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PHARM 3 > anti-epileptics > Flashcards

anti-epileptics Flashcards

1
Q

simple partial sz

A

no LOC

abnl activity of a single limb or muscle group

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2
Q

complex partial sz

A

LOS

motor dysfunction

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3
Q

generalized sz

A

immediate LOC

no evidence of localized onset

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4
Q

absent sz EEG

A

spike and wave pattern (3 Hz)

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5
Q

drugs that block voltage gated Na+ channels

A

phenytoin
carbamazepine
lamotrigine
zonisamide

may contribute to effects of: phenobarbital, valproate, topiramate

prevent AP and stop release of glutamate

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6
Q

phenytoin

A

drugs that block voltage gated Na+ channels

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7
Q

carbamazepine

A

drugs that block voltage gated Na+ channels

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8
Q

lamotrigine

A

drugs that block voltage gated Na+ channels

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9
Q

zonisamide

A

drugs that block voltage gated Na+ channels

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10
Q

drugs that block t- type calcium channels

A

ethosuximide
valproate

used for absence seizures

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11
Q

ethosuximide

A

drugs that block t- type calcium channels

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12
Q

valproate

A

drugs that block t- type calcium channels

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13
Q

drugs that enhance GABA transmission postsynaptically

A

benzodiazepines
barbiturates
topiramate

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14
Q

drugs that enhance GABA transmission presynaptically

A

tiagabine = inhibit GABA reuptake

vigabatrin = inhibit degradation of GABA - via inhibition of GABA aminotransferase

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15
Q

drugs that reduce glutamatergic transmission post-synaptically

A

phenobarbital

topiramate

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16
Q

topiramate

A

drugs that reduce glutamatergic transmission post-synaptically

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17
Q

phenobarbital

A

drugs that reduce glutamatergic transmission post-synaptically

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18
Q

gabapentin

A

drugs that reduce glutamatergic transmission pre-synaptically

via blocking presynaptic VG Ca2+ channels

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19
Q

pregabalin

A

drugs that reduce glutamatergic transmission pre-synaptically

via blocking presynaptic VG Ca2+ channels

20
Q

Levetiracem

A

drugs that reduce glutamatergic transmission pre-synaptically - via binding to synaptic vesicle glycoprotein 2A

21
Q

main drugs used for partial and secondarily generalized tonic-clonic sz

A
  • Carbamazepine
  • Oxcarbazepine
  • Levetiracetam
  • Zonisamide
  • Phenytoin
  • Valproate
  • Lamotrigine
  • Topiramate
  • Phenobarbital
22
Q

tonic clonic general seizures main drugs used

A
  • Carbamazepine
  • Oxcarbazepine
  • Valproate
  • Lamotrigine
  • Phenytoin
  • Topiramate
23
Q

DOC for absence seizures

A

ethosuximide

valproate = atypical absent seizures (if EEG doesn’t match normal absence sz) and if tonic-clonic sz present

24
Q

myoclonic sz DOC

A

valproate

topiramate also used

levetiracetam used as adjunctive

25
Q

atonic sz DOC

A

valproate and lamotrigine

often refractory to all drugs

26
Q

febrile convulsions tx

A

<15 mins = supportive therapy

> 15 mins = diazepam IV/rectal

27
Q

status epilepticus algorithim

A

IV lorazepam –> IV phenytoin/fosphenytoin –> IV phenobarbital –> general anesthesia with IV midazolam/propofol/barbituates

28
Q

drug induced seizures in non-epileptic pt tx

A

diazepam
lorazepam
phenobarbital

29
Q

break through seizure tx

A

diazepam rectal gel

30
Q

anti-epileptics that induce p450

A

carbamazepine
phenobarbital
phenytoin

31
Q

anti-epileptic that inhibits p450

A

valproate

32
Q

valproate AE

A

hepatotoxic
p450 inhibitor
inhibits metabolism of several drugs

33
Q

phenytoin AE

A 
diplopia
gingival hyperplasia
coarsening of facial features in children
hirsutism
steven johnson's

0 order elimination

34
Q

carbamazepine AE

A

aplastic anemia
agranulocytosis
stevens johnson

35
Q

anti-epileptics that can cause steven johnsons

A

phenytoin
lamotrigine**
carbamazepine
phenobarbital

36
Q

which anti-epileptic has a black box warning

A

lamotrigine = stop at first sight of rash

37
Q

phenobarbital AE

A 
sedation
stevens johnson
tolerance
hyperactivity
p450 inducer
38
Q

primidone AE

A

same metabolite of phenobarbital - same AE

sedation
stevens johnson
tolerance
hyperactivity
p450 inducer
39
Q

vigabatrin AE

A

visual field loss

40
Q

feblamate AE

A

aplastic anemia
hepatotoxicity

used for refractory epilepsy

41
Q

discontinuing anti-epileptic tx

A

if sz free for 3-5 years

SLOW - esp with benzo and barb - to avoid withdrawal seizures

42
Q

anti-epileptic OD

A

rarely lethal

most dangerous = respiratory depression

43
Q

highest rate of fetal malformations out of anti-epileptics

A

valproate

44
Q

newborn hemorrhagic dz with anti-epilep

A

enzyme induced anti-epileptics can inc degradation of vit K

should supplement mom and newborn with vit K

45
Q

first line for essential termor

A

primidone

propranolol

PHARM 3 (21 decks)

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