Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Top 100 drugs flashcards SET 3 > Anti-epileptics > Flashcards

Anti-epileptics Flashcards

1
Q

Valproate - indications ?

A
  1. epilepsy - first line for prophylaxis of tonic clonic seizures, absence, focal and myoclonic
  2. some Status epilepticus - those not responding to benzos
  3. Bipolar - acute treatment of manic and prophylaxis against recurrence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

valproate - MOA?

A

Weakly inhibits neuronal sodium channels, stabilising resting membrane potentials and reducing neuron excitation.
+ increases GABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

valproate SE

A

GI upset
neuro and psych: ataxia, tremor and behaviour change
thrombocytiopenia
deranged lfts
hair loss
BMF, Pancreatitis, antiepileptic hypersensitivity syndrome
Teratogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Valproate warnings

A

not for women of child bearing age esp not in 1st trimester

avoid in hepatic impairment and reduce dose in severe renal impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

valproate interactions

A
  • inhibits cyp450

- increases plasma conc of lamotrigine and cyp450 drugs e.g. warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

valproate starting dose for epilepsy

A

600mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

valproate starting dose for bipolar

A

750mg 1-3 divided doses . maintain at 1-2g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what advice can you give to patients on valproate to avoid upset tummy

A

take with food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

DVLA advice on valproate

A

Advise patients not to drive unless they have been seizure-free for 12 months, and for 6 months after changing or stopping treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Carbemazepine indications

A
  1. epilepsy - prophylaxis for tonic clonic and focal

2. trigeminal neuralgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

MOA of carbemazapine

A

inhibit neuronal sodium channels -

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

SE of Carbemazapine

A

Gi upset
neurological effects - ataxia and dizzy

odoema

hyponatraemia

hypersensitvity - rash

antiepileptic hypersensitivity syndrome - 2 months of treatment - SJS and pyrexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the teratogenic effects of carbamezapine

A

neural tube defects, cardiac and urinary tract problems and cleft palate

if must take during pregnancy - high dose folic acid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what situations should you prescribe carbamezapine with caution

A

hepatic, renal or cardiac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

important interactions of carbemazapine

A

cyp 450 inducer. do not give with cyp450 inhibiters e.g. macrolides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what two routes can you prescribe carbamezapine

A

PO

PR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how should you stop carbamezapine

A

taper slowly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

gabapentin and pregabalin indications

A
  • add on for focal epilepsies if others have failed
  • neuropathic pain including painful diabetic neuropathy
  • an option for generalised anxiety disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

MOA of gabapentin and pregabalin

A

bind with pre-synaptic voltage sensitive calcium channels. stopping release of excitatory NTs = reduced neuronal excitability. similar structure to GABA.

same effect in peripheral nerves so reduces pain

20
Q

main side effects of gabapentin and pregabalin

A
  • drowsy
  • ataxia
  • dizziness
    improve after first few weeks of treatment
21
Q

When should the dose of gabapentin and pregabalin be reduced

A

when there is renal impairment

22
Q

what other drugs should you be careful prescribing gabapentin and pregabalin in

A

benzodiazepines due to overload of sedation

23
Q

what affect does gabapentin have on urine dip

A

Protein +ve. send protein creatinine ratio instead

24
Q

Lamotrigine indications

A
  1. seizure prophylaxis in epilepsy. esp in focal, tonic clonic and absence
  2. bipolar depression
25
MOA of Lamotrigine
- reduces na influx into neuron. | - inhibits post synaptic glutamate receptor - helps depression
26
lamotrigine SE
Headache, drowsy, irritable, blurred vision, dizzy, GI symptoms severe - skin rash, hypersensitivity
27
when should you avoid prescribing lamotrigine
if patients have hypersensitivity to other antiepileptic drugs
28
when should dose of lamotrigine be adjusted
moderate or severe hepatic impairment
29
can you use lamotrigine in pregnancy
yes - plasma concentration measurement should be considered as metabolism changes
30
Lamotrigine interactions
- as it is metabolised by glucoronidation - CARBAMEZAPINE, PHENYTOIN, OESTROGENS, RIFAMPICIN AND PROTEASE INHIBITORS. = conc reduces - glucorinidation inhibited by valproate so rise in levels.
31
levetiracetam (keppra) indications
1. seizure prophylaxis in epilepsy. - focal 1nd line or add on for myoclonic and tonic clonic 2. for refractory cases of status epilepticus
32
moa of keppra
synaptic vesicle protein 2a (SV2A) - glycoprotein in excitatory and inhibitory synapses . keppra interferes with vesicles function = modulates neuronal excitability.
33
SE keppra
usually none - drowsiness - weakness - dizzy - headache - rare - mood disturbance and psychiatric issues. suicidal ideation and serious hyepersensitivity
34
when is dose reduction of keppra needed
renal impairment
35
can you give keppra in pregnancy
yes
36
can and should keppra be given IV
Yes it can be given however is more expensive. also it has good bioavailability so oral and iv dose remains same
37
indications for benzos
1. Status epilepticus and seizures 2. alcohol wihdrawal reaction 3. sedation for intervention 4. short term anxiety or insomnia treatment
38
MOA of benzos
facilitate enhanced binding of GABA to GABAaR. = depress synapses
39
SE of benzos
drowy sedation coma in overdose - loss of airway reflexes = airway obstruction and death dependancy if ltm abrupt cessation = withdrawal reaction
40
benzos - when do you adjust dose
elderly - giv elower dose
41
who do you avoid giving benzos
- respiratory impaired patients NM disease patients - liver failure - can cause hepatic encephalopathy - is must then use lorazepam
42
what drugs to benzos interact with
- additive to sedating drugs e.g. opioids including alcoho and opioids. mostly depend on CYP450 so dont use with CYP-i.
43
which are the longer acting benzos
lorazepam, diazepam
44
what benzo is used for alcohol withdrawal
chlordiazepoxide | 2nd = Di or lor
45
what benzo is used for sedation
midazolam - short half life
46
what benzo is used for anxiety and insomnia
- temazepam - no longer than 2/52
47
OD of benzo? what drug?
flumenazil. not in mixed OD

Top 100 drugs flashcards SET 3 (65 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions