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Anti Epileptic Drugs

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toxarezo's version from 2017-10-12 06:36

Section

Drug Name and Action
Drug NameDrug Action
PhenytoinNa+ channel blocker
CarbamazepineNa+ channel blocker
LamotigineNa+ channel blocker
PrimidoneGABA Receptor potentiator (Barb)
Diazepam/lorazepamProlongs GABA-gated Cl- channel opening
Valproic AcidBlock Na, Ca, Facilitate GABA
EthosuximideReduces Ca++ current in T-type channels
GabapentinBinds to alpha2delta subunit of Ca++ channel
PregabalinBinds to alpha2delta subunit of Ca++ channel
LevetiracetamInhibits SNARE protein, change glutmatate and GABA release
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Interactions
DrugsInteractions
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
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Drug Characteristics
DrugCharacteristics
Phenytointeratogen, Na+ channel blocker, non-sedative, zero order kinetics, exacerbates absence
CarbamazepineTCA analog, Na+ channel blocker, aplastic anemia, exacerbates absence, great for partial complex
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
Lamotriginebroadspectrum for partial and general, used w/valproate to reduce valproate dose, rash, diplopia, Na+ channel blocker
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
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