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Neuro Path (2nd Year) > Anti-Epileptics > Flashcards

Anti-Epileptics Flashcards

Anti-Epileptics

1
Q

antieplipetic Cyp450 Inducer (5)

A

phenobarbital
ethosuximide
phenytoin
carbamazepine
tobacco

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2
Q

antieplipetic Cyp450 inhibitor (5)

A

erythromycin
Ca channel blockers
trimethoprim/sulfa
fluconazole
valproate
valproate
lorazepam
lamotrigine

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3
Q

levetiracteam relationship inducers/inhibitrs

A

does neither b/c not really metabolized

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4
Q

older people have more or less albumin

A

less

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5
Q

is renal excretion in older people increased or decreased

A

decreased

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6
Q

neonates have higher or lower protein binding than adults

A

lower

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7
Q

neonates have higher or lower metabolic rate when it comes to drugs when compared to adults

A

higher

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8
Q

do kids need higher or lower dose of durgs

A

higher b/c higher metabolism

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9
Q

pregnancy needs higher or lower does of anti-epileptics

A

higher

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10
Q

5 classes of drugs that interact w/ Anti epileptics

A

birth control
coumadin
anti-depressants
cholesterol-lowering
chemo

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11
Q

Phenobarbital use

A

all seizures except absence

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12
Q

Phenobarbital route

A

PO, IV

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13
Q

Phenobarbital half life

A

100 hours

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14
Q

Phenobarbital is metabolized where

A

liver

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15
Q

Is Phenobarbital inducer of liver enzymes?

A

yes

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16
Q

Phenobarbital toxicity (3)

A

hyperactivity in kids, sedation in adults, joint issues

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17
Q

Phenobarbital mechanism

A

GABA agonist
opens Cl channels
hyperpolarization

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18
Q

Phenytoin Use and best use

A

all seizures except absence. best used for focal and secondarily generalized seizures

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19
Q

Phenytoin mechanism

A

blocks voltage gated Na channels

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20
Q

where is phenytoin metabolized?

A

liver

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21
Q

what happens to metabolism when phenytoin is metabolized at high doses?

A

0 order kinetics

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22
Q

phenytoin half life

A

variable 6-24 hrs

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23
Q

phenytoin toxicity (3)

A

gingival hyperplasia, osteomalacia, ataxia

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24
Q

phenytoin relationship w/ weight

A

neutral

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25
Q

Benzo Use (4)

A

very effective for all seizure types–withdrawal, sedatives, anxiolytics

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26
Q

benzo drug of choice for…

A

Status epilepticus, alcohol withdrawal, withdrawal seizures

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27
Q

benzo mechanism

A

agonist at GABA receptor

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28
Q

benzo route

A

PO, IV

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29
Q

benzo toxicity (3)

A

sedation, depression, withdrawal

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30
Q

benzo caveat

A

addiction, tachyphylaxis

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31
Q

benzo metabolized where? is it an enzyme inducer

A

liver
no

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32
Q

funny story for carbamazepine

A

funny story: carbamazepine: carbs, need chewing= trigeminal neuralgia. carbs are food, need salt= Na channel blockade. Carbs are food= weight gain

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33
Q

carbamazepine mechanism

A

Na channel blockade

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34
Q

carbamazepine route

A

oral

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35
Q

carbamazepine half life

A

12 hours

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36
Q

where is carbamazepine metabolized/

A

liver

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37
Q

carbamazepine drug interactions (2)

A

ca channel blockers and macrolide antibiotics

38
Q

carbamazepine most effect dru for

A

focal seizures/ epilepsy

39
Q

carbamazepine side effects

A

steven Johnson syndrome

40
Q

carbamazepine relationship w/ weight

41
Q

Carbamazepine use: best use and other uses (4)

A

best for focal and secondarily generalized seizures.
Mood stabilizer
trigeminal neuralgia

42
Q

ethosuximide use

43
Q

ethosuximide mechanism

A

blocks T type calcium channels (mainly in thalamus)

44
Q

ethosuximide route

45
Q

ethosuximide half life

A

12-24 hours

46
Q

ethosuximide toxicity

A

sedation, GI distress, occasional behavioral changes

47
Q

ethosuximide metabolized where. Is it an inducer?

A

liver
mild inducer

48
Q

valproate funny story

A

Valproate funny story: valproate is a pro works on seizure, migraine, and bipolar. P= Potassium channels

49
Q

Valproate Use (3)

A

all seizure types, migraine, and bipolar
most effective drug

50
Q

Valproate mechanism

A

not well understood
maybe Na channels
maybe increase GABA
maybe affects Ca and K conductance

51
Q

Valproate route

A

oral and IV

52
Q

valproate half-life

53
Q

valproate toxicity

A

GI, weight gain, menstrual problems, hair loss, thrombocytopenia, pancreatitis, hepatic encephalopathy

54
Q

valproate relationhip w/ weight

55
Q

valproate metabolized where. Is it an inducer?

A

liver
not a major inducer

56
Q

Gabapentin Mechanism

A

increases GABA levels in brain. May block Ca channels

57
Q

Gabapentin route

58
Q

Gabapentin half life

59
Q

Gabapentin toxicity

A

sedation, GI distress, pedal edema

60
Q

gabapentin relationship w/ weight

61
Q

Gabapentin use (5)

A

partial and secondarily generalized seizures.
Anxiolytic
sedative
anti-spasmodic
peripheral neuropathy

62
Q

gabapentin is metabolized where? inducer?

A

not metabolized
not an enzyme inducer

63
Q

lamotrigine funny story

A

funny story: skin rashes are lame, Stevens Johnson is lame

64
Q

Lamotrigine mechanism

A

blocks release of glutamate pre-synaptically and blocks Na post synaptically

65
Q

Lamotrigine route

66
Q

Lamotrigine metabolism

A

renally excreted after glucoronidation

67
Q

lamotrigine half life

68
Q

lamotrigine toxicity

A

allergic rash 5-10%

69
Q

lamotrigine special use

A

preferred drug for pregnancy

70
Q

lamotrigine relationshiop w/ weight

71
Q

Lamotrigine use

A

all seizures
Bipolar
neuropathic pain

72
Q

topiramate funny story

A

takes care of all top problems: seizures, migraines, neuropathic

73
Q

topiramate metabolized where?

A

some hepatic, mostly renal

74
Q

topiramate inducer?

A

not an inducer

75
Q

topiramate half life

76
Q

topiramate route

77
Q

topiramate toxicity

A

sedation, aphasia, parasthesias , kidney stones

78
Q

topiramate relationshiop w/ weight

79
Q

topiramate use

A

seizures except absence
migraine prevention
neuropathic pain

80
Q

topiramate mechanism

A

Na channel blockade
GABA agonist
glutamate antagonist

81
Q

levetiracetam funny story

A

levetriacetam = vesicles

82
Q

Levetiracetam mechanism

A

not super well known..might block Ca channels and maybe stops vesicles from being released

83
Q

Levetiracetam metabolized where? inducer?

A

2/3 excreted renally unchanged. some renal hydrolysis. not protein bound. not inducer

84
Q

Levetiracetam toxicity

A

cognitive and behavioral probelms

85
Q

Levetiracetam route

A

IV and oral

86
Q

levetriacetam special use

A

good for pregos

87
Q

levetiracetamrelationship w/ weight

88
Q

Levetiracetam use

A

and generalize seizers
swiss army knife of seizure meds
favorite anti epileptic in hospitals

89
Q

Which AEDs work on GABA

A

Barbs benzos topiramate

90
Q

Which AEDs work on glutamate

A

lamotrigine, topiramate

91
Q

Which AEDs work on Na

A

Phenytoin
Carbamazepine
Valproate
topiramate
lamotrigine

92
Q

Which AEDs work onCa

A

ethosuximide

Neuro Path (2nd Year) (6 decks)

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