VITAMIN -K

• Group of lipophilic, hydrophobic vitamins.
• Needed for the post-translational modification of coagulation proteins.
• Phylloquinone (vitamin K1) is the major dietary form of vitamin K.

• Vitamin K2 (menaquinone, menatetrenone) is produced by bacteria in the intestines.

Carbamazepine (Tegretol): most common; for generalized tonic-clonic and all partial seizures; especially active in temporal lobe epilepsies

Mechanism: ↓ reactivation of Na channels (↑ refractory period, blocks high frequency cell firing, ↓ seizure spread)

Side effects: induces hepatic microsomal enzymes (can enhance metabolism of other drugs)

Pramlintide -Amylin mimetics

Mechanism
synthetic analogue of human amylin that acts in conjunction with insulin
↓ release of glucagon
delays gastric emptying

Clinical use

type I and II DM

Anticonvulsants: include carbamazepine (use when lithium not tolerated; may not be as effective) .

valproic acid (use when lithium not tolerated; rapid onset)

 Other sedatives: carisoprodol, cyclobenzaprine, and methocarbamol are used for muscle relaxation.

Baclofen
1. Used in spasticity states to relax skeletal muscle.
2. Occasionally used in trigeminal neuralgia.

Antihistamines (first-generation H1 receptor blockers)
1. Used for sedation (e.g., diphenhydramine).

Ethyl alcohol

Aquaretics
An aquaretic is a class of drug that is used to promote aquaresis, the excretion of water without electrolyte loss.

Lithium, demeclocycline

Mechanism of Action

1.    Block ADH action on distal tubule and collecting duct. Blocking ADH decreases H2O permeability. H2O is not recovered (distal tubule) using osmotic draw of counter-current multiplier so aquaretics reduce water reabsorption (tubule to blood stream). 
2.    Net effect is an increase in free water clearance