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Neuro Pharm Quiz > Anti-Seizure Drugs > Flashcards

Anti-Seizure Drugs Flashcards

1
Q

drugs that treat and prevent seizures ____ the likelihood of firing of neurons in various parts of the brain

A
  • reduce
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2
Q

a seizure is caused by the transient (ordered/disordered), (synchronous/asynchronous) rhythmic firing of whole populations of brain neurons

A
  • disordered

- synchronous

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3
Q

seizures are often referred to as an ____________ in the brain

A
  • electrical storm
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4
Q

___ seizures are localized to smaller regions in one hemisphere of the brain

A
  • partial
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5
Q

partial seizures are further defined as simple partial or complex partial depending on

A
  • loss of consciousness
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6
Q

generalized seizures affect which hemisphere

A
  • both
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7
Q

______ is a life-threatening medical emergency in which a seizure lasts for more than five minutes or in which two or more seizures occur within a five minute period without a return to normal status in between

A
  • status epilepticus
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8
Q

mutations in ion channels that do what can promote depolarization

importance of this

A
  • promote Na+ or Ca2+ influx
  • reduce K+ efflux
  • reduce Cl+ influx
  • what anti-seizure drugs act on
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9
Q

_____ is the predominant excitatory neurotransmitter in the brain

_______ is the predominant inhibitory neurotransmitter in the brain

what do anti-seizure drugs do to alter these

A
  • glutamate (inhibit)

- GABA (stimulate)

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10
Q

MOA of Carbmazapine

A
  • presynaptic VG Na+ channel inhibitor

- bind to inactivated Na+ channel and slows the rate it resets

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11
Q

MOA of Lamotrigine

A
  • presynaptic VG Na+ channel inhibitor

- bind to inactivated Na+ channel and slows the rate it resets

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12
Q

MOA of Phenytoin

A
  • presynaptic VG Na+ channel inhibitor

- bind to inactivated Na+ channel and slows the rate it resets

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13
Q

MOA of Valproate

A
  • presynaptic VG Na+/Ca2+ channel inhibitor
  • bind to inactivated Na+ channel and slows the rate it resets
  • ALSO inhibits GABA transaminase slowing breakdown of GABA. also inhibits a second enzyme in GABA breakdown
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14
Q

action potentials travel down the length of the axon through the sequential opening of voltage gated ___ channels

A
  • Na+
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15
Q

do the VG Na+ channel inhibitors effect the neurons that are not involved in the seizure

A
  • no
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16
Q

toxicities of phenytoin

A
  • gingival hyperplasia
17
Q

toxicities of carbamazepine

A
  • water retention

- hyponatremia

18
Q

toxicities of valproate

A
  • alopecia (hair loss)

- weight gain

19
Q

MOA of Gabapentin

A
  • presynaptic VG Ca2+ channel inhibitor

- reduce release of glutamate into synapse

20
Q

MOA of Pregabalin

A
  • presynaptic VG Ca2+ channel inhibitor

- reduce release of glutamate into synapse

21
Q

do Gabapentin and Pregabalin affect GABA signaling

A
  • no
22
Q

MOA of Levetiracetam

A
  • inhibits release of glutamate

- blocks vesicle fusion protein SV2A

23
Q

MOA of Felbamate

A
  • MATES COMPETE WITH
  • competitive antagonist of ligand-gated glutamate receptors (Na+ channel)
  • NMDA
24
Q

MOA of Topiramate

A

MATES COMPETE WITH

  • competitive antagonist of ligand-gated glutamate receptors (Na+ channel)
  • AMPA
  • GABA-A receptor positive modulator
25
Q

toxicities of Felbamate

A
  • aplastic anemia

- acute liver failure

26
Q

toxicities of Topiramate

A
  • weight loss

- kidney stones

27
Q

MOA of Ethosuximide

used for what seizures

A
  • post synaptic T-type Ca2+ channel inhibitor
  • slows depolarization and reduces circuit output
  • absence only
28
Q

MOA of Tiagabine

A
  • increase synaptic levels of GABA by inhibiting GABA reuptake transporter on presynaptic neuron
29
Q

MAO of Vigabatrin

A
  • increases synaptic levels of GABA
  • inhibit GABA transaminase slowing breakdown of GABA
  • Valproate has the same function
    BOTH START WITH A V
30
Q

toxcities of Vigabatrin

indication for this drug

A
  • permanent loss of vision

- only if other therapies fail

31
Q

MOA of Benzodiazepines

examples of drug

A
  • GABA-A receptor positive modulator
  • increase frequency of Cl- channel opening
  • Clonazepam
32
Q

MOA of Barbiturates

examples of drug

A
  • GABA-A receptor positive modulator
  • increase duration of Cl- channel opening
  • Phenobarbital
33
Q

toxicities associated with almost all anti-seizure drugs

A
  • somnolence
  • dizziness
  • fatigue
  • ataxia
  • vision disruptions
  • nausea/vomiting
34
Q

which anti-seizure drugs are prone to drug-drug interactions

how so

how does this effect contraceptive meds

A
  • Valproate - inhibit CYP2C9
  • Carbamazepine - induce CYP2C9 (reduce effectiveness of contraceptive meds)
  • Phenytoin - induce CYP2C9 (reduce effectiveness of contraceptive meds)
35
Q

which anti-seizure drug can induce its own metabolism

A
  • Carbamazepine
36
Q

importance of phenytoin metabolism

A
  • at high doses it is metabolized by zero order kinetics - drug in excess compared to the enzymes that metabolize it
  • interferes with metabolism of other drugs
37
Q

which ant-seizure drugs are teratogenic

how?

A
  • phenytoin - reduce serum levels of folate
  • carbamazepine - reduce serum levels of folate
  • valproate
  • topiramate
38
Q

what do you give for status epilepticus

A
  • benzo (lorazepam and diazepam) + phenytoin

Neuro Pharm Quiz (5 decks)

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