics, exacerbates absence
CarbamazepineTCA analog, Na+ channel blocker, aplastic anemia, exacerbates absence, great for partial complex
OxcarbamazepineCBZ analog, less potent/more safe than CBZ, Na+ channel blocker
Phenobarbitaloldest AED, prolongs opening of GABA-gated Cl- channels, great for partial and tonic-clonic and febrile seizures, sedation, exacerbates absence and atonic
Primidonemetabolized to phenobarb, great for partial and tonic-clonic, Na+ channel blocker, sedation
Valproateinhibits GABA breakdown, great for tonic-clonic and myoclonic and absence, VERY TOXIC - teratogen (spina bifida), hepatotoxicity, tremor
Ethosuximidedrug of choice for absence, safe and effective, inhibits low-threshold T-type Ca++ channel
Clonazepamlong acting, good for absence, increases frequency of GABA-gated Cl channel opening, sedation
VIgabatrinfor partial seizures, mental illness is contraindication, inhibits GABA breakdown, psychosis
Lamotriginebroadspectrum for partial and general, used w/valproate to reduce valproate dose, rash, diplopia, Na+ channel blocker
Felbamatebroadspectrum but severe toxicity, aplastic anemia, severe hepatitis, Na+ channel and NMDA receptor antagonist
Topiramatebroadspectrum for partial and tonic-clonic, Na+ channel blocker, migraine drug, decreased appetite
TiagabineGABA reuptake inhibitor, for partial and tonic-clonic, asthenia, depression
Zonisamidebroadspectrum for general and partial, sulfonamide derivative, Na+ channel blocker and T-type Ca++ channel inhibitor, minimal interaction with other AEDs
Gabapentinwide margin of safety, not many CNS toxicities, GABA analog, binds to alpha2delta subunit on Ca++ channels
Levetiracetamtargets SNARE proteins on NT vesicles, high safety margin, asthenia
Pregabalinbinds to alpha2delta subunit on Ca++ channel, effective at low dose, good for chronic pain and fibromyalgia
Diazepam and lorazepamprimary treatment for status epilepticus, increased freq of GABA channel opening, sedation (children show hyperactivity), robust tolerance, IV route