Neuro

• Sodium channel blockers

  Carbamazepine

  Oxcarbazepine

  Lamotrigine (Lamictal)

  Phenytoin (Dilantin)

  Fosphenytoin

  Topiramate (Topamax)
• Inhance GABA inhibitory transmission

  Tigabine

  Vigabatrin

  Benzodiazepines

  Phenobarbital

  Valproic acid
• Calcium Channel blockers

  Valproic acid
• Epilepsy misc meds

  Gabapentin (Neurontin)

  Pregablin (Lyrica)

  Levetiracetam (Keppra)
• Acetylcholinesterase inhibitors

  Donezepil (Aricept)

  Galantamine

  Rivastigmine
• NMDA Receptor Antagonist

  Memantine (Namenda)
• Dopamin precursor + related

  Levodopa

  Carbidopa

  Levodopa/Carbidopa (Sinemet)

  Levodopa, Carbidopa, Entacapone
• Catechol-O-methyltransferase (COMT) - inhibitors

  Entacapone
• Monoamine oxidase inhibitors

  Rasagiline

  Selegiline
• Antiviral agent

  Amantadine
• Dopamine Receptor Agonists

  Pramipexole

  Ropinirole (Requip)

  Rotigotine

  Bromocriptine

  Apomorphine
• Cholinergic Receptor Antagonists (Anticholinergics)

  Benztropine

  Trihexyphenidyl
• Lamotrigine - Lamictal
• Phenytoin - Dilantin
• Topiramate - Topamax
• Gabapentin - Neurontin
• Pregablin - Lyrica
• Levetiracetam - Keppra
• Donepezil- Aricept
• Memantine - Namenda
• Levodopa/Carbidopa - Sinemet
• Ropinirole - Requip
• What is MOA of sodium channel blockers

  Bind to and stabilize sodium channels that are inactivated

  • binds to channels that are in inactivated state (thus have been previously open)
  • targets channels that open/close more freq
  • acts on rapidly firing neurons and have less effect on neurons only firing action potentials
• What is MOA of carbamazepine

  Enhance sodium channel inactivation
• Carbamazepine may worsen absence seizures and may not be tolerated in the elderly
• What are adverse effects of carbamezepine 


  Dizziness

  Diplopia

  Leukopenia

  Hyponatremia
• What is MOA of Oxcarbazepine

  Enhance sodium channel inactivation 

  Modulate calcium channels
• Monitor sodium in oxcarbazepine and it has reduced effectiveness of contraceptives at doses > 1200mg/day
• what are adverse effects of Oxcarbazepine 


  Dizziness

  Diplopia

  Ataxia

  Hyponatremia (worse than carbamazepine)

  Visual disturbances

  N/V
• what is MOA of lamotrigine

  
  

  Enhance sodium channel inactivation 

  Decrease glutamate release
• Which sodium channel blocker needs to be titrated

  Lamotrigine
• Which sodium channel blocker is the go to tx of epilepsy in pregnant people

  Lamotrigine
• What are adverse effects of lamotrigine


  Sedation

  Diplopia

  Ataxia

  Rash - could become SJS (report this side effect)
• What is MOA of phenytoin

  Enhance sodium channel inactivation 
• A small hange in dose of phenytoin can lead to a large change in plasma concentration
• What are adverse effects of phenytoin

  
  

  Nystagmus

  Ataxia

  Gingival hyperplasia

  Osteomalacia
• What is MOA of fosphenytoin 


  Enhance sodium channel inactivation

  • prodrug of phenytoin 
  • IV or IM 
• What is MOA of Topiramate

  Enhance sodium channel inactivation 

  Acts as agonist at GABA-A receptors

  Acts as a glutamate antagonist
• What is reccomended for topiramate

  Adequate hydration
• What can topiramate do to contraceptives

  decrease efficacy of contraceptives at doses > 200 mg/day