24: Antiepileptic Drugs

Question 1

an epileptic seizure is a

Answer 1

transient occurrence of signs and symptoms due to abnormal excessive and synchronous neuronal activity in the brain

Question 2

are seizures synchronus or not

Answer 2

synchronous

Question 3

3 definitions of epilepsy

Answer 3

2 unprovoked seizures occurring >24 hours apart

one unprovoked seizure and increased probability of 60% of further over the next 10 years

diagnosis of an epilepsy syndrome

Question 4

simple partial seizure

Answer 4

no impairment of consciousness

motor, sensory, or autonomic symptoms

Question 5

no impairment of consciousness

Answer 5

simple partial seizure

Question 6

altered consciousness and behavioural arrest

Answer 6

complex partial seizure

Question 7

complex partial seizure

Answer 7

altered consciousness and behavioral arrest

motor automatism

Question 8

secondary generalized seizures

Answer 8

focal seizure that becomes generalized

Question 9

classes of generalized seizures

Answer 9

generalized tonic clonic
absence
myoclonic

Question 10

can generalized seizures be nonconvulsive

Answer 10

yes- either convulsive or not convulsive

Question 11

loss of consciousness with hyperextension of body followed by rhythmic full body contractions

Answer 11

generalized tonic-clonic

Question 12

sudden impairment of consciousness

always starts in childhood

Answer 12

absence seizures

Question 13

sudden muscle contractions without loss of consciousness

Answer 13

myoclonic- generalized seizures

Question 14

normal neuronal activity is

Answer 14

not synchronized

Question 15

imbalance in seizures

Answer 15

increased excitatory mechanisms

decrease inhibitory mech

Question 16

what are increased during seizures

Answer 16

glutamate receptors (NMDA, AMPA)
sodium and calcium influc

Question 17

what are decreased during seizures

Answer 17

GABA
VG potassium channel
Ca2+ dependent potassium channels

Question 18

antiepileptic drugs inhibit

Answer 18

abnormal neuronal discharge

Question 19

are antiepileptic drugs curative

Answer 19

no- no effects on underlying cause

Question 20

MOA of antiepileptic drugs

Answer 20

enhance GABA
block Na and Ca2+ channels
inhibit Glu receptors
open K+ channels

Question 21

phenobarbital and BZs action

Answer 21

enhance GABA receptor activation

Question 22

tiagabine action

Answer 22

inhibit GABA reuptake

Question 23

vigabatrin action

Answer 23

inhibit GABA breakdown

Question 24

sodium channel blockers are ________ blockade and preferentially bind to

Answer 24

use dependent

inactivated state of channel

Question 25

what channels are responsible for absence seizures

Answer 25

T type calcium channel

Question 26

AEDs modulate T type calcium channels

Answer 26

ethosuximide

valproic acid

Question 27

P/Q type calcium channels

Answer 27

modulate the release of various NT including GABA

Question 28

AEDs that act on P/Q type calcium channels

Answer 28

gabapentin and pregabalin

Question 29

levetiracetam and birvaracetam action

Answer 29

binds to synaptic vesicle protein 2A (SV2A) and modulates NT release

Question 30

perampanel is a

Answer 30

noncompetitive AMPA receptor antagonist

Question 31

retigabine is a

Answer 31

K+ channel opener

Question 32

drugs for focal seizures

Answer 32

carbamazepine
lamotrigine
levetiracetam
phenytoin

Question 33

drugs for general tonic clonic

Answer 33

carbamazepine
lamotrigine
levetiracetam
phenytoin
valproic acid/ divalproex

Question 34

AEDs for absence seizures

Answer 34

ethosuximide

valproic acid/ divalproex

Question 35

AEDs for myoclonic seizures

Answer 35

valproic acid/ divalproex