USMLE Step 1

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Pharmacology

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Antiepileptics

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Levetiracetam

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Summary

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Key Points

  • Levetiracetam
    • Mechanism
      • Unknown; may modulate GABA and glutamate release, inhibits voltage-gated Ca+ channels
      • Binds to synaptic vesicle protein SV2A, which may modulate synaptic transmission by altering vesicle fusion
    • Clinical Use
      • Broad spectrum antiepileptic (1st line)
        • Treats partial (focal) seizures, generalized (tonic-clonic) seizures
    • Adverse Effects
      • Relatively few side effects
        • Popular in the hospital (and 1st-line in chronic seizure management) due to its relatively safety among the antiepileptics
      • Neuropsychiatric symptoms (e.g. personality changes), fatigue, drowsiness, headache may be seen