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PPE > 11.1 Anti-Epileptics > Flashcards

11.1 Anti-Epileptics Flashcards

1
Q

What is Epilepsy?

A

An episodic discharge of high frequency neuronal activity resulting in a seizure

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2
Q

What are the types of epileptic seiures?

A

Partial - simple (conscious) or complex (change of consciousness)
General - Grand Mal or Petit Mal (Absence)

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3
Q

What do you treat a patient with in an emergency?

A

Benzodiazepines (IV or Rectal)

Phenytoin (IV)

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4
Q

What do you do if an epileptic person is pregnant?
Advice?
Medication?

A

If not severe then maybe take off drug
Weigh up if more risk to taking off or not

Think of using Lamotrigine (less risk of BDs)
Give Vitamin K and Folate

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5
Q

What is Status Epilepticus?

A

A seizure lasting more than 5 mins or when seizures run into each other –> a long one.

Medical Emergency
Can come from any type of seizure

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6
Q

What are the main types of drugs used in epilepsy?

A

VG Na Channel Blockers

GABA increasing drugs

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7
Q

What are the examples of Na Channel Blockers?

A

Phenytoin
Carbamezepine
Lamotrigine

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8
Q

What are the general rules of epilepsy treatment

A

Aim for Monotherapy
Increase dose very gradually
Monitor Carefully

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9
Q

Describe Carbamezapine
PK?
ADRs?
DDIs?

A 
VG Na Channel Blocker
Well absorbed
Highly protein bound
Linear PK
CYP inducer, induces itself so half life can half over long term
DON'T USE if AV conduction problems
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10
Q

Describe Phenytoin
PK?
ADRs?
DDIs?

A 
Highly protein bound
Non Linear PK
Varied half life 6-24hrs
CYP inducer but not of its own metabolism
Hyperplasia of gingiva
Rash (SJ)
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11
Q

Which seizures do you use Carbamezepine in?

Phenytoin

A

All but Absence Seizures

Phenytoin is 2nd line in an emergency

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12
Q

Describe Lamotrigine
PK?
ADRs?
DDIs?

A

Linear PK
t1/2 of 24hrs

Not a CYP inducer so fewer side effects
Less risk of birth defects

COCP decreases levels and more risk with other AEDs

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13
Q

Which seizures can you use Lamotrigine in?

A

All
Not 1st line for paeds
Pregnancy is safer
Young, fertile women

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14
Q

How do Benzodiazepines work?

A

Attach to GABA receptor and increase GABA sensitivity

Increase inhibitory neuronal control

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15
Q

Describe Benzodiazepines
PK?
ADRs?
DDIs?

A

Varied t1/2
Linear
Well Absorbed

DDIs with other AEDs

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16
Q

ADRs of Benzodiazepine

A

Resp Depression
CNS Depression
Dependence
Confusion

So don’t use long term

17
Q

Which drug do you use in absence seizures?

A

A Benzodiazepine - Clonazepam

18
Q

What drug is first line for general seizures?

A

Valproate Sodium

PPE (25 decks)

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