Medication Guide
Sodium Channel Blockers
Abbr. Generic Name Brand Name Class 2nd Mechanism of Action Mechanism Details Drug Company Description
CBZ Carbamazepine Tegretol, Carbatrol AED/Carboxamide - Use- and voltage-dependent blockade of neuronal volatage-gated sodium channels. Effective for focal seizures and primary tonic clonic and secondarily generalized tonic clonic seizures. May worsen absence and myoclonic seizures.
LAC Lacosamide Vimpat AED - Blocks voltage-gated sodium channels via a selective effect on slow inactivation of channels; may also relate to interaction with collapsing-response mediator protein-2. Add-on therapy for focal seizures with or without secondary generalization. Monotherapy in children 17 years older.8
LTG Lamotrigine Lamictal AED - Use- and voltage-dependent blockade of neuronal voltage-gated sodium channels Monotherapy and add-on therapy for focal and generalized seizures. Also used for seizures associated with Lennox-Gastaut syndrome. Valproate adjunct for children 2-12 years of age.
OXC Oxcarbazepine Trileptal AED/Carboxamide - Use- and voltage-dependent blockade of voltage-gated sodium channels, may increase potassium conductance, reduces presynaptic glutamate release, possibly by blocking high threshold calcium channels. Add-on therapy for Lennox-Gastaut syndrome.
PHT Phenytoin Dilantin AED - Use- and voltage-dependent blockade of neuronal voltage-gated sodium channels. Effective for focal and tonic clonic seizures. Ineffective against absences. Blood testing is essential to guide the doses.
RFM Rufinamide Inovelon, Banzel Carboxamide - Blockage of neuronal sodium channel. Add-on therapy for Lennox-Gastaut syndrome.
VPA Valproate Depakote, Epilim AED - Use- and voltage-dependent blockage of neuronal voltage-gated sodium channels; possible blockage of T-type calcium channels; increases synthesis and release of GABA. Effective for all types of seizures.
GABAergic
Abbr. Generic Name Brand Name Class 2nd Mechanism of Action Mechanism Details Drug Company Description
CLB Clobazam Frisium, ONFI BZD - Enhanced GABAergic neurotransmission, binds at benzodiazepine site Add-on therapy.
CLZ Clonazepam - BZD - Binds to benzodiazepine receptor, enhances GABA effects Effective for focal, tonic clonic, myoclonic and absence seizures.
FBM Felbamate Feltabol AED - Inhibits NMDA glutamate receptor mediated activity by modulating glycine binding sites on the receptor; blocks voltage activated sodium channels; possibly increases GABAA receptor activity. Mono- or add-on theraphy for Lennox-Gastaut syndrome.
NTZ Nitrazepam - BZD - Binds to benzodiazepine receptor, enhances GABA effects. Effective for infantile spasms only.
PBT Phenobarbital - BARB/AED - Increases the duration of opening of GABA mediated chloride channels by binding to an allosteric site for GABA receptor. Effective for focal and tonic clonic seizures.
PRM Primidone Mysoline AED - Metabolized to phenobarbitol, acts on GABA receptors. Primidone is not often used in children. Effective for all seizure types except typical absences
STP Stiripentol Diacomit Aromatic Allytic Alcohol - Increases GABA transmission through a barbiturate like effect, increases opening of GABAA receptors in the hippocampus, possibly also increases GABAA in brain through interfering with its uptake and metabolism. Add-on therapy for tonic clonic seizures for children with severe myoclonic epilepsy in infancy (SMEI or Dravet syndrome) where other treatment has not worked.
TGB Tiagabine Gabitril AED - Prevents GABA re-uptake by binding and inhibiting GAT1 thus prolonging GABA in the synapse. Children >12 add on for partial seizures.
VBG Vigabatrin Sabril AED - Increases GABA brain concentrations through irreversible inhibition of GABA transaminase. Effective for focal seizures with or without secondarily generalized seizures where other treatment has not worked. Used for West syndrome with Tuberous Sclerosis. May worsen absence and myoclonic seizures. Not widely prescribed due to possible side effects.
Calcium Channel Blockers
Abbr. Generic Name Brand Name Class 2nd Mechanism of Action Mechanism Details Drug Company Description
ETX Ethosuximide Zarontin AED - Binds to and blocks T-type calcium channels. Effective for typical and atypical absences.
GBP Gabapentin Neurontin AED/Analgesic - Inhibits calcium currents and neurotransmitter release by binding to the alpha2-delta subunit of high voltage-activated calcium channels Monotherapy and add-on therapy for focal seizures with or without secondary generalization (where other treatment has not worked). May make myoclonic and absence seizures worse
ZNS Zonisamide Zonegran AED/Sulfa - Blocks voltage dependent neuronal sodium and T-type calcium channels. Children >16. Add-on therapy for focal seizures with or without secondary generalization.
Binds to Synaptic Vesicle Protein 2A
Abbr. Generic Name Brand Name Class 2nd Mechanism of Action Mechanism Details Drug Company Description
BRV Brivaracetam (not FDA approved) Racetam - Binds to synaptic vesicle protein 2A. -
LEV Levetiracetam Keppra AED CCB Binds to synaptic vesicle protein 2A. Emonotherapy and add-on therapy for focal seizures with or without secondary generalization. Add-on therapy for myoclonic seizures in Juvenile Myoclonic Epilepsy.
Other/Multiple
Abbr. Generic Name Brand Name Class 2nd Mechanism of Action Mechanism Details Drug Company Description
AZA Acetazolamide - CAI - Carbonic anhydrase inhibitor. Effective for focal, tonic clonic and absence seizures.
CLO Clonidine - Antihypertensive alpha2 agonist - -
MDZ Midazolam - BZD - - -
PER Perampanel Fycompa AED GLY Non-competitive AMPA receptor antagonist. Mono-therapy for children >12 years for partial onset seizures.
TPM Topiramate Topamax AED GABA, GLY, SCB Blockade of neuronal sodium and calcium channels, augmenting GABA activity at some GABAA receptor subtypes, inhibition at the AMPA/kainate subtype of the glutamte receptor. Used for focal seizures with or without secondary generalization and tonic clonic seizures, where other treatment has not worked. Topiramate has a licence for monotherapy but is not widely used as a first line drug.
Steroids
Abbr. Generic Name Brand Name Class 2nd Mechanism of Action Mechanism Details Drug Company Description
ACTH ACTH - Steroid Steroid - -
PRD Prednisolone - Steroid Steroid - -

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