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Pharmacology - AEDs (*Clinical Patients with different Presentations…
Pharmacology - AEDs
*Steve-Johnson Syndrome
- medical emergency from diffusing rash over entire body
- 3 Vampire AEDs cause SJ syndrome in their victims
--> Ethan Hawk = Ethosuxamide
--> Carl the bartender = Carbamazapine
--> LAMO Larry (one direction) = lamotrigine
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*Status Epylepticus
- "BENZO to touch your PHENY-TOES, then FALL VAL the way to the LEVEL ground"
--> 1st line: BENZOs = Midaz IM or intranasal / IV Lorazapam if in hospital
--> 2nd line = Phenytoin IV (given same time as Benzo for prevention of further seizures)
--> 3rd line = Phenobarbitol, valproate, levetiracetam
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*Valproate
- "ALL-PrO athletes have ALPRO symptoms ... they GABA on the bench and drink SALTY gatorade"
- "ALPrO"
--> anemia
--> liver toxicity (rare but serious/check LFTs)
--> pancreatitis
--> rO = spinafibida / NTDs
- "GABA/ SALTY" = increase GABA and decrease V-gated Na+ channels
- 1st line for myoclonic seizures?
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*Phenytoin
- "In ZERO degree weather, If you don't SALT the roads, you'll foster/INDUCE snow HYPERPLASIA and need a TOIN' TRUCK"
- "SALT TOIN' TRUCK" = Phenytoin blocks Na+ channels
--> foster = prodrug form of phenytoin/faster by IV
- "ZERO degrees" = zero order kinetics
- "INDUCE" = CYP Inducer
--> part of CYP T
- "HYPERPLASIA" = gingivitis hyperplasia
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*Ethosuxamide
- 1st line treatment in Absence siezures
--> Valproate 2nd line
- "Ethan Hawke SUX blood to feed Calcium to his TENDER BONES"
- "Ethan Hawke SUX" = Ethosuxamide
- "calcium to feed TENDER BONES" = Ethosux blocks Ca++ channels
Absence seizures and Ethosuxamide
- 1st line treatment in Absence siezures
--> Valproate 2nd line
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*Carbamazapine
- "CARL the Vampire at the LOCAL McClarin's Pub brings a round of SALTY blood shots and CARBS to chew in your CHEEKS"
- "CARL vampire / LOCAL McClarins" = carbamazapine 1st line for FOCAL siezures
- "CARBS to chew in your CHEEKS" = carbamaz also 1st line for Trigeminal neuralgia
- "SALTY blood shots" = carbamaz blocks Na+ channels
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*Lamotragine
- “Remember: “LAMO Larry from 1 direction is LAMO for 2 reasons: He tried a GIN with SALT and he has NO ALPHAMALE GLUTS!”
- LAMO LARRY TRIED a GIN= lamotrigine
- 2 reasons = 2 methods of action
--> Gin with salt = blocks sodium voltage gated channels
--> blocks glutamate also
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*Levitiracetam
- “Remember: “Levetating magic trick --> Levitate her ass (TAMMY is his assistant)“
- levetiracetam magic TRICK = MOA unknown
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*Zonosamide
- 5 SSSSS
- sick
- psychosis
- somnelence
- stones (kidney stones)
- Steve-Johnson
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*Lacosamide
- Note this is the medication that Drewber is on, works well for him
- Think **"Andrew LIKES TACOS… but eats them SLOW with MILK lacosamide affects slow inactivation calcium channels
"**
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*Topiramate
- “Remember: “Two Pirate Mates GAB while mopping the SALT water off the deck.”
They get 3 SSS S/E while GABBING and mopping SALT WATER:
- Sea sick = lose weight
- Psychosis = think each other are mermaids
- Sleepy = somnolence
- 2 pirate mates = topiramate
- GAB while mopping SALT WATER = topiramate blocks sodium channels + increases GABA
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