Anti-Seizure Drugs / Antiepileptic

Question 1

What is Epilepsy?

Answer 1

group of chronic CNS disorders.
recurrent, periodic and unpredictable seizures accompanied by unconsciousness/amnesia.

Question 2

What are seizures?

Answer 2

sudden, transitory, and uncontrolled episodes of brain dysfunction
resulting from abnormal discharge of neuronal cells.

Question 3

What are the two main types of seizures?

Answer 3

Partial and Generalised

Question 4

What is status epilepticus?

A severe, prolonged seizure state rather than a type of seizure.

Answer 4

Seizures lasting 20-30 mins
or
Multiple seizures without recovery in between.

Can lead to systemic hypoxia (Low Oxygen), hyperpyrexia (Extremely High Fever),
cardiovascular collapse, and renal shutdown.

Question 5

What are the subtypes of partial seizures?

Answer 5

Simple - while the person is alert
Complex- change in awareness of surroundings.
Secondary generalization- begins in one area and spreads.

Simple: conscious and alert
Complex: confused or unreponsive

Question 6

What are the subtypes of generalized seizures?

Answer 6

Absence - staring and blinking without falling
Myclonic - body jerks
Tonic-clonic - stiffening, falling jerking
Tonic- Falling heavily to the ground
Atonic- falling forwards

Question 7

What are the goals of treating seizures?

Answer 7

1. Block repetitive neuronal firing.
2. Block synchronization of neuronal discharges.
3. Block propagation of seizure.
4. Minimize SE with the simplest drug regimen.
   MONOTHERAPY IS RECOMMENDED IN MOST CASES

Question 8

What are the strategies for treating seizures?

Answer 8

1. Modification of ion conductance.
2. Increase inhibitory (GABA) transmission.
3. Decrease excitatory (glutamate) activity.

Question 9

Mechanism of Valproate, Topiramate, Carbamazepine and Phenytoin

also oxcarbazepine

Answer 9

Block/inactivates Na channels firing at high
frequencies

Question 10

Ethosuximide and Valproate Mechanism

Answer 10

Reduction in the flow of Ca+ through T - type Ca+channels in thalamus

Question 11

Valproate blocks Na channels and reduces flow of Ca
T/F

Answer 11

T

Question 12

Mechanism of

Phenobarbital
Clonazepam

Answer 12

prolongs duration of Cl- channels opening. inhibits high frequency repetitive firing at high concentrations

Increases the frequency of Cl- channel opening.

Question 13

Mechanism of
Gabapentin

Answer 13

Blocks Ca channels