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N P Neuro part > 030515 antiseizure drugs > Flashcards

030515 antiseizure drugs Flashcards

1
Q

many of the anti-epileptic drugs are metabolized by

A

liver (a good percent of the drug is metabolized by liver in many cases)

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2
Q

phenytoin MOA

A

use dependent effect on sodium channels-keep inactivation gate closed longer

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3
Q

uses of phenytoin

A

generalized tonic-clonic seizures

partial seizures

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4
Q

the anti-epileptic drugs are highly protein bound-what implciations does this hv?

A

can interact w other drugs that are protein bound

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5
Q

side effects of phenytoin

A

CNS-dose dependent-nausea, anorexia, apathy, sedation, ataxia, nystagmus, diploplia

dose-independent:

  • gingival hyperplasia
  • hirsutism
  • teratogenicity
  • hypersensitivity rxns
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6
Q

MOA of carbamazepine

A

similar to phenytoin

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7
Q

use of carbamazepine

A

partial seizures

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8
Q

notable toxicity of carbamazepine

A

teratogen: increased risk of spinal bifida, though risk is lower than w valproic acid

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9
Q

oxycarbazepine

A

newer analog of carbamazepine. less likely to cause CNS side effects and less enzyme induction

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10
Q

use of ethosuximide

A

first choice drug for absence seizures

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11
Q

MOA of ethosuximide

A

reduces low threshold T-type Ca currents in thalamic neurons

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12
Q

MOA of valproic acid

A

blocks repetitive neuronal firing (good for partial seizure)

may reduce t type Ca currents (good for absence seizures)

increases GABA concen

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13
Q

use of valproic acid

A

absence sizures
absence seizures w concomitant generalized tonic clonic seizures

generalized tonic clonic seizures and partial seizures

myoclonic seizures

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14
Q

side effects of valproic acid

A

teratogenicity-spinal bifida
hepatotoxicity

these are the non- dose related ones

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15
Q

felbamate MOA

A

acts at glycine modulatory/allosteric site on NMDA receptor as antagonist. also potentiates GABA

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16
Q

use of felbamate

A

partial seizures refractory to other agents

17
Q

gabapentin MOA

A

unknown

18
Q

use of gabapentin

A

adjunct therapy in tx of partial seizures w or wo secondarily generalized tonic clonic seizures

19
Q

MOA of pregabalin

A

structurally similar to gabapentin but more potent

20
Q

use of pregabalin

A

adjunctive therapy for partial seizures

management of neuropathic pain

21
Q

MOA of lamotrigine

A

blocks repetitive APs and may block Na ch

22
Q

use of lamotrigine

A

partial, generalized tonic-clonic and absence seizures

not as good as ethosu. and valproic acid for absence seizures

23
Q

MOA of topiramate

A

inhibits excitatory transmission by antagonizing ability of excitatory amino acids to activate the kainate/AMPA subtype of glutamate receptor

blocks the SPREAD of seizures

24
Q

use of topiramate

A

add-on therapy for partial seizures

25
Q

tiagabine

A

inhibits GABA transporter (GAT-1) and thus reuptake of GABA

26
Q

use of tiagabine

A

add-on tx for both complex and simple partial seizures

27
Q

levetiracetam MOA

A

unknown

28
Q

use of levetiracetam

A

adjunct tx for partial seizures

adjunct tx of myoclonic seizures

29
Q

zonisamide MOA

A

acts at both Na and Ca ch. reduces voltage-dependent transient inward currents (T-type Ca currents)

30
Q

use of zonisamide

A

adjunct tx of adults w partial seizures

31
Q

vigabatrin MOA

A

acts by irreversibly inhibiting GABA metabolism-GABA transaminase inhibitor

32
Q

use of vigabatrin

A

adjunct tx of refractory complex partial seizures and infatile spasms

33
Q

clobazam

A

adjunct tx for seizures associated w Lennox Gastaut syndrome (severe form of epilepsy)

blocks voltage dependent Na and Ca ch, suppresses neuronal hypersynchronization and inhibits carbonic anhydrase

34
Q

lacosamide

A

enhances slow inactivation of voltage gated Na ch

adjunct tx of partial seizures

35
Q

perampanel

A

new drug
AMPA allosteric antagonist

partial seizures

36
Q

ezogabine

A

adjunct tx of partial seizures

K ch facilitator (UNIQUE)

37
Q

rufinamide

A

not clearly known

adjunct tx of seizures assoc w Lennox Gastaut syndrome

N P Neuro part (18 decks)

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