Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BMB W10 > 10-17 L1 Epileptic drugs > Flashcards

10-17 L1 Epileptic drugs Flashcards

1
Q

Whats the difference b/t seizure and epilepsy?

A
  • Seizure
    • the clinical manifestation of an excessive and hypersynchronous discharge of a population of cortical neurons (subjective symptoms of objective signs)
  • Epilepsy
    • a disorder in which there is a tendency to have recurrent seizures.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pt hase impaired consciousness (often abrupt onset and brief) somtimes with automatisms (loss of postural tone, or enuresis; begin in childhood (formerly petit mal) and usuall cease by age of 20 yrs

  • no aura or warning
  • motionless blank stare
  • short duration
A

Absence seizures (generalized)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Treatment of Absence seizures

  • which is used in uncomplicated absence seizure
  • which is used in pt generalized tonic-colnic or myoclonic seizures
A
  • Ethosuximide or Valproic acid are the perfered choice
  • Ethosuximide
    • often used in uncomplicated absence seizures if patients can tolerate its gastrointestinal side effects
  • Valproic acid
    • particularly useful in pts who have concomitant generalized tonic-colnic or myoclonic seizures.
  • Clonazepam
    • is effective but has the disadvantage of causing sedation and tolerance.
  • lemaotrigine, levetiracetam and zonisamide are alos effective in absence seizures.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pt has impaired conciousness that is preceded, accompanied or followed by psychological symptoms. what is this type of seizure called?

  • Aura or automonimc psychic epigastric or olfactory sensation
A

Partial seizures, complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Treatment of Partial seizures (complex)

A
  • Treatment
    • Carbamazepine (oxcarbazepine)
    • lamotrigine
    • phenytoin
  • Alternative
    • felbamate
    • phenobarbital
    • topiramate
    • valproic acid
  • new drugs
    • anticonvulsants can be used adjunctively including
    • gabapentine
    • pregabalin (structual congener)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

pt has multiple myoclonic muscle jerks

  • characterisitc hfeature of juvenile myoclonic epilepsy (a generalized epilepsy syndrome)
A

Myoclonic seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment of myoclonic seizures

A
  • Valpronic acid
  • lamotrigine is approved for adjunctive use, but is commonly used as monotherapy
  • Clonazepam can be effective (high doses required cause drowsiness)
  • Back up:
    • *levetriacetam *
    • topiramate
    • zonisamide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pt has a tonic phase (<1 min), invovles abrupt loss of conciousness, muscle rigidity and respiratory arrest.

Pt has a clonic phase (2-3 min) invovles jerking of body muscles, with lip or tongue biting, and fecal and urinary incontinence

A
  • Tonic-clonic seizures
  • grand mal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Treatment of generalized tonic-clonic seizures or grand mal

A
  • Valproic acid
  • carbamazepine
  • phentoin
  • phenobarbital (or primidone)
    • adults: alterantive drugs
    • infants: drug of choice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is monotherapy?

What is therapeutic range?

A
  • Monotherapy
    • pts tend to have fewer adverse effects
    • quite often combinations don’t work
    • aim for monotherapy first
  • Therapeutic range
    • general guid
    • balance seizure control and side effects to optimamly determine dose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cabamazepine (Tegretol)

  • Indication
  • Pharmacokinetics
  • Adverse effects
A
  • Indication
    • partial onset seizures only
  • Pharmacokinetics
    • _liver metabolized _(increaseins the clearance of its self and other drugs: clonazepam, lamotrigine and valproic acid)
    • moderate protein binding
    • many interactions
  • Adverse effects
    • Drowsinees
    • nausea
    • dizziness
    • visual distrubance
    • Rash (steven johnson 1/5k, TEN 10%)
    • liver failure (1/200k)
      *
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Phenytoin (Dilantin)

  • Indicaitons
  • Pharmacokinetics
  • Adverse effects
A
  • Indicaitons (not used anymore)
    • partial & generalized
  • Pharmacokinetics
    • non-linear (w clinically important saturation)
    • highly protein bound
    • many interactions
  • Adverse effects
    • drowsiness
    • dizziness
    • unsteady gait
    • gum hypertrophy
    • Rash
    • Rare liver failur
    • aplastic anemia (severe rash)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lamotrigine (Lamictal)

  • Indications
  • Pharmacokinetics
  • Adverse effects
A
  • Indications
    • partial or generalized onset seizures
  • Pharmacokinetics
    • Liver metabolized
    • Low protein binding
    • few interactions
  • Adverse effects
    • sedation is uncommon
    • dizziness
    • rash 5%
    • Rare severe rash
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which of the following drugs are liver metabolized?

A
  • Carbamazepine (Tegretol)
  • Lamotrigine (Lamictal)
  • Valproate (Depakote)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Levetiracetam (Keppra)

  • Indications
  • Pharmacokinetics
  • Adverse effects
A
  • Indications
    • partial or generalized onset seizures
  • Pharmacokinetics
    • not liver metabolized
    • no protein binding
    • no important interactions
  • Adverse effects
    • drowsiness
    • irritability
    • Rash
    • Liver failure
    • aplastic anemia not seen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which drugs are invovled in dealing with partial or generalized onset seizures?

A
  • Phenytoin (Dilantin)
  • Lamotrigine (Lamictal)
  • Levetiracetam (Keppra)
  • Valproate (Depakote)
17
Q

Valproate (Depakote)

  • Indications
  • Pharmacokinetics
  • Adverse effects
A
  • Indications
    • partial or generalized onset seizures
  • Pharmacokinetics
    • Liver metabolized
    • highly protien bound
    • many interactions
  • Adverse effects
    • Drowsiness
    • weight gain
    • tremor
    • hair loss
    • rash rare
    • Liver failur rare but more common in childred.
18
Q

What is the drug of choice for most generalized onset seizures?

A
  • Valproate (depakote)
  • be wary of teratogenesis
19
Q

What has the least drug interaction and protein binding?

A

Levetiracetam (Keppra)

20
Q

What epileptic drug is the least sedating?

A

Lamotrigine (Lamictal)

21
Q

What 2 antiepileptic drugs induce metabolism of other drugs?

A
  • Carbamazepine (Tegretol)
  • Phenytoin (Dilantin)
22
Q

What anti-epileptic drug inhibits metabolism of other drugs?

A

Valproate (Depakote)

23
Q

What anti-epileptic drugs are highly protein bound?

A
  • Valproate (Depakote)
  • Phenytoin (Dilantin)
24
Q

What should a female patients of child-bearing years be perscribe if they are treated with anti-epileptic drugs?

A

BMB W10 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions