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Neuropharma > AED > Flashcards

AED Flashcards

1
Q

Mechanism of action of Rufinamide

A

Prolong the inactivation state of Na channel

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2
Q

Phenobarbital drug that can be used in insomnia

A

secobarbital

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3
Q

Protein binding of PB

A

70%

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4
Q

Can be used in Lennox Gastaut Syndrome

A

Felbamate

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5
Q

oral source of lacosamide

A

Phenylalanine

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6
Q

Half life of Zonisamide

A

1-3 days

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7
Q

What are the mechanism of action of lamotrigine

A

Blockade of Na channel
Inhibit voltage Ca channel (N & P/Q Type)
Decrease synaptic release of glutamate

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8
Q

This AED is similar to imipramine

A

Carbamazepine

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9
Q

Maximum dose of Levetiracetam

A

3000mg/d

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10
Q

This AED is an Sulfonamide derivatives

A

Zonisamide

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11
Q

What drug increases its level when given lamotrigine

A

VPA

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12
Q

Clinical use of phenytoin

A

Partial and generalized seizure (primary and secondary)

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13
Q

Elimination of Phenytoin

A

First order kinetics

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14
Q

Felbamate may cause this toxicity

A

Aplastic anemia

Hepatitis

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15
Q

Peak level of CBZ is achieved at

A

6-8hours

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16
Q

Half life of Vigabatrin

A

6-8 hours

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17
Q

Effective plasma level of Felbamate

A

30-100mg/ml

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18
Q

Elimination of Gabapentin

A

Renal

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19
Q

Volume of distribution of PB

A

0.6L/kg

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20
Q

Half lite of phenytoin

A

12-36h

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21
Q

Drug interaction of Felbamate

A

Increase level of PHT and VPA

Decrease CBZ

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22
Q

This AED is a substituted monosaccharide

A

Topiramate

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23
Q

Peak concenration of lacosamide

A

1-4 hours

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24
Q

If sulfonamide is added with phenytoin what will happen?

A

Displaces phenytoin from protein increasing its free drug concentration

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25
Q

AE of VPA

A

Elevation of liver profile, thrombocytopenia, hyperammonemia, spina bifida

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26
Q

Protein Binding of CBZ

A

70%

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27
Q

Absorption of Phenytoin in GI

A

Complete at 3-12 hrs

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28
Q

Most common toxicity of CBZ

A

Diplopia and ataxia

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29
Q

Half life of perampanel

A

70-110 hours

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30
Q

What AED has an antifolate activity

A

Lamotrigine

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31
Q

Drug interaction of ethosuximide

A

VPA decreases ETX

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32
Q

Bioavailability of lacosamide

A

100%

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33
Q

Half-life of lacosamide

A

13 hours

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34
Q

Half life of rufinamide

A

6-10 hours

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35
Q

Protein binding of VPA

A

90%

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36
Q

What is the metabolite of Primidone

A

Pb –> PEMA

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37
Q

What drug makes topiramate less effective

A

OCP

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38
Q

Mechanism of action of VPA

A
  1. Blocks NMDA receptor mediated excitation
  2. Increases GABA
  3. facilitates glutamic acide decarboxylase (for GABA synthesis)
  4. Potent inhibitor of histone deacetylase
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39
Q

Volume of distribution of VPA

A

0.15 L/kg

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40
Q

What is the mechanism of action of Lacosamide

A

Enhances slow inactivation voltage gated Na channel

Binds to CRMP blocks BDNF and NT-3

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41
Q

What is the metabolite of Oxcarbazepine and its halflife

A

Eslicarbazepine

8-12 hours

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42
Q

Metabolism of Stiripentol

A

Inhibitor of CYP3A4 CYP1A2 and CYP 2C19 (increase the level of other AED)

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43
Q

half-life of lamotrigine

A

24 hours

44
Q

Toxicity of Phenytoin

A 
Nystagmus
Ataxia
Diplopia
Hirsutism
Hyperplasia of gingiva
Coarse facial
Osteomalacia
Decreased DTR
NADH2COD
45
Q

Excretion of Phenobarbital is enhance by

A

Alkalinization of urine

46
Q

This is an triazole derivatives

A

Rufinamide

47
Q

This congener of phenytoin causes dermatitis, aggranulocytosis and hepatitis

A

Mephytoin

48
Q

Mechanism of action of Perampanel

A

Acts at post synaptic AMPA receptor that shortens the repetitive discharge of neuronal system

49
Q

Mechanism of action of Stiripentol

A

Enhances GABAergic transmission of Cl channel and GAB-A receptor

50
Q

Mechanism of action of pregabalin and gabapentin

A

α2δ subunit-containing voltage-gated calcium channels

51
Q

What is the mechanism of action of Phenobarbital (4)

A

Prolong opening of Cl channel (main)
Allosteric modulator on GABA-A
Suppress high frequency of Na conductance
At high dose: blocks L and N Type Ca Channel

52
Q

Adverse effect of Retigabine

A

Decrease visual activity

Blue skin discoloration (Potiga)

53
Q

Clinical use of topiramate

A
  1. monotherapy for partial and GTC
  2. LGS
  3. Infantile spasm and absence
  4. migraine
54
Q

Adverse effect of Vigabatrin

A

irreversible visual field defect

55
Q

What is the mechanism of action of Zonisamide

A
  1. reduces the low threshold of Ca T-type channel
56
Q

Clinical use of CBZ

A

Partial and GTC seizure
Trigeminal neuralgia
Bipolar disorder

57
Q

Mechanism of action of Retigabine

A

K channel facilitator

58
Q

What is the mechanism of action of Levetiracetam

A

Binds to synaptic vesicle (SV2A)

59
Q

What is the advantage of Eslicarbazepine

A

once daily dosing

60
Q

Mechanism of action of OXazolidonedione

A

Raises threshold for seizure discharge after repetitive thalamic stimulation

61
Q

Therapeutic level of CBZ

A

1-2g

62
Q

Indication for acetazolamide

A

Catamenial Sz

63
Q

TD of PB

A

15-30mcg/ml

64
Q

Indication of Gabapentin

A

postherpetic neuralgia

adjunct in GTC and Partial Sz

65
Q

Adverse effect of perampanel

A

behavioral adverse reaction

66
Q

What is improved in Oxcarbazepine

A

Toxicity profile

67
Q

Half life of ethosuximide

A

40 hours

68
Q

Clinical uses of Ethosuximide

A

Absence Seizure (Drug of choice)

69
Q

AE of topiramate

A

Hypospadias
Urolithiasis
Glaucoma

70
Q

Mechanism of action of Felbamate

A

NMDA receptor NRI-2B

Barbiturate like potentiation of GABA-A receptor

71
Q

What test should be done if patient is on Phenytoin?

A

Thyroid function test (has affinity with thyroid binding globulin)

72
Q

Mechanism of action of Zonisamide

A
  1. Blocks Na CHannel

2. Acts on T type voltage gated Ca Channel

73
Q

Protein binding of perampanel

A

95%

74
Q

Indication of Pregabalin

A

Partial Sz +/- secondary generalization
Fibromyalgia
Anxiety Disorders

75
Q

Protein binding of topiramate

A

15%

76
Q

Clinical use of Stirpentol

A

Adjunct with clobazam and VPA for refractor GTC

Myoclonic epilepsy of infanct (SMEi, Dravets)

77
Q

Half life of VPA

A

9-18 hours

78
Q

Protein binding of Pregabalin

A

None

79
Q

Volume of distribution of lamotrigine

A

1-1.4L/Kg

80
Q

Anticonvulsant metabolite of CBZ

A

11-epoxide

81
Q

Half-life of levetiracetam

A

6-8 hours

82
Q

Half life of topiramate

A

20-30 hours

83
Q

Drug interaction of perampanel

A

Induces CBZ and PHT

When use with CBZ - half life is reduced to 25 hours

84
Q

Mechanism of action of Tiagabine

A

inhibitor of GABA uptake
Inhibit GAT-1 than GAT 2 and 3
Increase intracellular GABA

85
Q

This makes eslicarbazepine less effective if given with this drug

A

Oral contraceptives

86
Q

What is the antiseizure agent of Phenobarbital

A

Barbituric Acid

87
Q

Halflife of Phenobarbital

A

4-5 days

88
Q

Mehanism of action of CBZ

A

Blocks Na

Potentiate K

89
Q

Therapeutic level of ethosuximide

A

60-100mcg/ng

90
Q

Protein binding of Levetiracetam

A

10%

91
Q

Peak concentration of VPA

A

2 hours

92
Q

AE of Zonisamide

A

Cognitive impairment

93
Q

CLinical use of lamotrigine

A

Adjunct therapy
monotherapy for partial Sz,
Absence sz, LGT
Bipolar disorders

94
Q

Drug interaction of CBZ

A

Increase matanolism of PHT ETX and VPA
Increase staeady state of VPA
Decrease steady state of PHT and PBZ

95
Q

Mechanism of action of Topiramate

A
  1. Blocks voltage gated Na channel
  2. Potentiate inhibitory effect of GABA
  3. Depress action of Kainate on glutamate receptor
96
Q

Half life of Gabapentin

A

5-8 hours

97
Q

This drug enhances the effect of GABA by irreversibly inhibiting GABA-aminotransferase

A

Vigabatrin

98
Q

Pharmacodynamics of Retigabine

A

Linear kinetics and absorption is not affected by food

99
Q

Phenobarbital can worsen this type of seizure

A

Absence

Infantile spasm

100
Q

Half-life of Tiagabine

A

5-8 hours

101
Q

Drug interaction of VPA

A
  1. Inhibit metabolism of Pb PHT and CBZ
102
Q

Mechanism of action of Phenytoin

A

Prolingation of inactivated Na channel

Blocks the persistence of Na channel

Decrease Ca permeability

103
Q

Acetazolamide exerts its antiSz activity by

A

mild acidosis

104
Q

Clinical indication of Phenobarbital

A

GTC and partial Seizure

105
Q

Elimination half-life of stiripentol

A

Non-linear kinetics

106
Q

Therapeutic level of VPA

A

25-30mg/kg/day

Neuropharma (6 decks)

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