Accepted
at 7:08 p.m. Jul, 30, 2025
by
heptachlor
Author:
pock
Type of change:
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Rationale for change
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Name 5 narrow spectrum antiepileptics
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Treatment: Trigeminal neuralgia
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Carbamazepine
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Adverse Effects (9) : Carbamazepine & Phenytoin
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(1) Ataxia
(2) Diplopia
(3) SIADH
(4) Agranulocytosis/Aplastic anemia
(5) CYP450 induction
(6) DRESS syndrome
(7) Teratogen
(8) Stevens-Johnson syndrome
(9) Drug induced lupus
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What type of fetal malformations is Carbamazepine associated with?
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Neural tube defects
(As well as general fetal dysmorphisms)
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Name 4 adverse effects of Phenytoin not present in Carbamazepine
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(1) Megaloblastic anemia
(2) Gingival hyperplasia
(3) Hirsutism
(4) Decreased bone density
(Strong induction of CYP450 system ⇒ ↑ Steroid metabolism ⇒ ↑ Rate of Vit. D inactivation ⇒ Osteopenia)
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What fetal malformations is Phenytoin associated with?
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Cleft palate
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Define: Status epilepticus
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Continuous (≥ 5-30 min) seizure
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Treatment: Status epilepticus (acute setting)
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IV Benzodiazepine
(Ben's diner is above the "order status" sign = Benzo first and Phenytoin second)
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Treatment: Status epilepticus (maintenance stage)
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Phenytoin
(Ben's diner is above and and tow truck below the "order status" sign and the tow truck is below = Benzo 1st and Phenytoin 2nd)
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Treatment: Status epilepticus (refractory)
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Barbituate
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MOA: Gabapentin
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Inhibits voltage gated Ca2+ channels
("Gabapentin does NOT bind to GABA receptors. I repeat, Gabapentin does NOT bind to GABA receptors")
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Which anti-seizure medication is effective against neuropathic pain?
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Gabapentin
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Adverse Effect: Gabapentin
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Ataxia
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MOA: Vigabatrin
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Irreversibly inhibits GABA transaminase
(Notice this is an degradative enzyme rather than ion channel/transmembrane receptor)
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MOA: Tiagabine
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Inhibits GABA reuptake
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What type of seizures are narrow spectrum anti-epileptics used for?
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Focal seizures (partial) (and generalized tonic clonic)
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More About This Topic
Entire Sketch
4.3 - Carbamazepine, phenytoin, gabapentin, tiagabine, vigabatrin
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