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Clinical Neuro Ex 2 > Anti Convulsant Pharm > Flashcards

Anti Convulsant Pharm Flashcards

1
Q

Excitatory and Inhibitory Neurotransmitter

A

Excitatory: Glutamate
Inhibitory: GABA

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2
Q

Effects Na+ / K+ movement across the cell

A

Na+ entering the cell is excitatory (depolarization)

K+ leaving is inhibitory, hyperpolarization

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3
Q

Location of the Cortex

A

Periphery of the brain

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4
Q

Absent Seizures are a subcategory of? Hemisphere affected? Areas of brain involved?

A

Primary Generalized Seizure
Both hemispheres affected
Abnormal synchronization of the thalamus and cortex

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5
Q

Absent Seizure SX

A

pt looks normal but, they are unresponsive, difficult to detect

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6
Q

Absent Seizure EEG Pattern

A

spike and wave

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7
Q

Drugs that inhibit Na channels affect ___ seizures

A

focal and secondary generalized seizures NOT absent seizures

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8
Q

Drugs that Inhibit Na+ Channels

A 
Valproic Acid
Lamotrigine
Lacosamide 
Phenytoin 
Carbamazepine
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9
Q

Phenytoin used for ___ seizures? MOA?

A

Focal and tonic clonic seizures, NOT absent seizures

Slows the rate of recovery of the Na+ channels back to resting state

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10
Q

Carbamazepine MOA? Drug interactions?

A

Induces the P450. Decreases the rate of recovery of Na+ channels like Phenytoin
Decreases phenytoin bioavailability
Alters plasma levels of oral contraceptives, antibiotics (cyclosporins)
Methadone and L-Dopa

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11
Q

Na Channel Resting Position

A

Closed, the linker molecule is off to the side

Cell is hyperpolarized

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12
Q

Na Channel Activated Position

A

Open, Na can enter cell

Cell depolarizes

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13
Q

Na Channel

A

Cell is depolarized, K+ channels are opening to hyperpolarize cell
Linker molecule blocks the channel

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14
Q

Role of T-type Ca++ channel blockers in Absent Seizures

A

Normal state: depolarized + inactive in awake state

Absent Seizure: the Ca++ channel gets hyperpolarized activates the channel, causing the spike and wave pattern

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15
Q

What category of seizures do T-type Ca++ Channel blockers work on?

A

Absent seizures

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16
Q

Three specific benzodiazepines used for focal and tonic-clonic seizures?

A

Diazepam, Lorazepam, Midazolam

17
Q

How do drugs that block High voltage Ca++ channels work? Can not be used for?

A

Inhibit entry of Ca ions into the presynaptic neuron which prevents the release of neurotransmitter
Absent seizures

18
Q

Vigabatrin MOA? 2 Indications?

A

GABA analog, irreversibly minds to GABA transaminase, thereby increasing GABA levels
Infantile spasms and refractory focal epilepsy

19
Q

What population is pregabalin for? Why?

A

Hepatic impaired patients because the drug is metabolized by the kidneys

20
Q

The type of seizure that Na+ channel inhibitors are not used for?

A

Absent Seizures

21
Q

3 Indications for Valproic Acid

A

generalized
focal
absence seizures

22
Q

Effect of phenytoin and carbamazepine on P450 enzymes

A

Both can induce the enzyme and alter the metabolism of various drugs: oral contraceptive, antibiotics, and levodopa

23
Q

Carbamazepine Treats..

A

focal seizures

24
Q

Drugs that inhibit Na+ channels are most effect on ___seizures?

A

Focal and secondary generalized NOT absent seizures

25
Q

Cabamazepine used for __ seizures? Half life? Kinetics?

A

Focal seizures, suppresses their spread
10 to 20 hrs which is decreased with chronic treatment
first order, more attractive than phenytoin in pts with potential drug interactions

26
Q

Drugs that block T-type Ca2+ channels are for?

A

Absent seizures

27
Q

Role of GABA in surround inhibition

A

prevents synchronization of surrounding neurons

28
Q

Another name for an absent seizure

A

petit mal

29
Q

Myoclonic Seizure

A

muscle twitching/jerking…lasts for only a few minutes

30
Q

Two Advantages of Fosphenytoin over Phenytoin Administered via?

A

more potent/soluble than phenytoin
parentally administered
rapid converted to phenytoin

31
Q

Why lacosamide is alternative to phenytoin/carbamazepine? For what seizure type?

A

enhanced slow inactivation of Na+ channels
fewer drug interaction
adjunctive therapy for focal seizures

32
Q

Why aren’t glutamate receptors used as a therapy in humans?

A

Adverse behavioral side effects

Clinical Neuro Ex 2 (5 decks)

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