Anticonvulsants

Question 1

Use of Phenytoin **

Answer 1

Non-sedating anticonvulsant
Partial seizures, generalized tonic-clonic seizures
(PS, Gen T-C)

Question 2

Mechanism of Phenytoin **

Answer 2

Blocks Na+ channels,
Dec. Glutamate, Inc.
GABA ??

Question 3

Use of Carbamazepine **

Answer 3

PS, Gen T-C,

Prophylaxis of Bipolar Disorder

Question 4

Mechanism of Carbamazepine **

Answer 4

Blocks Na+ channels

Question 5

Toxic affects of Carbamazepine **

Answer 5

Induces Cyt P450 (increases metabolism of other drugs)

Question 6

Uses of Phenobarbital **

Answer 6

Sedatinganticonvulsant – safe for infants

PS, Gen T-C

Question 7

Uses of Gabapentin/ Pregabilin

Answer 7

PS, Gen T-C

Question 8

Mechanism of Gabapentin/ Pregabilin

Answer 8

Blocks VG Ca++ channels, decrease synaptic release of GLU

Structural analog of GABA – increases release of GABA

Question 9

Uses of Levitiracetam

Answer 9

PS, Gen T-C

Question 10

Mechanism of Levitiracetam

Answer 10

Binds to synaptic vesicular protein SV2A, modifies release of GLU and GABA

Question 11

Uses of Topirimate

Answer 11

PS, Gen T-C

Question 12

Mechanism of Topirimate

Answer 12

Blocks VG Na+ channel, potentiates GABA effect (diff site then Benzo’s/Barb’s), weak carbonic anhydrase inhibitor

Question 13

Uses of Ethosuxamide

Answer 13

Absence seizures

Question 14

Mechanism of Ethosuxamide

Answer 14

Reduces low-threshold Ca++ currents in Thalamic neurons (stop an absence seizure)

Question 15

Toxic effects of Ethosuxamide

Answer 15

Gastric distress – Pain, N/V Lethargy, headache, dizziness, euphoria

Question 16

Uses of Valproic Acid/Sodium Valproate **

Answer 16

Generalized Seizures, Bipolar Disorder

Question 17

Mechanism of Valproic Acid/Sodium Valproate **

Answer 17

Valproate Ion blocks NMDA receptors, increases GABA levels, facilitates glut acid decarboxylase for GABA synthesis, inhibits GAT-1 transporter/reuptake, inhibits GABA transaminase/degradation of GABA, Inhibits HDAC’s