Use: drug of choice in tonic clonic and partial seizures

MOA: decrease sodium conduction

ADRs: diplopia, rash, ataxia, memory loss(long term use), agranulocytosis, aplasitc anemia, hepatitis 

Preg class D: documented fetal risk

Interactions: enzyme inducer, ^ metabolism of drugs

class: benzo

use: backup for myoclonic and abscence seizure

MOA: potentiate GABA

ADRs:ataxia, drowsiness, dependence

interactions: alcohol, phenytoin

use: DOC in abscence seizures

MOA:calcium channels

ADR: GI distress, weight loss, lethargy

Rare but serious: blood dyscrasias

Preg class C: documented animal risk, no human study

Use: lennox gastaut syndrome (epilepsy in young uns)

MOA: glutamate antagonism

use: backup in partial seizures

also good for chronic pain and bipolar

ADRs: ataxia, drowsiness, dizziness, fatigue

overall less ADRs than others

preg class C

use: doc for partial and atypical abscence seizures

may improve depression, better tolerated than carbamazopine and phenytoin

MOA: sodium channels, glutamate antagonist

ADRs: diplopia, blurred vision, rhinitis, hypersensititviy(skin)

oral, low plasma protein binding, low P450 metabolism

use: backup in tonic-clonic and partial seizures

ADRs: dizziness, drowsiness, irritability

Preg C

active metabolite of carbamazapine

use: doc in partial seizures

ADR: decrease induction of P450 verses carbamazapine

phenobarbital

Primidone(prodrug)

reserved for infancts(quick absorption)

ADR: cognitive effect with long term use

phenytoin

dilantin(extended release)

highly plasma protein bound (caution w/ warfarin)

non-linear metabolism- double dose 30x blood conc

use: most effective for tonic clonic and partial seizures

MOA: alter multiple channels Na > Ca

ADR: gingival hyperplasia, drowsiness, nystagmus, lymphadenopathy

interaction: potent enzyme inducer

class 5 controlled

use: peripheral neuropathy DOC

2nd line for partial seizure

MOA: GABA potentiation

ADRs: dizziness, somnolence, dry outh, blurred vision, edema, myoclonus    

based on GABA structure

use: backup for partial seizures

ADRs: GI upset, dizziness, tremor, drowsiness

monosaccharide

use: backup in partial seizures

MOA: acts on GABA receptors

decreased sodium channels/neuron firing

ADRs: sedation, fatigue, drowsy, mental dulling

speech problems( dose related) out of order sentances

use-broadest spectrum used for all and bipolar

doc in abscence seizures

MOA: decrease sodium channels

increase GABA availablilty

ADRs: gi upset

hypersensitivity- thrombocyotopenia and hepatotoxicity

sulfonaminde derivative

use: backup for abscence seizures

MOA: ALL 3 increase GABA

decrease Na and Ca

decrease glutamate

ADRs:cognitive impairment, hypersensitivity

contraindicated in pt with sulfoniamide allergies