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Index
»
PHARMACOLOGY 1
»
Drugs for Epilepsy Chapter 12
»
DRUGS - Generalized Seizures
level: DRUGS - Generalized Seizures
Questions and Answers List
level questions: DRUGS - Generalized Seizures
Question
Answer
• introduced as a "PURE PETIT MAL" drug • MOA: has an important effect on Ca2+ currents, reducing the lowthreshold current DOC for ABSENCE SEIZURE
ETHOSUXIMIDE • Zarontin®
• are phenylsuccimides that were developed and marketed before ethosuximide • used as ANTI-ABSENCE DRUG
Phensuximide & Methsuximide - has been used for partial seizures
• also used as the free acid, Valproic Acid • MOA: blocks high-frequency firing of neurons, modifies amino acid metabolism • Very effective against ABSENCE SEIZURE and is often PREFERRED when the patient has CONCOMITANT GENERALIZED TONIC-CLONIC ATTACKS Myoclonic seizures Generalized Tonic-Clonic Seizures MANAGEMENT OF BIPOLAR DISORDER MIGRAINE PROPHYLAXIS
SODIUM VALPROATE • Depakene®
Therapeutic Level SODIUM VALPROATE
• 50-100mcg/mL
First Oxazolidinedione former DOC for ABSENCE SEIZURE Toxicity: Sedation
Trimethadione
Other Drugs Used in Management of Epilepsy
BENZODIAZEPINES
• given IV or rectally for STOPPING CONTINUOUS SEIZURE ACTIVITY, especially GENERALIZED TONIC-CLONIC STATUS EPILEPTICUS •BENZODIAZEPINE
DIAZEPAM • Valium®
•MORE EFFECTIVE AND LONGER ACTING THAN DIAZEPAM for STATUS EPILEPTICUS •BENZODIAZEPINE
LORAZEPAM • Ativan®
• a long acting drug with DOCUMENTED EFFICACY against ABSENCE SEIZURE, MYOCLONIC SEIZURES and INFANTILE SPASM
CLONAZEPAM • Klonopin®
used for INFANTILE SPASM AND MYOCLONIC SEIZURES
NITRAZEPAM
• approved in USA as an adjunct treatment of complex partial seizures in adults • Toxicities: drowsiness and lethargy
CLORAZEPATE • Tranxene®
Limitations for BZD Use
• Pronounced sedative effect • Tolerance
• a DIURETIC whose main action is the INHIBITION OF CARBONIC ANHYDRASE • MOA: mild acidosis in the brain
ACETAZOLAMIDE • Diamox®