Anti Seizure And Anti Epileptics

Question 0

Summary of factors contribute to seizure vs control

Answer 0

Epsps Ipsp
Na influx K efflux
Ca currents Cl influx
Paroxysmal depolarization Pumps
Low ph

Question 1

May exacerbate bleeding disorders

Answer 1

Valproic acid

Question 2

Newer aeds have ______ cns sedating effects than classical

Answer 2

Less

Question 3

_____ receptor is responsible for absence sezuire

Answer 3

T

Question 4

Nmds recptor blockers

Answer 4

Reduce seizure incidence

Question 5

Carbamazepine

Answer 5

1st line for partial seizure
Moa- slows rate of recovery of na channels
AUTO INDUCTIVE STATE
AE: agranulocytosis and aplastic anemia in elderly
Induces cyp450 enzymes

Question 6

Oxcarbazepine

Answer 6

Improved version of carbamazepine
Moa: blockade of na channels
Ae: cns sedation
Stimulate cyp3a inhibit cyp2c19

Question 7

Phenytoin

Answer 7

1st line forpartial
Mediated by slow rate of recovery of na
Peak level - 4-12 hrs
Ae: cns sedation(nystagmus, diplopia) GUM HYPERPLASIA

Question 8

Lamotrigine

Answer 8

Mono therapy for refractory partial seizure
Effective against generalized
Moa- dependent inhibition of na; inhibit ca channels
Ae: dermatitis

Question 9

Zonisamide

Answer 9

Add on for partial and generalized
Moa: blocks na and t type ca
Ae: cns sedation

Question 10

Lacosamide

Answer 10

Inactive against clonic but efficacious against hippocampal kindled seizures; improved zonisamide
Ae: headache, nausea, dizziness, diplopia

Question 11

Phenobarbital

Answer 11

1st effective organic anti seizure
Not used for coma patients
Synaptic inhibition through gabaa receptor
Ae: cns, ataxia, rash, tolerance, 
C/i for diagnosing brain dead patients

Question 12

Clonazepam

Answer 12

Doc for myoclonic seizure and subcortical clonus
Anxiolytic, anti depressant, hypnotic
Ae: withdrawal may induce exacerbation of seizures: insomnia,a nxiety, psychosis, tremor

Question 13

Diazepam

Answer 13

Status epilepticus
Allosteric modulator
Cns, tolerance, dependence, hyperexcitability

Question 14

Valproic acid

Answer 14

1st line for generalized
Enhance gabatransmission, block na
Hepatotoxicity, birth defects
Potentiate cns depressants

Question 15

Tiagabine

Answer 15

Add on therapy
Interferes with gaba reuptake
Cns sedation

Question 16

Gabapentin

Answer 16

Add on for partial
Also for neuropathic pain and migraine
Eliminated by RENAL excretion
Somnolence, dizziness,ataxia, fatigue

Question 17

Vigabatrin

Answer 17

Add on for partial
Mono for infantile spasms
Blocks gaba metab
Cns sedation, opthal abnormal

Question 18

Felbamate

Answer 18

3rd line for refractory partial

Aplastic anemia, severe hepa

Question 19

Topiramate

Answer 19

Block na, inc freq gaba openings
Ae: can precipitate renal canaliculi: due to carbonic anhydrase
Drug inter: lessen effectiveness of birth control pills

Question 20

Levetiracetam

Answer 20

Add on for partial
Most commonly used drug at present
Ae: somnolence, asthenia, dizziness, cns depression, behavioral change

Question 21

Ethosuzomide

Answer 21

For Absence
Blocks t type ca currents
Ae: gastric distress: pain, nausea, vomitting; less cns
Drug inter: inhibition of metab if with valproic

Question 22

Retigabine

Answer 22

Novel aed

K channel opener

Question 23

Aeds that do not appear inducers or inhibitors of cyp system

And also NOT METAB BY LIVER

Answer 23

Gabapentin
Lamotrigine
Tiagabine
Levetiracetam
Zonisamide

Question 24

Doc for partial

Answer 24

Carbamazepine
Phenytoin
Valproic

Question 25

Doc for primary generalizetc

Answer 25

Carbamazepine
Phenytoin
Vslproic(not approved)

Question 26

Doc for generalized absence

Answer 26

Ethosuximide

Valproate

Question 27

Doc for atypical absence, myoclonic, atonic

Answer 27

Valproate

Lamotrigine

Question 28

Doc for infantile spasms

Answer 28

Corticotropin

Zonisamide