Anti-epilepsy drugs

Question 1

4 general treatments of epilepsy

Answer 1

1. drugs
2. surgery
3. diet
4. vagal stim

Question 2

who is main treater of epileps

Answer 2

family doc

Question 3

what active pathologies must be ruled out

Answer 3

infections, tumors, metabolic probs

Question 4

what is anti-convulsant hypersensitivity treatment

Answer 4

PT presents with fever then rash in 1-8 weeks of new treatment

Question 5

what causes AHS

Answer 5

aromatic amine drugs - need to find a new one

Question 6

what is seizure success stats

Answer 6

2/3 never have another

1/3 will never get drug control

Question 7

what to do with intractable PTs

Answer 7

send for surgery, diet etc

Question 8

what are 2 most commonly intractable seizures

Answer 8

1. complex partial - also most common type

2. West’s and Lennox-Gastaut

Question 9

what are 3 common comorbidities

Answer 9

1. anxiety
2. depression
3. suicide (3x)

Question 10

common AED side effects

Answer 10

stomach upset and sedations

Question 11

what is problem with theray

Answer 11

compliance, but not abuse

Question 12

what is best type of therapy

Answer 12

monotherapy, if doesn’t work switch - not multi-drugs

Question 13

why not poly-drugs

Answer 13

often interact and involve the liver

Question 14

how does valproate interact

Answer 14

increases blood levels of other drugs

Question 15

how do phenobarbital, phenytoin, and carbamazepine interact

Answer 15

lower blood levels of other drugs

Question 16

what is a well known interaction

Answer 16

AEDs and warfarin and birth control pills

Question 17

how to stop AEDs

Answer 17

slowly and be aware that can lose license

Question 18

what about AEDs in preg

Answer 18

can maintain, because seizures are worse than the drugs

Question 19

2 known tertogens

Answer 19

valproate and phenytoin

Question 20

3 major mechs of AEDs

Answer 20

1. inhib of voltage gated sodium channels (VDSCs)
2. enhance GABA
3. inhibit voltage gated potassium channels

Question 21

2 VDSC drugs

Answer 21

1. phenytoin

2. carbamazepine

Question 22

how does VDSC work

Answer 22

keep the Na channel in inactive state a little longer so doesn’t fire at very rapid rates

Question 23

what are 2 GABA drugs

Answer 23

1. barbituates

2. benzos

Question 24

1 Ca channel drug

Answer 24

ethosuxamide

Question 25

where do Ca channel blockers work

Answer 25

in thalmus

Question 26

1 drug for absence seizure only

Answer 26

ethosuxamide

Question 27

drug used only for tonic-clonic and partial (4)

Answer 27

1. phenobarbital - GABA
2. phenytoin - VDSC
3. carbamazepine - VDSC
4. Levitiracetam - not sure

Question 28

what is major issue with phenytoin

Answer 28

switches to zero order metabolism and can lead to long half life and therfore toxicity

Question 29

4 broad spectrum drugs

Answer 29

1. vaproate - watch out for hepatitis
2. clobazam - GABA - sedation
3. lamotragine - VDSC -
4. topiramate -topamax - sedation and weight loss

Question 30

drugs for stat. epilepticus

Answer 30

1. ativan - benzo

2. phenytoin IV