Anti-Convulsants Flashcards
Epilepsy treatment aimed at
- elevating seizure threshold (stabilize membrane) or
2. limiting propagation (reduce synaptic transmission or nerve conduction)
MOA of gabapentin and pregabalin
VSCC at A2-Delta ligand binding site
MOA of valproic acid, divaloproex
?VSSC at unknown binding site
MOA of lamotrigine and carbamazepine
L: VSCC (decrease Glu release) and VSSC (suppress repetitive APs)
C: VSSC at channel site in Alpha subunit
tx of Grand mal (Generalized Tonic-Clonic) seizures
- Valproate
- Levetriacetam
- Lamotrigine
*also tx of Atonic myclonic sz
tx of Generalized Absence seizures (Petit mal)
- Ethosuximide
2. Valproate
A 9-year-old boy is sent for neurologic evaluation because of episodes of apparent inattention. Over the past year, the child has experienced episodes during he develops a blank look on his face and his eyes blink for 15 sec. He immediately resumes his previous activity. Which one of the following best describes this patient’s seizures? A. Simple partial B. Complex partial C. Tonic-clonic D. Absence E. Myoclonic
D. Absence
A 42-year-old man undergoes a neurologic examination because of episodes of apparent confusion. Over the past year, the man has experienced episodes during which he develops a blank look on his face and fails to respond to questions. Moreover, it appears to take several minutes before the man recovers from the episodes. Which of the following best describes this type of seizure? A. Focal-simple partial B. Focal-complex partial C. Tonic-clonic D. Absence E. Myoclonic
B. Focal-complex partial
Tx of Partial seizures
- Carbamazepine (Tegretol)*
- Levetiracetam
- Lamotrigine
A young male patient suffers from a seizure disorder characterized by tonic rigidity of the extremities followed in 15-30 sec of tremor progressing to massive jerking of the body. This clonic phase lasts for 102 min, leaving the patient in a stuporous state. Of the following drugs, which is most suitable for long-term management of this patient? A. Lamotrigine B. Ethosuximide C. Diazepam D. Carbamazepine E. Gabapentin
A. Lamotrigine
D. Carbamazepine
A 52-year-old man has had several focal complex partial seizures over the last year. Which of the following therapies would be the most appropriate initial therapy for this patient? A. Lamotrigine plus carbamazepine B. Levetiracetam C. Clonazepam D. Ethosuximide E. Phenytoin F. Watchful waiting
B. Levetiracetam
Which of the following anticonvulsive agents does NOT result in additive CNS depression (increased somnolence) when given with opioid analgesics?
A. Phenytoin (Dilantin ®)
B. Carbamazepine (Tegretol®)
C. Phenobarbital (Luminal®)
D. Diazepam (Valium®)
E. Levetiracetam (Keppra®)
F. All of the above will produce additive CNS depression
F. All of the above will produce additive CNS depression
Potential mechanisms of action of anticonvulsant drugs include all of the following EXCEPT:
A. Enhancement of GABA activity
B. Enhancement of glutamate activity
C. Decrease spread of abnormal neuronal foci through normal tissue
D. Blockade of sodium channel to suppress repetitive action potential
E. Blockade of T-type Ca++ channels in thalamocortical pathways
B. Enhancement of glutamate activity
What drugs?
MOA: inhibit sodium channel fxn to suppress repetitive AP firing
Phenytoin
Carbamazepine
Lamotrigine
topiramate
What drugs?
MOA: enhance the inhibitory effect of GABA via increased opening of Cl channels
Benzos and phenobarbital
*Valproate partly works by increased GABA action