Anticonvulsants (antiepileptic drugs)
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- čas přidán 21. 05. 2016
- This is a brief summary of anticonvulsants, or medicines used to treat epilepsy.
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ADDITIONAL TAGS:
Anticonvulsants
Drug
Mechanism of action
Modern approach
Other indications
Side effects (unique/notable listed first)
Interaction
Metab
Carbamazepine
Na+ channel blocker: binds inactive Na channel, extend inactivation
simple partial, complex partial, secondary generalized (narrow)
bipolar disorder, trigeminal neuralgia
Hyponatremia... bone marrow suppression; hepatotox; sedation; dizziness; n/v; double vision; ataxia; fetal malform; bone demineraliz; Stevens-Johnson syndrome
p450 induction
hepatic
Phenytoin
Na+ channel blocker: complex actions
simple partial, complex partial, secondary generalized (narrow)
n/a
Bone demineralization; gingival hyperplasia (long term use); hypotension, arrhythmias, tissue necrosis ( IV admin)... bone marrow suppression; hepatotox; sedation; dizziness; n/v; double vision; ataxia; fetal malform; Stevens-Johnson syndrome
p450 induction
hepatic
Lamotrigine
Na+ channel blocker: selective for excitatory neuron NT like glutamate
all seizure types (broad spectrum)
bipolar disorder; antidepressant effects
Stevens-Johnson syndrome (life threatening rash)... sedation; dizziness; n/v; double vision; ataxia; fetal malform; bone demineraliz; Stevens-Johnson syndrome
p450; OCPs decrease efficacy
hepatic
Ethosuximide
Ca2+ channel blocker (α subunit, T type, thalamic)
absence seizures (narrow spectrum)
n/a; just first line for absence seizures
sedation; dizziness; n/v; double vision; ataxia; fetal malform; bone demineraliz; Stevens-Johnson syndrome
n/a
hepatic
Phenobarbital
GABA antagonist: augments GABA receptor (Cl channel)
simple partial, complex partial, secondary generalized (narrow)
Tremors (similar to primidone for essential tremor)
Hyperactivity, addiction, sedation... bone marrow suppression; hepatotox; dizziness; n/v; double vision; ataxia; fetal malform; bone demineraliz; Stevens-Johnson syndrome
p450 induction
hepatic
Valproate
many: blocks Na, enhance GABA, block Ca
all seizure types (broad spectrum)
Migraine prophylaxis, bipolar disorder
fetal malformation (strongest teratogen); weight gain, tremor, hair loss, fulminant hepatic failure (limits use in kids); bone marrow suppression... sedation; dizziness; n/v; double vision; ataxia; fetal malform; bone demineraliz; Stevens-Johnson syndrome
p450 inhibitor
hepatic
Topiramate
many: blocks Na, enhance GABA, block glutamate (NMDA) receptor
all seizure types (broad spectrum)
Migraine prophylaxis
Cognitive impairment, weight loss, kidney stones... sedation; dizziness; n/v; double vision; ataxia; fetal malform; bone demineraliz; Stevens-Johnson syndrome
Decreases efficacy of OCPs
70:30 hepatic: renal
Gabapentin
unknown or partially known mechanism
simple partial, complex partial, secondary generalized (narrow)
Neuropathic pain, chronic pain
Ankle edema, weight gain... sedation; dizziness; n/v; double vision; ataxia; fetal malform; bone demineraliz; Stevens-Johnson syndrome
Antacids (limit bioavailability)
renal
Pregabalin
unknown or partially known mechanism
simple partial, complex partial, secondary generalized (narrow)
Neuropathic pain; fibromyalgia
Ankle edema, weight gain... sedation; dizziness; n/v; double vision; ataxia; fetal malform; bone demineraliz; Stevens-Johnson syndrome
Antacids (limit bioavailability)
renal
Levetiracetam
unknown or partially known mechanism
all seizure types (broad spectrum)
n/a
Depression, behavioral/psychiatric issues (up to 15%)... sedation; dizziness; n/v; double vision; ataxia; fetal malform; bone demineraliz; Stevens-Johnson syndrome
n/a
renal
Really appreciated to your informative and instructive chart. Learn and capture things instantly.
Thanks a lot :DD i think you should make another website to compile all the charts .
THANKS ALOT SIR, VERY PRECISE SPECIFIC TO THE POINT , REFRESHER VIDEO
GOD BLESS YOU
Sir thanks a lot for detailed working
Is there a way u can get all 15 medications i was told by my neurologists that's how many there are but good video dude
I have epilepsy and use the Keppra or Levec whatever its called pill and I hate its side effects mostly migraine
wish there was a cure for this seizure life.
Phenobarbital isn't a GABA antagonist though?
No Briviact updates yet? That’s what I’m on.
I'm decreasing my tegretol m getting myself off. I been 20 pounds heavier. I'm on it for bipolar. I wonder if my drvrealized I died from hyponatremia in the military? And my teeth I lost two n they chipped! Wow. I want to try keppra
Topiramate acts more on AMPA/kainate receptors
I was on a plethora of them, I’ve been of for months now and I feel so stupid and I can’t concentrate and can’t think
The side effects are life altering, I always feel sedated, I zero energy. Very hard to get motivated. I experimented way back when I was younger, I Stopped my Meds. The Energy that I had was surreal. I felt Amazing. Reality set in & I started taking my Meds again. I take Carbamazepine. I do I cure the side effects Sedation in particular?
I also taking carbazepine from 4 yrs
Always feel sedated
Is Phenobarbital not a GABA agonist? As it helps increase Cl- into the neurone, so that there is hyperpolarisation?
Yeah it is! I have no idea where the antagonist has come from, it binds to the Barbiturate receptor on the GABAa receptor which increases the duration of opening, of the GABA, allowing a greater influx in Cl- ions, and therefore hyper polarisation of the pre-synaptic axon, decreasing the likelihood of creating a potential.
Good lecture. Phenobarbital is GABA agonist
Phenytoin is used as an anti-arrythmic agent isn't it? I dont think the "n/a" for other indications is right
You got to change phenobarbital to GABA agonist because it makes no sense for to be antagonist and augment the receptors. but good video overall
Guys be careful of Sodium Valproate I have a possibly permanent movement disorder because of it ,and they don't tell you about those type of effects.
I was on levitiracetam worst drug in the world i went from 75 kg to 103 kg and deep depression and depersonalization..
SJ syndrome is more than a rash dude: it’s where your skin actually comes off. Good lord
its not absaaaaance seizure, its absence
It actually is said that way. A French doctor first named it
GABA AGONIST not antagonist. I won't even continue watching after that.