Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Anti-Seizure Drugs > Flashcards

Anti-Seizure Drugs Flashcards

1
Q

Who should be started on anti seizure drugs?

A

If a patient has had 2 or more unprovoked seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name drugs that lower seizure threshold (5)

A
  1. Theophylline
  2. Alcohol
  3. Phenothiazines (high-dose)
  4. Antidepressants (ex. Bupropion)
  5. Street drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When to stop anti-seizure medications?

A
  1. Seizure free for 2-4 years
  2. Complete seizure control within 1 year
  3. Onset of seizures between 2-35

AND normal neuro exam + EEG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 3 mechanisms of action for anti-seizure drugs?

A
  1. Enhance GABA (inhibitory)
  2. Turn down Glutamatergic (excitatory)
  3. Modify ion conductance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do benzodiazepines (Diazepam, Lorazepam) work?

A

bind to single site on chloride-ion channel which facilitates opening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Flumazenil: MOA

A

reverses effects of the benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which seizure is associated with a 3Hz spike and wave pattern on EEG?

A

Generalized Absence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Generalized Absence: Tx

A
  1. Ethosuximide***
  2. Lamotrigine
  3. Valproic acid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ethosuximide: clinical application

A

Generalized absence only!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ethosuximide: ADEs

A
  • Headache
  • Blood dyscrasias (unspecified blood abnormality)
  • *Monitor CBC**
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ethosuximide: MOA

A

decreases glutamate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Lamotrigine: MOA

A

decreases glutamate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lamotrigine: Clinical applications

A
  1. Generalized Absence
  2. Generalized Tonic-clonic
  3. Focal aware
  4. Focal/Generalized myoclonic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lamotrigine: ADEs

A
  1. Serious skin rash (go low and slow)***

2. Diplopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Valproate/Valproic acid: MOA

A

alters GABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Valproate/Valproic acid: ADEs

A
  1. Hepatotoxicity*
  2. Teratogenic**
  3. Pancreatitis*
  4. Alopecia
17
Q

Clonazepam: MOA

A

Enchance GABA

18
Q

Clonazepam: clinical applications

A
  1. Generalized Absence
  2. Focal/Generalized myoclonic
  3. Infantile spasms***
19
Q

Clonazepam: ADE

A

sedation

20
Q

Topiramate: Clinical applications besides seizures

A

Migrane!

21
Q

Topiramate: ADEs

A

cognitive slowing

confusion

22
Q

Which medications should be avoided as they worsen absence seizures? (4)

A
  1. Carbamazepine
  2. Vigabatrin
  3. Gabapentin
  4. Tiagabin

(pheytoin, and phenobarbital are ineffective and old!)

23
Q

According to US Guidelines, what is the drug of choice for tonic-clonic seizures?

A

Topiramate*

24
Q

What are the 3 FDA approved medications for tonic-clonic seizures?

A
  1. Lamotrigine
  2. Levatriacetam
  3. Perampanel
25
Q

Levetiracetam: ADE

A
  • behavioral problems (aggression, irritable)

- Headache

26
Q

Carbamazepine: ADE

A

Serious dermatologic reactions in Asians, and people with HLA-B (SJS and TEN)

  • Aplastic anemia
  • Agranulocytosis
  • Ataxia
  • Diplopia
  • Hyponatremia
  • Metabolic bone disease
27
Q

What is interesting about Carbamazepine’s pharmacokinetics?

A

induces own metabolism

28
Q

Lacosamide: MOA

A

blocks effect of neurotrophins

29
Q

Lacosamide: ADEs

A

small increase in PR interval

30
Q

Phenytoin (Dilantin): ADEs

A
  1. Cardiovascular risk associated with rapid infusion**
  2. Nystagmus (first sign of toxicity)
  3. Gingival hyperplasia
  4. Hirsuitism
  5. Folate deficiency
31
Q

Phenobarbital: ADEs

A
  • Sedation (can cause coma or death)**
  • Intellectual blunting
  • Behavioral changes (idiosyncratic - hyperactive)
32
Q

Phenobarbital: pharmakokinetics

A

Long-half life and inducer of P450 (many reactions!!!)

33
Q

What is the biggest worry you have for a patient taking Vigabatrin?

A

Permanent vision loss***

34
Q

What is the biggest concern for taking Perampanel?

A

serious psychiatric and behavioral reactions

35
Q

Tigabine: ADEs

A
  1. Concentration and attention difficulties
  2. Behavioral disturbance
  3. Increased appetite
36
Q

What is the 1st line treatment for Myoclonic seizures?

A

Levetriacetam (Keppra)

37
Q

Levetiracetam: ADEs/interactions

A

minimal and rare!

Pharmacology (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions