Anticonvulsant drugs Flashcards
evolution of a normal neural network into an epileptic one
epileptogenesis
successive seizures make subsequent seizures more likely/severe (disease is progressive)
autocatalytic
This kind of seizure is in a specific area in one cerebral hemisphere
partial seizure
This type of seizure is in a specific area in one cerebral hemisphere but no loss of consciousness
simple partial seizure
This type of seizure is in a specific area in one cerebral hemisphere but consciousness is impaired
complex partial seizure
What are the 5 types of generalized seizures?
Absence, myoclonic, tonic-clonic, tonic, atonic
What are two of the major receptors associated with gene mutations and epilepsy?
GABA-A, voltage gated sodium channels (SCN1A)
Are there curative anti-epileptogenic drugs?
No, anti-epileptic drugs (AEDs) are not curative. They just prevent the manifestation of neural excitation
What percent of patients have seizures that don’t respond to AED treatment?
20-30%
What are 2nd and 3rd generation anticonvulsants used for?
“add-on” or adjunctive therapy, and some are used for refractory (drug resistant) seizures
Phenytoin is what kind of AED?
voltage-gated sodium channel blocker
What are voltage gated sodium channel blockers used for?
Broad spectrum, most seizures except abscence
What is special about the pharmacokinetics about phenytoin?
the majority is plasma protein bound, it’s metabolized by P450, and has dose-dependent kinetics
Major side effects/toxicity of phenytoin
gingival hyperplasia, hirsutism, hypersensitivity reaction, effects on bone marrow and hepatic fx that necessitate drug withdrawal, cardiac arrhythmias, teratogenic
Use of fosphenytoin
prodrug of phenytoin for short-term, parenteral use in status epilepticus and during neurosurg seizures
