anti seizure Flashcards
is a seizure transient or consistent?
transient
is a seizure synchronous or asynchronous?
synchronous
when can a seizure be epileptic?
if unprovoked
is epilepsy consistent or nonconsistent?
consistent
is epilepsy predictable or unpredictable?
unpredictable
what is the definition of epilepsy?
disorder of neuron excitability
when would an EEG show lapses of awareness?
absence seizure
neurotransmitter tone can be excitatory or inhibitory depending on the ____?
effect
what are the three monoamines?
5HT, NE, Dopa
what are the 2 inhibitory AAs?
glycine, GABA
does inhibiting glycine and GABA increase or decrease seizures?
inc
does agonizing glycine and GABA increase or decrease seizures?
dec
what are the 2 excitatory AAs?
glutamate and aspartate
does inhibiting glutamate and aspartate increase or decrease seizures?
dec
does agonizing glutamate and aspartate increase or decrease seizures?
inc
what are the 5 antiseizure drug receptors?
Na
Ca
GABA
AMPA
NMDA
which 2 receptors are glutamate receptors?
NMDA/AMPA
what type of channels are NMDA/AMPA?
ligand gated ion channel
what happens when glutamate binds NMDA/AMPA?
they open
what are the 4 requirements of NMDA receptor?
glutamate bind, glycine bind for glutamate to activate, Mg expelled from pore, Calcium/Na/K
when glutamate binds NMDA, what does Mg expelling from the pore cause?
depolarization
what does glycine binding the NMDA receptor cause?
increase in opening frequency
What happens when the AMPA receptor is activated by glutamate binding?
Na influx, K efflux (depolarized)
is Ca required for AMPA or NMDA?
NMDA
what does AMPA receptor have a site for?
glutamate
what does NMDA have a site for?
glutamate, glycine
what does GABA have a site for?
barbituate, benzo, GABA
does lamotrigine bind receptors?
no
what is lamotrigine MOA?
blocks glutamate release into synapse
what is felbamate MOA?
binds to glycine site on NMDA receptor and prevents Na entry from influx of Na after glutamate binds
what does felbamate prevent?
glycine binding so glutamate cant work and Na doesnt enter cell
what is topiramate MOA?
binds to glutamate site on AMPA receptor and stops Na influx
what does topiramate block?
glutamate binding to AMPA receptor is stopped by topiramate
what does a GABA receptor require?
GABA binding, benzo/barbituate,
Cl
what do benzo/barbituates require to work?
GABA binding
what do barbituates do to channel opening?
increase duration of opening
what happens as a result of benzo/barbituates making the channel open longer?
Cl enters
what happens when Cl enters?
repolarization (–) channel charge and harder to open
what is the MOA of diazepam?
binds to benzodiazepam site of GABA to increase Cl entrance and frequency of channel opening
what do benzodiazepines do to the channel opening?
increase frequency of opening
what is the MOA of phenobarbital?
binds GABA’s barbituate site and increase Cl entry to increase duration of channel opening
what is the MOA of tiagabine?
blocks GABA-T to SS conversion by preventing GABA reuptake via GAT-1
GAT-1 REUPTAKE BLOCK
what is the MOA of valproate and vigabatrin?
inhibit GABA-T so GABA repackaging and release are increased
GABA-T BLOCK
what is a secondary action of valproate?
inhibits SS breakdown
what is the MOA of Gabapentin?
promotes release of GABA
what is the MOA of phenytoin and carbamazepine?
block sodium channel on post synaptic neuron
what happens as a result of phenytoin and carbamazepine?
lengthens refractory period
(6) what drugs can lengthen the refractory period by inactivating Na channels?
phenytoin
carbamazepine
lamotrigine
topiramate
valproate
zonisamide
what is the MOA of ethosuximide?
block t-type Ca channel by decreasing thalamic pacemaker Ca current
(T/F) valproate can also block t-type Ca channel by decreasing thalamic pacemaker Ca current?
T
