Anti-Epileptic and CNS

Valproic Acid MOA

Increases GABA availability and decreases neuronal firing

Valproic Acid A/E

Hepatoxicity, pancreatitis, thrombocytopenia

Valproic Acid Considerations

No pregnancy and monitor LFT and Anylase/Lipase

Phenytoin MOA

Decreases sodium influx and stabilizes neuronak membranes

Phenytoin A/E

Gingival hyperplasia, ataxia, Gi upset, nystagmus, Steven Johnson Syndrome, dysrhythmias, IV hypotension

Phenytoin helpful way to remember A/E

“Gums, Gait, GI”

Phenytoin Considerations

Oral contraceptives are less effective

Carbamazepine MOA

Decreased Na+ conduction and less firing

Carbamazepine A/E

S-J syndrome and bone marrow suppression

Carbamazepine Considerations

C: CBC monitoring

A: Avoid Grapefruit

R: Rash Risk

B: Blurred vision, dizziness, CNS

S: SIADH

Tenazepam MOA

CNS depression

Tenazepam A/E

Sedation, dizziness, tolerance, dependence, withdrawal seizures

Tenazepam Considerations

No alcohol or CNS Depressant avoid opioids

Tenazepam Sleep

4-6 hrs

Zolpidem MOA

Sedative

Zolpidem A/E

Dizziness, daytime drowsiness, complex sleep behaviors, and depression

Zolpidem considerations

No alcohol or CNS depressant

Zolpidem Sleep

More than 6-8 hrs