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
Anticonvulsants (antiepileptic drugs) camera iphone 8 plus apk | |
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