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Neurology > Anticonvulsants > Flashcards

Anticonvulsants Flashcards

1
Q

What are the four mechanisms of Anticonvulsants?

A
  1. Enhance sodium channel inhibition
  2. Inhibit calcium channels
  3. Enhance GABA inhibition
  4. Inhibit glutamate receptors
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2
Q

Which drugs inhibit sodium channels?

A

Phenytoin, carbamazepine and lamotrigine

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3
Q

Which drugs inhibit calcium channels?

A

Ethosuximide, valproic acid, gabapentin, pregabalin

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4
Q

Which drugs enhance GABA ?

A

Benzodiazepines, barbiturates

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5
Q

What is the MOA of Phenytoin?

A

Prolongs the inactivation state of voltage gated sodium channels.

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6
Q

What are 2 pharmacokinectic properties of phenytoin?

A
  1. Induces CYP3A4

2. 90% bound to albumin

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7
Q

What are the side effects of phenytoin?

A
  1. Fatigue
  2. Dizziness
  3. Diplopia
  4. Cognitive impairment
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8
Q

What is the MOA for Carbamazepine?

A
  1. Blocks reactivation of voltage gated sodium channels.

2. Blocks NE reuptake

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9
Q

What are the side effects of carbamazepine?

A
  1. Dizziness
  2. Ataxia
  3. Nystagmus
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10
Q

Which drugs side effect can cause Steven-Johnson syndrome?

A

Lamotrigine

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11
Q

What are the MOAs of Valproate?

A
  1. Inhibits voltage gated sodium channels
  2. Inhibits T-type calcium channels
  3. May increase GABA synthesis and decrease degradation.
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12
Q

What are the side effects of Valproate?

A
  1. Tremor
  2. Hair loss
  3. Thrombocytopenia
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13
Q

What is the MOA of Ethosuximide?

A

Inhibits T-type calcium channels in thalamic neurons.

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14
Q

What population is Ethosuximide used for?

A

Absence seizures in children

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15
Q

What is the MOA of Zonisamide?

A

Inhibits T-type Calcium channels and prolongs the inactivation of sodium channels.

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16
Q

What is the side effect of Zonisamide?

A

Difficulty concentrating and renal stones.

17
Q

Discuss Zabapentin

A

GABA analog that may interac with Alpha-2-Delta subuni of L type voltage-sensitive calcium channels. Unchanged in urine

18
Q

What are the MOAs for Topimarate?

A
  1. Poteniates GABA response
  2. Decreases glutamate receptor activity
  3. Blocks voltage gated sodium channels
19
Q

What is the main side effect of topimarate?

A

Weight loss

20
Q

Which drugs have no effect of hepatic enzymes?

A
  1. Ethosuximide
  2. Gabapentin
  3. Levatirectam
  4. Pregabalin
21
Q

Which drugs induce CYP450 enzymes?

A
  1. Carbamazepine
  2. Phenobarbital
  3. Phenytoin
22
Q

Which drugs inhibit P450 enzymes?

A

Topimarate, Valproate

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