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pharm exam 3 > Anticonvulsant > Flashcards

Anticonvulsant Flashcards

1
Q

Seizure

A

spontaneous firings of neurons

convulsion

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2
Q

convulsion

A

activation of motor neurons leading to involuntary contraction of skeletal muscle

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3
Q

simple partial seizure

A

least complicated, minimal spread. affects only on muscle group. no loss of consciousness, person still alert and remembers what happens

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4
Q

complex partial seizure

A

spreading to other areas of brain: altered consciousness, automatism

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5
Q

Absence seizure (petit mal)

A

less severe; sudden onset and abrupt cessation, brief loss of consciousness (could have little motor jerking of eyelid), impaired consciousness

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6
Q

When is absence seizure most commonly found

A

children under 15

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7
Q

Phases of Tonic- clonic

A
  1. aura
  2. tonic phase:muscle tensing, rigidity of all extremities
  3. clonic phase: convulsion–>uncontrolled shaking body
  4. Stuporous state and sleep: confusion, amnesia, nausea
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8
Q

what type of seizures is common in children?

A

atonic, absence (petit mal)

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9
Q

clonic and myoclonic

A

loss of consciousness w/rhythmic clonic contractions phase, sudden flexion/extension of body and limbs

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10
Q

infantile spasm

A

epileptic syndrome. NOT a seizure type. recurrent myoclonic jerks

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11
Q

Status Epilepticus

A

continuous or very rapid recurring seizures that require immediate therapy

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12
Q

what are the main targets of anticonvulsant drugs?

A

Na and Ca channels to inhibit firing of certain hyper-excitable cerebral neurons, or increasing effects of GABA

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13
Q

what agents block T type channels of the Ca channels

A

ethosuximide, valprate

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14
Q

inhibiting Ca channels is effective against what seizure?

A

Absence seizure

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15
Q

which agents block L type Ca channels

A

lamotrigine, topiramate, gabapentin

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16
Q

What agents block AMPA receptors

A

phenobarbital, topiramate, lamotrigine

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17
Q

which agent blocks NMDA receptors

A

Felbamate

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18
Q

what agents tx absence seizure

A

ethosuximide, valproate, lamotrigine, topiramate

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19
Q

what drugs are used for status epilepticus

A

diazepam, lorazepam, phenytoin, fosphenytoin

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20
Q

which drugs block the inactivated state of Na channels

A

phenytoin, carbamazepine, Lamotrigine

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21
Q

Phenytoin function

A

blocks inactivated state of Na channels, increase release of GABA

22
Q

phenytoin clinical use

A

main drug for tonic clonic, partial seizure, status epilepticus

23
Q

what is the main drug for tonic-clonic (grand mal)

A

phenytoin

24
Q

what agent can cause gingival hyperplasia

A

phenytoin

25
Q

what agent can cause fetal hydantoin syndrome

A

phenytoin

26
Q

How is Fosphenytoin diff from phenytoin

A

Newer drug, more soluble able to use IV or IM route

27
Q

what is carbamazepine used for

A

clonic tonic seizure, partial seizures, trigeminal neuralgia,, bipolar, acute alcohol withdrawal

28
Q

what anticonvulsants also treat manic phase in bipolar disorder

A

Valproic acid and carbamazepine

29
Q

what is the number one drug to treat trigeminal neuralgia

A

carbamazepine

30
Q

whats the difference between oxacarbazepine?

A

oxacarbazepine has a LONGER active metabolite and fewer drug interaction

31
Q

what are carbamazepine side effects

A

SIADH: fluid retention, hyponatremia

Tetraogenic

32
Q

what metabolizes into phenobarbital

A

primidone

33
Q

whatis most commonly used for neonatal seizures

A

phenobarbital

34
Q

clinical use for phenobarbital

A

neonatal seizure, status epilepticus

35
Q

Main drug for Status epilepticus

A

benzodiazepine: DIazepam!

36
Q

ethosuximide MOA

A

blocks ttype Ca channels; inactive metabolite

37
Q

what agents can cause tetraogenic side effect?

A

carbamazepine, valproic acid

38
Q

whats the common drug used for neuropathic pain

A

gabapentin

39
Q

gabapentin MOA

A

blocks presynaptic Ca channels

40
Q

Gabapentin clinical use

A

generalized tonic seizure, partial seizure, neuropathic pain

41
Q

what causes steven johnson syndrome

A

mixing of valporoic acid and Lamotrigine–>toxicity–>bad rash–>SJ syndrome

42
Q

lamotrigine MOA

A

blocks Na and Ca channels

43
Q

Felbamate mOA

A

blocks Na channels and glutamate receptors

44
Q

Which agent specficially inhibits GABA reuptake

A

Tiagabine

45
Q

what drugs do you want to avoid with pregnancy, why?

A

phenytoin (fetal hydatoin syndrome) , tetraogenic:Carbamazepine, valproic acid

46
Q

what type of elimination is phenytoin

A

zero-order elimination

47
Q

what decreases phenytoin metabolism

A

barbiturates: high concentration of phenobarbital, warfarin

increased pheny

48
Q

what is the difference between spasticity and spasm

A

Spasticity: exaggerated muscle stretch reflex due to injury in CNS

spasm: injury is local and NOT in CNS

49
Q

which drug has Steven johnson syndrome side effect

A

Lamotrigine

50
Q

which drug is used for muscle spasm? spasticity?

A

baclofen: spasticity
diazepam: spasm

pharm exam 3 (9 decks)

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