FA 2019 Epilepsy Drugs Notes

Mnemonics of the Page

- Vision gone all bad with Vigabatrin

- 1st line in neonates is Phenobarbital
- Sucks to have silent (Absent) seizures refers to Ethsuximide
- Ethsuximide side effects mnemonic is EFGHIJ
- E for Ethsuximide, F for fatigue, G for GI distress, H for headache, I for itching
and J for SJS syndrome
- Phenytoin side effects mnemonic is PHYNYTOIN NAME ITSELF
- P for P-450, H for hirsutism, E for enlarged gums, N for Nystagmus, Y for
yellow brown skin, T for Teratoginicity, O for Osteopenia, I for Inhibited
folate absorption, N for neuropathSy, S for syndromes (SJS, DRESS,SLE-Like)

Mode of Action

GABA

- Benzodiazepines
- Gabapentin
- Levetiracetam
- Phenobarbital
- Topiramate
- Valproic Acid
- Vigabatrin

Na+

- Carbamezapine
- Lamotrigine
- Phenytoin
- Fosphenytoin
- Topiramate
- Valproic Acid

CA 2+

- Ethosuximide
- Gabapentin
- Levetiracetam

Glutamate

- Lamotrigine
 - Levetiracetam

GABA and Ca 2+ = Gabapentin, Levetiracetam

GABA and Na 2+ = Valproic acid + Topiramate

Seizures Types

- Parietal focal (Not in) Benzodiazepines and Ethosuximide

- Tonic Clonic (Not in) Benzodiazepines, Ethsuximide, Gabapentin, Vigabatrin
- Absense (Only in ) Ethsuximide, Lamotrigine, Valproic acid
- Status epilepticus (Only in) Benzodiazepines, Phenobarbital, Phenytoin,
Fosphenytoin

Side Effects

Sedation : Benzodiazepines, Gabapentin, Phenobarbital, Phenytoin, Fosphenytoin,

Topiramate
Tolerance: Benzodiazepines, Phenobarbital,
Dependence: Benzodiazepines, Phenobarbital
Respiratory Depression: Benzodiazepines, Phenobarbital
Diplopia: carbamezapine, Phenytoin, Fosphenytoin
Ataxia: Carbamezapine, Gabapentin, Phenytoin, Fosphenytoin
P450= Carbamezapine, Phenobarbital, Phenytoin, Fosphenytoin,
SJS= Carbamezapine, Ethosuximide, Lamotrigine, Phenytoin, Fosphenytoin
Black box warning: Lamotrigine, Vigabartin
Neuropathy: Gabapentin, Phenytoin, Fosphenytoin
Neuropsychiatric symptoms (Personality Change) : Levetiracetum
Hemophygocytic, Lymphohistiocytosis: Lamotrigine
Fatigue: Ethosuximide, Levetiracetam
GI Distress: Ethosuximide, Valproic Acid
Headache: Ethsuximide, Levetiracetam

Special Notes:

MgSo4 is used as first line for eclampsia seizures

Blood dyscrasias (Agranulocytosis, Aplastic anemia) in Carbamezapines
Liver toxicity in Carbamezpine and Valproic Acid
Teratoginicity in (Carbamezapine as cleft lip, palate and spina bfida)(Phenytoin+
Fosphenytoin as fetal hydantoin syndrome)
SIADH (Syndrome of Inappropriate anti-dieutric syndrome) in Carbamezapines
Trigeminal Neuralgia = Carbamezapine
Migraine prophylaxis in Topiramate and Valproic Acid
Myoclonic seizures + Bipolar disorder = Valproic Acid
Weight loss in Topiramate
Weight gain in Valproic acid
SSSSSS=Topiramate
6S’s=
{{ Sedation
Slow congnition
Stones kidney
Skinny (weight loss)
Sight (glaucoma)
Speech }}

Neural tube defects + Pancreatitis + Tremer + Pregnancy = Valproic acid