Pathophys/MOA
What must be "hyper" in the neurons for a seizure to occur?
hyperexcitability and hypersynchronization
Which ASD has a BBW for fetal risk?
CBC, LFTs, CMP
Which generation of ASDs has the simplest kinetics?
Second Generation
Name 3 medications that can precipitate seizures.
stimulants, bupropion, tramadol, theophylline, cocaine, estrogen, antipsychotics, anticholinergics, antibiotics, etc.
What voltage-gated ion channels are involved in seizure activity?
K, Na, Ca, Cl
What are the BBWs for clonazepam and clobazam?
concomitant use w/ opioids; abuse, misuse, addiction; dependence and withdrawal
Levetiracetam
carbamazepine
Which ASD is contraindicated in someone with a sulfa allergy?
Zonisamide
modulation of SV2A glutamate release
Which ASD has a REMS and why?
Vigabatrin
Which of the carbamazepine deritivatives is most likely to cause hyponatremia?
Which ASD is a strong CYP3A4/UGT inhibitor?
Valproate
What supplementation should be considered for patients on long-term ASD therapy?
Vitamin D and calcium
absence, myoclonic, clonic, tonic, tonic clonic, atonic
Perampanel
Which ASD lengthens the PR interval?
Lacosamide
What is the target therapeutic range for phenytoin?
10-20mcg/mL (1-2mcg/mL free)
Which 2 first generation ASDs can aggravate absence seizures?
carbamazepine and phenytoin
Name 4 general MOAs of antiseizure drugs.
Na channel inhibition, Ca channel inhibition, GABA receptor agonism, inhibition of GABA metabolism/reuptake, inhibition of AMPA receptor, inhibition of NMDA receptor, SV2A binding, unknown
Which allele increases the risk of SJS/TEN in a patient on carbamazepine?
HLA-B*1502
Which 2 second generation ASDs cause the most cognitive slowing?
topiramate and zonisamide
Which ASD has saturable GI absorption? At what dose?
Gabapentin
Doses > 1,200mg
Which ASDs are beneficial in patients with migraines?
carbamazepine, valproate, topiramate