Anticonvulsants PDF

Anticonvulsants Bromides General - MOA is unclear - Decreases NS discharge and interferes with chloride transport - Long half life - Sodium bromide and potassium bromide Bromide toxicity - Blindness - Coma - Dysphoria - Stupor - Ataxia - Paresis Potassium bromide -...

Anticonvulsants Bromides General - MOA is unclear - Decreases NS discharge and interferes with chloride transport - Long half life - Sodium bromide and potassium bromide Bromide toxicity - Blindness - Coma - Dysphoria - Stupor - Ataxia - Paresis Potassium bromide - Compounded typically and must be given with food - Must monitor serum levels - Can be used in combination with phenobarbital - Disadvantages - Resp dysfunction - Nausea vomiting - PU, PD\< polyphagia - Sedation - Ataxia - Narrow therapeutic index Others Dopamine Phenobarbital Primidone - Good option if phenobarbital is poorly tolerated - Has 3 metabolites that elicit and action - Phenobarbital - Primidone - Phenylethylmalonamide - Disadvantaged - Hepatotoxicity - Hepatic necrosis - Possibly no advantage over just using phenobarbital Gabapentin - Alpha 2 delta ligands - Gamma amino acid derivatives - Glutamate blocker - Given by mouth - Advantages - Reduces release of excitatory neurotransmitter glutamate - Can be used to help with neuropathic pain - Often used. In conjunction with phenobarbital or Kbr - May induce sedation Zonisamide - Sulfonamide - NA/CA channel blocker - Given by mouth - Advantages - Option for animals reactive to phenobarbital - Can be used in conjunction with phenobarbital - Minimal side effects - Wide therapeutic ranges - Disadvantaged - Not fully understood - Expensive - Very short half life