Anti-Seizure Drugs

Question 1

Key hepatic enzyme inhibiting Anti-seizure drug

Answer 1

Valproate

Question 2

Ethosuximide Adverse efects

Answer 2

GI distress

Question 3

Representative Drugs for Absence seizures (T-type inhibitors)

Answer 3

• Ethosuximide (Zarontin)

Question 4

Phenytoin Mechanism of Action

Answer 4

Sodium Block

Question 5

Given Valproic Acid and Lamatrogine’s Mechanism of action, what are its indications?

Answer 5

All kinds of seizures

Question 6

Valproic acid has a Triple mechanism of Action, where it’ll inhibit Na+, but it will also inhibit ______ channels and promote _____ neurotransmitter production

Answer 6

• Calcium

- GABA

Question 7

Indications for Carbamazepine and Phenytoin?

Answer 7

The 4 Easy Uses of Anti-seizure drugs

Question 8

Which drug is a modified Carbazepine, which has less adverse side effects, but more likely to cause hyponatremia?

Answer 8

Oxcarbazepine

Question 9

Long-term use of anti-seizure drugs puts patients at risk for ______

Answer 9

Osteoporosis

Question 10

Ethosuximide MOA

Answer 10

T-Type Calcium Block

Question 11

Valproate is huge in Neural Tube Defects, but 2 also distinguishing effects:

Answer 11

1. Alopecia

2. Weight Gain

Question 12

Valproic acid has a Triple mechanism of Action, where it’ll inhibit Na+, but it will also inhibit ______ channels and promote _____ neurotransmitter production

Answer 12

• Calcium

- GABA

Question 13

Tiagabine MOA

Answer 13

Inhibit GABA (GAT-1)
(Reuptake blocker)

Question 14

Given Valproic Acid’s Mechanism of action, what are its indications?

Answer 14

All kinds of seizures

Question 15

Representative Drugs for Partial seizures

Answer 15

Phenytoin, Carbamazepine

Question 16

Hirsutism and Gingival hyperplasia are two distinguishing side effects of which anti-seizure drug?

Answer 16

Phenytoin

Question 17

Phenobarbital MOA

Answer 17

Target GABA-A receptor

- Prolongs Cl- channel opening

Question 18

Phenobarb indications

Answer 18

4 easy seizures

Question 19

Lamotrigine has two funny drug interactions:

1. Valproate will cause _____ lamotrigine.
2. Phenytoin or Carbamazpine will cause _____ lamotrigine.

Answer 19

• More (because Valproate is super needy and displaces)

- Less (because Cyps go on super metabo mode with Pheny and Carba)

Question 20

Phenobarb is used for _____ but not for _____

Answer 20

• Children

- Adults

Question 21

3 Contra-indications of Phenytoin

Answer 21

1. Myoclonic
2. Absence
3. Lennox-Gastaut

(The Twitch/Muscle-based diseases don’t want sodium to be blocked)

Question 22

Carbamzepine is just like Phenytoin, except it also can auto-induce its own metabolism and will present with 3 different, key adverse effects. _____, ______, _______.

Answer 22

1. Hyponatremia
2. Leukopenia
3. Terrible Rash

Question 23

Aside from weight gain, Vigabatrin distinguishing side effect

Answer 23

Retinal Toxicity & pieripheral vision loss

Question 24

Tiagabine is only really good to treat ______ seizures

Answer 24

Focal

Question 25

Do not use Gabapentin or Pregabalin for ____ & _____ seizures, or ____ _____ ______ seizures

Answer 25

• Myoclonic
• Absence
• Generalized Tonic Clonic

Question 26

Gabapentin and Pregabalin MOA

Answer 26

Inhibit Calcium channels (with a2d1)

Question 27

Tiagabine, Vigabatrin, and Gabapentin/Pregabalin are all cleared by the ______

Answer 27

Kidneys

Less Drug-drug interactions

Question 28

What is significant of phenytoin’s PK curve?

Answer 28

Starts off linear, becomes exponential at higher doses

Question 29

Benzos should only be used for the special kind of seizures. Name 5

Answer 29

1. Status Epilepticus
2. Lennox
3. Myoclonic
4. Atonic
5. Absence Seizures

Question 30

Benzo MOA

Answer 30

Target GABA-A receptor

- Prolongs Cl- channel opening

Question 31

Perampanel Adverse Effects

Answer 31

• Black Box warning: Suicidal Thoughts

Question 32

Phenobarb adverse scary effect

Answer 32

Respiratory depressions

Question 33

What are the 4 easy uses of Anti-seizure drugs?

Answer 33

1. Simple Partial
2. Complex Partial
3. Secondarily Generalized
4. Primary Generalized Tonic-Clonic

Question 34

Vigabatrin MOA

Answer 34

Inhibit GABA breakdown

• Target GABA Transaminase
• less breakdown means more drug

Question 35

Tiagabines distinguishing side effects

Answer 35

GI probs

Question 36

2 Key Pharmacokinetic facts of the needy Valproate?

Answer 36

1. HIGH albumin binding, so high drug displacement

2. Hepatic Enzyme inhibitions

Question 37

The Brand-new Perampanel MOA

Answer 37

• Non Comp

- Bind AMPA to Antag Glutamate

Question 38

Representative Drugs for Status Epilepticus Initial vs Long-term

Answer 38

Initial: Benzodiazapines(1st line), Lorazepam, Diazepam, or Clonazepam

Long-term: Phenytoin, Phenobarbital

Question 39

What’s the awesomest thing about Lamotrigine’s (Lamictal) pharmacokinetics?

Answer 39

Does NOT induce or inhibit CYPs

Question 40

Lamotrigine has a similar Mech as Valproic acid with Na and Calcium inhibition but differs in that _______ neurotransmitter is inhibited

Answer 40

Glutamate

Question 41

2 Key Hepatic enzyme inducing Seizure drugs?

Answer 41

1. Pheny

2. Carba

Question 42

Valproate is the most deadly to the ______

Answer 42

Fetus

Question 43

3 Contra-indications of Phenytoin

Answer 43

1. Myoclonic
2. Absence
3. Lennox-Gastaut

(The Twitch/Muscle-based diseases don’t want sodium to be blocked)

Question 44

Indications for Carbamazepine and Phenytoin?

Answer 44

The 4 Easy Uses of Anti-seizure drugs

Carba more selective for partial though

Question 45

The unique target of Levetiracetam (Keppra); thought to decrease neurotransmitter release

Answer 45

Synaptic Vesicle Protein 2A (SVP2A)