IP7 Exam 1

Carbamazepine brand name

Tegretol

What generation is Carbamazepine?

First generation

Oxcarbazepine brand name

Trileptal

What generation is Oxcarbazepine?

Second generation

Eslicarbazepine acetate brand name

Aptiom

What generation is eslicarbazepine acetate?

Third generation

Carbamazepine, Oxcarbazepine, and Eslicarbazepine acetate are which drug class?

Iminostilbenes (sodium channel inhibitors)

Phenytoin brand name

Dilantin

What generation is Phenytoin?

First generation

Which drug has non-linear elimination kinetics?

Phenytoin

Fosphenytoin sodium brand name

Cerebyx

What generation is Fosphenytoin sodium?

Second generation

Phenytoin and Fosphenytoin sodium are which drug class?

Hydantoins (sodium channel inhibitors), but also increase GABA concentration and decrease glutamate release

What side effect is unique to Carbazepine, Oxcarbazepine, and Eslicarbazepine acetate?

Hyponatremia

What two drugs have minimal cognitive impact?

Levetiracetam and Lamotrigine

What two drugs have greater cognitive impact?

Topiramate and Zonisamide

What two drugs do you have to titrate dose?

Carbamazepine and Lamotrigine

What two drugs have the side effect of weight loss?

Topiramate and Zonisamide

What drug has the side effect of weight gain?

Valproic acid

What drug is the most likely to give psych symptoms as a side effect?

Levetiracetam

What two drugs can cause metabolic acidosis/renal stones?

Topiramate and Zonisamide

What two drugs have gingival hyperplasia as a side effect?

Phenytoin and Fosphenytoin sodium

Lamotrigine brand name

Lamictal

What generation is Lamotrigine?

Second generation

What drug has a boxed warning of rash -> SJS -> TEN, especially when combined with valproate?

Lamotrigine

Zonisamide brand name

Zonegran

What generation is Zonisamide?

Second generation

What drug cannot be used in patients with sulfa allergies?

Zonisamide

What drug has the side effects of oligohydrosis and renal stones?

Zonisamide

Lacosamide brand name

Vimpat

What generation is Lacosamide?

Third generation

What drug has an ADR of arrhythmia, including AV block?

Lacosamide

Diazepam brand name

Valium

Clonazepam brand name

Klonopin

Midazolam brand name

Versed

Lorazepam brand name

Ativan

What drugs should not be combined with opioids?

Benzodiazepines and Barbiturates

Phenobarbital brand name

Luminal

What drug class does Phenobarbital belong to?

Barbiturates

What generation is Phenobarbital?

First generation

What drug has a boxed warning of misuse, withdrawal reactions, and respiratory depression/death risks, especially when combined with opioids?

Phenobarbital

What drug class do benzodiazepines and barbiturates belong to?

GABAA receptor allosteric modulators

What drug class do Levetiracetam and Brivaracetam belong to?

Glutamate inhibitors

Levetiracetam brand name

Keppra

What generation is Levetiracetam?

Second generation

Brivaracetam brand name

Briviact

What generation is Brivaracetam?

Third generation

What drug class do Ethosuximide, Gabapentin, and Pregabalin belong to?

Calcium channel inhibitors (Cavs)

Ethosuximide brand name

Zarontin

What generation is Ethosuximide?

First generation

Gabapentin brand name

Neurontin

What generation is Gabapentin?

Second generation

Pregabalin brand name

Lyrica

What generation is Pregabalin?

Third generation

What are calcium channel inhibitors indicated for?

Absent seizures

Valproic acid brand name

Depakote

What generation is Valproic acid?

First generation

What drug has a boxed warning of being a teratogen?

Valproic acid

Vigabatrin brand name

Sabril

What drug has an ADR of cumulative risk of irreversible vision loss

Vigabatrin

What drug has an ADR of cumulative risk of irreversible vision loss?

Vigabatrin

Topiramate brand name

Topamax

What generation is Topiramate?

Second generation

What drug is contraindicated in metabolic acidosis?

Topiramate

What two drugs decrease efficacy of oral contraceptives?

Topiramate and Phenobarbital

Cannabidiol brand name

Epidiolex

What generation is Cannabidiol?

Third generation

What generation has an ADR of elevated liver enzymes?

Cannabidiol

What drugs should you avoid in a patient with Dravet syndrome?

Sodium channel blockers

What is the therapeutic drug range of Carbamazepine?

4-12mcg/mL

What is the therapeutic drug range of Phenobarbital?

15-40mcg/mL

What is the therapeutic drug range of Phenytoin?

10-20mcg/mL

What is the therapeutic drug range of Valproic acid?

50-100mcg/mL

What is the therapeutic drug range of Levetiracetam?

20-50mcg/mL

What do iminostilbenes look like?

Tricyclic with a nitrogen in the middle ring

Which iminostilbene is the only one metabolized by CYP?

Carbamazepine

Which iminostilbene is a prodrug?

Eslicarbazepine

What drugs produce toxic metabolites?

Carbamazepine, Phenytoin, Phenobarbital, Valproic acid, Felbamate, and Lamotrigine

What do hydantoins look like?

Imide on the five membered ring

What is GABA?

Gamma-aminobutyric acid

What drug is a irreversible GABA-transaminase (GABA-T) inhibitor?

Vigabatrin

What do Phenobarbital looks like?

Six membered ring with a diimide

What do lactams look like?

Five membered ring with C double NH2

What two drugs bind to SV2A?

Levetiracetam and Brivaracetam

What drugs are multitargeted?

Valproic acid, Topiramate, Cenobamate, and Lamotrigine

What does Cenobamate look like?

Ring made out of 4 nitrogens

What does Lamotrigine look like?

Six membered ring with 3 nitrogens

myoclonic

involuntary jerking of face, limb or trunk muscles

clonic

susained muscle contractions alternating with relaxation

tonic

sustained muscle extension (stiffening)

atonic

loss of postural tone (drop)

Glatiramer acetate brand name

Copaxone, Glatopa

Glatiramer acetate boxed warning

Anaphylactic reactions

Which interferon is dosed every two weeks instead of every week?

Pegylated interferonW

What are adverse effects of interferons?

Flu-like symptoms, depression

Teriflunomide brand name

Aubagio

Teriflunomide boxed warnings

Embryofetal toxicity and hepatotoxicity

How long does Teriflunomide remain in the plasma?

Up to two years

Dimethyl fumarate brand name

TecfideraM

Monomethyl fumarate brand name

Bafiertam