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PHAR0007 > Anti-epileptics > Flashcards

Anti-epileptics Flashcards

1
Q

What are (6) important AEDs?

A

Phenytoin, valproate, ethosuximide, carbamazepine, diazepam, phenobarbitone

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2
Q

What two key things do AEDs do?

A

Decrease excitation

Increase inhibition

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3
Q

How is excitation decreased?

A

Decrease efficacy at excitatory synapses, inhibiting VG cation channels - Na+, Ca2+

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4
Q

How is an increase in inhibition achieved?

A

Increase efficacy at inhibitory synapses, increase K+ channel activity

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5
Q

What drugs are used to reduce activity of Na+ channels?

A

Volproate, carbamazepine, phenytoin (block high frequency discharge without affecting low frequency firing)

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6
Q

What drugs are used to decrease activity at excitatory synapses?

A

Ethosuximide (generation of normal thalamocortico rhythms)

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7
Q

What drug blocks GABA metabolism? i.e. blocks GABA-transaminase

A

Valproate - increases GABA (inhibitory NT) in the brain

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8
Q

What drugs potentiate GABA action?

A

PAM of GABA-a receptors - BDZs, barbiturates

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9
Q

What newer drugs inhibit Na channels?

A

lamotrigine, topiramate

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10
Q

What blocks NMDA-type GluRs?

A

Felbamate - This is effective EXPERIMENTALLY.

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11
Q

What drug inhibits GABA uptake?

A

Tiagabine - inhibits GABA uptake membrane transporters thus increasing spread and duration of GABA

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12
Q

What is a key side effect of AEDs?

A

Teratogenicity - a substance that disturbs the development of an embryo/foetus
Valproate should not be used on women of child-bearing potential

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13
Q

Other side effects?

A

Changes in anticoagulant metabolism and oral contraceptive metabolism that could lead to prolonged bleeding (blood won’t clot normally) and unwanted pregnancies.

Epilepsy - could fall during a seizure –> loss of blood

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14
Q

Drugs used for partial seizures?

A

carbamazepine, valproate, phenytoin

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15
Q

Generalised tonic-clonic drugs?

A

Valproate, carbamazepine

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16
Q

Generalised absence drugs?

A

Ethosuximide

17
Q

Status epilepticus drugs?

A

Lorazepam, diazepam

18
Q

What is epilepsy?

A

Repeated occurence of sudden excessive/synchronous discharges in the cerebral cortical neurones causing a disruption of consciousness, impairment of mental function, disturbance of sensation.

19
Q

Epilepsy stats?

A

1/131 people have epilepsy, <75% achieve full seizure control through medication

20
Q

Aetiology?

A

Symptopathic (known cause e.g. trauma, CNS infection, post-natal trauma) or idiopathic (no known cause, genetics?)

21
Q

Types of seizure

A

Partial - complex or simple - both can lead to a secondary generalised seizure - 1 hemisphere

Primary generalised

PHAR0007 (9 decks)

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