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Pharm > Anticonvulsants > Flashcards

Anticonvulsants Flashcards

1
Q

What is epilepsy?

A

Chronic disorder characterized by recurrent seizures

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2
Q

What is the cause of primary epilepsy?

A

cause unknown

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3
Q

What is the goal of management for epilepsy?

A

Restoration of a normal pattern of activity

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4
Q

What are the two broad categories of seizures?

A

Partial

generalized

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5
Q

What are partial seizures?

A

Seizures that remain localized to one area of the brain, without LOC

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6
Q

Complex partial seizures usually start where in the brain? SSx?

A

Temporal lobe

Lip smacking, fumbling, scratching (no memory of events)

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7
Q

What are generalized seizures?

A

Abnormal electrical activity throughout the brain

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8
Q

What are tonic-clonic seizures?

A

LOC, with tonic spasms, followed by maximal tonic spasms

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9
Q

What is the tonic phase of a seizures?

A

Rigidity of all limbs, followed by a tremor that is actually an interruption of the tonis by relaxation

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10
Q

What is the clonic phase of a seizure?

A

Massive jerking of the body that slows over 0-120 seconds, usually leaving pt in a stuporous state

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11
Q

What is the physiological basis for seizures?

A

Abnormally excessive, synchronous, and rhythmic firing of hyperexcitable neurons

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12
Q

What are the four underlying causes of seizure development?

A
  1. CNS injury
  2. Congenital abnormality (birth trauma)
  3. Genetic factors
  4. Infections
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13
Q

What is the major genetic factor associated with seizures?

A

Defective genes coding for voltage gated ion channels, or GABA receptors

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14
Q

What are the ssx of complex partial seizures?

A

Impaired consciousness, dreamy disaffective state, and wwo automatisms

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15
Q

What are the ssx of absence (petit mal) seizures?

A

Impaired consciousness with staring spells, wwo eyeblink

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16
Q

Who usually has absence seizures? Prognosis?

A

Children, and is self-limiting

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17
Q

What are the characteristics of complex partial seizures?

A

Automatisms with affected consciousness

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18
Q

What are the four stages of generalized seizures?

A
  1. Aura
  2. Tonic phase
  3. Clonic phase
  4. Stuporous state and sleep
19
Q

What are tonic seizures?

A

LOC with severe hypertonic spasms and autonomic effects

20
Q

What are atonic seizures?

A

Sudden LOC with rhythmic clonic contractions, and autonomic effects

21
Q

What are infantile spasms?

A

Recurrent myoclonic jerks of the body with sudden flexion or extension of the body and limbs

22
Q

What is status epilepticus?

A

Continuous or very rapid recurring seizures, usually of the tonic-clonic type

23
Q

What are the three stages of seizures development?

A
  1. Initiation
  2. Synchronization of surrounding
  3. Propagation
24
Q

What are the three main EPSPs in the CNS?

A

Na influx
Ca current
Paroxysmal depolarization

25
Q

What are the four main IPSPs in the CNS?

A

K efflux
Cl influx
Pumps
Low pH

26
Q

What percent of patients do not respond to antiepileptics?

A

20%

27
Q

What percent of pts can antiepileptics completely eliminate seizures?

A

66%

28
Q

What is the surgery that can be used to treat epilepsy?

A

Temporal lobe resection

29
Q

What is the major issue with seizures?

A

Poorly controlled seizures are associated with a neuronal loss mediated by an excitotoxic process

30
Q

What is the role of the vagus nerve in treating seizures?

A

Stimulation of it can reduce seizures

31
Q

What are the three major drugs used to treat partial seizures?

A

Carbamazepine
Phenytoin
Valproate

32
Q

What are the three major drugs used to treat tonic/clonic seizures?

A

Carbamazepine
Phenytoin
Valproate

33
Q

What are the two major drugs used to treat absence seizures?

A

Ethosuximide

Valproate

34
Q

What are the two major drugs used to treat myoclonic seizures?

A

Clonazepam

Valproate

35
Q

What are the four major drugs used to treat status epilepticus?

A

Diazepam
Lorazepam
Phenytoin
Fosphenytoin

36
Q

What are the three main MOA of anticonvulsants?

A
  1. Decrease glutamate activity
  2. Increase inhibitory GABA
  3. Alter movement of ions across membrane (Ca)
37
Q

What is the MOA of phenytoin?

A

Inactivation of VG Na channels

38
Q

What is the MOA of carbamazepine?

A

Inactivation of VG Na channels

39
Q

What is the MOA of lamotrigine?

A

Inactivation of VG Na and Ca channels

40
Q

What is the MOA of ethosuximide?

A

Inactivation of VG Ca channels

41
Q

What is the MOA of gabapentin?

A

Inactivation of VG Ca channels

42
Q

What is the MOA of retigabine?

A

increase of K channel opening

43
Q

What is the MOA of levetiracetam?

A

SV2A synaptic vesicle proteins

44
Q

What is the MA of lacosamide?

A

CRMP-2

Pharm (73 decks)

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