Anticonvulsants

Question 0

Phenytoin side effects (5)

Answer 0

gingival hyperplasia
coarsening of facial features
mild neuropathy
abn. vit D metabolism
risk of SJS

Question 1

Phenytoin MOA and use

Answer 1

prolongs inactivation of Na+ channels

partial seizures, generalized tonic-clonic seizures

Question 2

Phenytoin metabolism (2)

Answer 2

metabolized by and induces CYP450s

zero order at therapeutic & high doses, first order at low doses

Question 3

carbamazepine (Tegretol) MOA (2)

Answer 3

blocks Na+ channels

decreases NE release & reuptake

Question 4

Carbamazepine (Tegretol) uses (4)

Answer 4

DOC: partial seizures
generalized tonic-clonic
bipolar
trigeminal neuralgia

Question 5

Carbamazepine (Tegretol) SE (3)

Answer 5

aplastic anemia
agranulocytosis
SJS

Question 6

DOC: partial seizures

Answer 6

Carabamazepine (Tegretol)

Question 7

metabolism of carbamazepine is increased by (2)

and decreased by (1)

Answer 7

phenobarbital, phenytoin

valproic acid

Question 8

carbamazepine increases the metabolism of (5)

Answer 8

phenytoin
ethosuxamide
valproic acid
haloperidol
OCPs

Question 9

Phenobarbital (Luminal) MOA

Answer 9

prolongs opening of Cl- channels at GABA receptor

Question 10

Phenobarbital (Luminal) use (3)

Answer 10

partial seizures
generalized tonic-clonic seizures

potential for abuse

Question 11

Lamotrigine (Lamictal) MOA

& something unique about its metabolism

Answer 11

voltage-dependent inactivation of Na+ channels; may also inhibit Ca2+ channels

half-life doubled by valproic acid

Question 12

Lamotrigine (Lamictal) use & SE (3)

Answer 12

partial seizures

N/V, rash, SJS

Question 13

Gabapentin (Neurontin) use (2)

Answer 13

adjunct for partial & generalized tonic-clonic seizures, neuropathic pain

taken TID, short half life- pt. compliance issues

Question 14

Gabapentin MOA

Answer 14

GABA analog, may augment GABA release

Question 15

Topiramate (Topamax) MOA (3)

Answer 15

blocks Na+ channels
potentiates GABA receptors
inhibits glutamate receptors

may inhibit spread of seizures

Question 16

topiramate (Topamax) use (3)

Answer 16

partial seizures
tonic-clonic seizures
migraine prevention

Question 17

topiramate (Topamax) SE (3)

Answer 17

increased metabolism of contraceptives
acute myopia
glaucoma

Question 18

Valproic acid (Depakene) MOA & uses (2)

Answer 18

blocks Ca2+ channels & Na+ channels

2nd choice for absence seizures
myoclonic seizures

Question 19

Valproic acid (Depakene) SE (2) and contraindication

Answer 19

GI, hepatotoxicity

pregnancy

Question 20

Ethosuxamine (Zarontin) MOA & use

Answer 20

inhibits low threshold (T-type) Ca2+ channels

DOC absence seizures

Question 21

Ethosuxmide (Zarontin) SE (3)

Answer 21

GI irritation
hiccup
metabolism inhibited by vaproate

Question 22

DOC absence seizures?

Answer 22

Ethosuxamide (Zarontin)

Question 23

DOC partial seizures?

Answer 23

Carbamazepin (Tegretol)

Question 24

20-90 s, grimacing, jerking of 1 extremity, not unconcious

Answer 24

simple seizure

Question 25

< 2 min, altered/loss conciousness, temporal lobe

Answer 25

complex seizure

Question 26

unconcious, contractions/relaxation

Answer 26

partial w/ secondary generalized tonic-clonic

Question 27

10-30 s, loss of awareness, mild clonic movements

Answer 27

absence (petit mal) seizure

Question 28

sudden loss of postural tone

Answer 28

atonic seizure