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Pharmacology and Therapeutics 2 Y2 > Anticonvulsants > Flashcards

Anticonvulsants Flashcards

1
Q

How to diagnose epilepsy

A

Electroencephalography (EEG) or MRI

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2
Q

Summarise the fundamental causes of epilepsy/seizures

A

Due to either an increase in excitatory transmission or a decrease in inhibitory transmission

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3
Q

5 different seizure types?

A

Tonic-clonic seizures – loss of consciousness-> muscle stiffening-> jerking/twitching-> deep sleep-> wakes up
Absence seizures – brief staring episodes with behavioural arrest
Tonic/atonic seizures – sudden muscle stiffening/sudden loss of muscle control
Myoclonic seizures – sudden, brief muscle contractions
Status epilepticus – > 5 min of continuous seizure activity

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4
Q

What are Tonic-clonic seizures

A

loss of consciousness-> muscle stiffening-> jerking/twitching-> deep sleep-> wakes up

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5
Q

What type of seizure involves loss of consciousness-> muscle stiffening-> jerking/twitching-> deep sleep-> wakes up

A

Tonic-clonic seizures

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6
Q

What are Absence seizures

A

brief staring episodes with behavioural arrest

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7
Q

What type of seizure involves brief staring episodes with behavioural arrest

A

Absence seizures

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8
Q

What are Tonic/atonic seizures

A

sudden muscle stiffening/sudden loss of muscle control

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9
Q

What type of seizure involves sudden muscle stiffening/sudden loss of muscle control

A

Tonic/atonic seizures

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10
Q

What are Myoclonic seizures

A

sudden, brief muscle contractions

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11
Q

What type of seizure involves sudden, brief muscle contractions

A

Myoclonic seizures

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12
Q

What is Status epilepticus

A

> 5 min of continuous seizure activity

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13
Q

What type of seizure involves > 5 min of continuous seizure activity

A

Status epilepticus

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14
Q

Simple vs complex seizures

A

Simple – retained awareness/consciousness

Complex – impaired awareness/consciousness

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15
Q

What drugs are used for Status epilepticus

A

Diazepam

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16
Q

What drugs are used for Tonic/atonic seizures

A

Valproate

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17
Q

What drugs are used for Absence seizures

A

Ethosuximide
lamotrigine
valproate

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18
Q

What drugs are used for Tonic-clonic seizures

A

Carbazepine
lamotrigine
valproate

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19
Q

What drugs are used for myoclonic

A

levetiracetam
topiramate
valproate

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20
Q

What drugs are used for simple partial/complex partial seizures

A

carbamazepine
lamotrigine
levetiracetam
valproate

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21
Q

What drug is used in ALL forms of epilepsy

A

Sodium valproate

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22
Q

Glutamate receptors? (3)

A

NMDA, AMPA and kainate

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23
Q

What is SVA2

A

Synaptic vesicle associated (SV2A) protein allows vesicle attachment to presynaptic membrane

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24
Q

what is the name of the protein which allows vesicle attachment to presynaptic membrane

A

SVA2

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25
Q

families of drugs used as anti-convulsants?

A

VOLTAGE-GATED Na+ CHANNEL BLOCKER

VGCC blockers

Glutamate exocytosis inhibitors

Glutamate receptor antagonist

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26
Q

Example of VGSC antagonist

A

Carbamazepine or LAMOTRIGINE

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27
Q

Example of VGCC antagonist

A

Ethosuximide

28
Q

Example of SV2A inhibitor?

A

Levetiracetam

29
Q

Glutamate receptor antagonist

A

topiramate

30
Q

topiramate is an example of a ….

A

Glutamate receptor antagonist

31
Q

Levetiracetam is an example of a

A

SVA2 inhibitor

32
Q

Ethosuximide is an example of a

A

VGCC antagonist

33
Q

Carbamazepine is an example of a

A

VGSC antagonist

34
Q

What type of seizures are VGSC antagonists indicated in

A
  • Tonic-clonic seizures
35
Q

What type of seizures are VGCC antagonist indicated in

A
  • Absence seizures
36
Q

What type of seizures are SVA2 inhibitor indicated in

A
  • Myoclonic seizures
37
Q

What type of seizures are glutamate receptor antagonists indicated in

A
  • Myoclonic seizures
38
Q

What type of seizures is sodium valproate good for

A

All

39
Q

What type of seizures are BDZ good for?

A

status epilepticus

40
Q

What type of drug is indicated for Myoclonic seizures

A

Glutamate receptor antagonist

41
Q

What type of drug is indicated for status epilepticus

A

BDZ

42
Q

What type of drug is indicated for Absence seizures

A

VGCC antagonists (and lamotrigine)

43
Q

What type of drug is indicated for tonic-clonic seizures

A

VGSC antagonists

44
Q

What type of drug is indicated for tonic/atonic

A

sodium valproate ONLY

45
Q

What type of seizure is the only effective treatment sodium valproate

A

Tonic/atonic

46
Q

What seizures is lamotrigine used for

A

Tonic-clonic

Absence

47
Q

What seizures is valproate used for

A

All

48
Q

What seizures is carbamazepine used for

A

Tonic clonic

49
Q

What seizures is ethosuximide used for

A

Absence

50
Q

What seizures is topiramate used for

A

Myoclonic

51
Q

What seizures is diazepam used for

A

Status epilepticus

52
Q

What seizures is levitarecetam used for

A

Myoclonic

53
Q

What seizures is ONLY valproate used for

A

Tonic atonic

54
Q

How does CARBAMAZEPINE work?

A
  • Stabilises inactive state of Na+ channel, reducing neuronal activity
55
Q

How does LAMOTRIGINE work?

A
  • Inactivates Na+ channels by blocking® reducing glutamate neuronal activity
56
Q

How does ETHOSUXIMIDE work?

A
  • T-type Ca2+ channel antagonist ® reduces activity in relay thalamic neurones
57
Q

How does LEVETIRACETAM work?

A
  • Binds to synaptic vesicle associated protein (SV2A) ® preventing glutamate release
58
Q

How does TOPIRAMATE work?

A
  • Inhibits NMDA & kainate receptors

- Also affects VGSCs & GABA receptors

59
Q

Onset and half life and indications of carbamazepine

A
  • Onset of activity within 1 hour (FAST)
  • 16-30-hour half-life (LONG)
    Indications:
  • Tonic-clonic seizures; partial seizures
60
Q

Onset and half life and indications of lamotrigine

A
  • Onset of activity within 1 hour (FAST)
  • 24-34-hour half-life (LONG)
    Indications:
  • Tonic-clonic seizures; absence seizures
61
Q

Onset and half life and indications of ethosuximide

A
  • Long half-life (50 hours)
    Indications:
  • Absence seizures
62
Q

Onset and half life and indications of levetiracetam

A
  • Fast-onset (1 hour); half-life (10 hours)
    Indications:
  • Myoclonic seizures
63
Q

Onset and half life and indications of topiramate

A
  • Fast-onset (1 hour); long half-life (20 hours)
    Indications:
  • Myoclonic seizures
64
Q

Onset and half life and indications of valproate

A
  • Fast onset (1h); half-life (12h)

Indicated for all

65
Q

Onset and half life and indications of diazepam

A
  • Rectal gel - Fast-onset (within 15 min); half-life (2 hours)
    Indicated for status epiliticus
66
Q

How does valproate work?

A
  • Inhibits GABA transaminase increases GABA-mediated inhibition
  • Means there is more GABA going around, also as GABA is metabolized to glutamate it means there’s less glutamate about
67
Q

How does diazepam work?

A
  • GABA receptor, PAM increases GABA-mediated inhibition

Pharmacology and Therapeutics 2 Y2 (24 decks)

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