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Pharmacology > Anti-convulsants > Flashcards

Anti-convulsants Flashcards

1
Q

____ are short term alteration in behavior due to
disordered, synchronous, rhythmic firing of brain
neurons.

A

Seizures

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2
Q

What distinguished partial (focal) seizures from generalized seizures?

A

Partial seizures start at a single site in the cortex while generalized involve both hemispheres

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3
Q

How can you distinguish simple versus complex partial seizures?

A

In simple partial seizures, you do not lose consciousness. In complex partial seizures you have a gradual LOC and strong emotions, lip-smacking, or hand wringing are features

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4
Q

3 spikes/sec on an EEG suggests someone is having a ___ seizure

A

Absence Seizure

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5
Q

Which type of generalized seizure is associated with 3Hz spikes, sudden, impaired consciousness, staring, blinking. Cause?

A

Absence Seizures

Cause: thalmic T-type Ca
channels

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6
Q

Which type of generalized seizures is characterized as sudden impaired
consciousness, 20 sec muscle rigidity then 1-2 min
violent rhythmic body and limb movements

A

Tonic-clonic

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7
Q

Which type of generalized seizures is characterized as shock-like single (< 1 sec) contraction of
muscle in whole body or an extremity

A

Myoclonic

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8
Q

What types are seizures begin as partial seizure and then transform into generalized?

A

Secondarily Generalized Seizure (focal to bilateral
tonic clonic)

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9
Q

What four anti-convulsant drugs inhibit voltage-gated sodium channels and prolong inactive state of channel?

A

Cabamazepine
Oxycarbazepine
Phenytoin
Valproic Acid

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10
Q

Which two drugs act on T-type Ca2+ channels to treat absence seizures?

A

1) Valproic Acid
2) Ethosuximide

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11
Q

Barbituates like (___, ____) and benzodiazepines like (_____) enhance effect of GABA on GABAa receptors

A

phenobarbital, primidone

diazepam

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12
Q

What anti-convulsant inhibits the reuptake of GABA?

A

Tiagabine

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13
Q

Vigabatrin prolongs the effect of ____

A

GABA

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14
Q

Which anti-convulsant drug can treat absence, myoclonic, partial, and tonic/clonic seizures?

A

Valproic Acid

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15
Q

Carbamazepine can induce its own metabolism (autoinduce) while ____ cannot

A

Oxcarbazepine

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16
Q

What three anti-convulsants are good monotherapy treatments for myoclonic seizures?

A

-Valproic Acid
-Phenytoin
-Carbamazepine

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17
Q

What two drugs are good for treating partial seizures (secondarily generalized)?

A

-Phenytoin
-Carbamazepine

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18
Q

Phenobarbital is a monotherapy for generalize ____ and partial seizures

A

tonic-clonic

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19
Q

How does phenobarbital act?

A

GABAa-receptor (potentiation of synaptic inhibition)

20
Q

Minor drug allergies occur in 1-2% of patients taking ____

A

phenobarbital

21
Q

Common side effect of anti-epileptic drugs?

A

Ataxia

22
Q

Phenytoin could have drug-drug interactions with which drug?

A

Warfarin

23
Q

Gingival hyperplasia is common with taking which anti-convulsant?

A

Phenytoin

24
Q

SJS is a side-effect with use of ____ or ____

A

Ethosuximide or Phenytoin

25
Q

Which drug can be used as a monotherapy/adjunct treatment for partial seizure?

A

Oxcarbazepine

26
Q

Which drug inhibits T type calcium channels, prolongs inactivation of sodium channels, and increases GABA synthesis (in vitro)

A

Valproic Acid

27
Q

Which drug has side effects of increase in hepatic blood enzymes and hepatic toxicity in kids 2 and under on multiple AED?

A

Valproic acid

28
Q

Which drug inhibits CYP2C0, result in increased concentrations of phenytoin, phenobarbital, also displaces phenytoin from plasma binding proteins?

A

Valproic Acid

29
Q

Benzodiazepines are adjunctive treatment for ___ and juvenile _____ seizures

A

absence; juvenile myoclonic seizures

30
Q

True or False: In general newer anti-epileptic drugs lack serious side effects, do not induce liver enzymes (less drug-drug interactions) and are approved for mostly adjunctive treatment

A

True

31
Q

____ is a newer anti-epileptic drug used as an adjunctive treatment for partial secondary seizures and for neuropathy/fibromyalgia. It is NOT metabolized, excreted unchanged in the urine.

A

Gabapentin

32
Q

Which drug is used to treat Lennox-Gustaut Syndrome?

A

Felbamate

33
Q

Which anti-epileptic drug has no drug-drug interactions and is used as an adjunctive treatment for partial and tonic/clonic seizures in adults and myoclonic seizures in kids

A

Keppra (Levetiracetam)

34
Q

What drug is a monotherapy and an adjunctive treatment for partial and generalized tonic clonic seizures?

A

Topiramate/Lamotrigine

35
Q

How does Topiramate work?

A

Inhibits sodium channels/AMPA kaonate receptors that enhance GABA receptors

36
Q

Which newer anti-epileptic drug is most apt to have drug-drug interactions?

A

Lamotrigine

37
Q

Clonazepam is a good alternative/adjunctive for treating _____

A

generalized absence seizures

38
Q

What two drugs are good adjunctive treatment to partial, secondarily generalized seizures?

A

Lamotrigine/Valproic acid

39
Q

______ _____ is a series of seizures where full recovery

A

Status epilepticus

40
Q

How is status epilepticus treated?

A

1) Sedate with benzodiazepine (lorazepam IV)
2) Once seizures are controlled, give fosphenytoin/keppra/ph

41
Q

Drug concentration increases
disproportionately as dosage is increased for what drug?

A

Phenytoin

42
Q

AED’s can alter vitamin D metabolism in liver, which can lead to ___-

A

osteoporosis

43
Q

Failure rate of ___ ____ is 3X more
in women taking AEDs

A

oral contraceptives

44
Q

Facial and cranial deformities
associated with ___, but all AEDs can
cause fetal hydantoin syndrome

A

phenytoin

45
Q

How do manage anti-convulsants in pregnant mother

A

-If on combo therapy, change to mono
-Give folate to reduce risk of neural tube birth defects
-

Pharmacology (53 decks)

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