Anticonvulsants Flashcards
Epilepsy
Neurological condition causing frequent seizures
Absence seizures
General
- characterised by 3Hz brain activity
- brief staring episodes with behavioural arrest
Complex partial/focal seizures
Partial/focal
-Impaired awareness/consciousness
Myoclonic seizures
General
-sudden, brief muscle contractions
Simple partial/focal seizures
Partial/focal
-Retained awareness/consciousness
Tonic/atonic seizures
General
-sudden muscle stiffening/sudden loss of muscle control
Tonic-clonic seizures
General
- loss of consciousness
- muscle stiffening
- jerking/twitching from sudden muscle contraction (wakes up from deep sleep)
- clonic convulsions
Carbamazepine pharmacodynamics
Stabilises inactive state of sodium ion channel, hence reducing neuronal activity
Carbamazepine pharmacokinetics
- Hepatic enzyme inducer
- Onset of activity within 1 hour
- 16-30 hour half life
Carbamazepine uses
Treats tonic-clonic seizures and partial seizures
-Potentially severe side effects in individuals with HLA-B*1502 allele (carbamazepine-induced Stevens-Johnson Syndrome and toxic epidermal necrolysis)
Absence seizure pharmacological treatment
- Ethosuximide
- Lamotrigine
- Sodium Valproate
Myoclonic seizure pharmacological treatment
- Levetiracetam
- Topiramate
- Sodium Valproate
Simple partial/Complex partial seizures pharmacological treatment
- Carbamazepine
- Levetiracetam
- Lamotrigine
- Sodium Valproate
Status epilepticus pharamacological treatment
Diazepam
Tonic/atonic seizures pharmacological treatment
Sodium Valproate
Tonic-clonic seizures pharmacological treatment
- Carbamazepine
- Lamotrigine
- Sodium Valproate
Status epilepticus
General
-more than 5 mins of continuous seizure activity
Lamotrigine pharmacodynamics
Inactivates sodium ion channel, hence reducing glutamate neuronal activity
Lamotrigine pharmacokinetics
- Onset of activity within 1 hour
- 24-34 hour half life
Lamotrigine uses
Treats tonic-clonic seizures and absence seizures
Ethosuximide pharmacodynamics
T-type calcium ion channel antagonist, hence reducing activity in relay thalamic neurones
Ethosuximide pharmacokinetics
-Long half life of 50 hours
Ethosuximide uses
Treats absence seizures
Levetiracetam pharmacodynamics
Binds to synaptic vesicle associated protein (SV2A), preventing glutamate release
Levetiracetam pharmacokinetics
- Fast onset of activity within 1 hour
- Half life of 10 hours
Levetiracetam uses
Treats myoclonic seizures
Topiramate pharmacodynamics
Inhibits NMDA receptors and Kainate receptors, also affecting VGSCs and GABA receptors
Topiramate pharmacokinetics
- Fast onset of activity within 1 hour
- Long half life of 20 hours
Topiramate uses
Treats myoclonic seizures
Diazepam pharmacodynamics
GABA receptor PAM-> increased GABA-mediated inhibition
Diazepam pharmacokinetics
- Rectal gel
- Fast onset of activity within 15 mins
- Half life of 2 hours
Diazepam uses
Status epilepticus
Sodium valproate pharmacodynamics
GABA transaminase inhibition-> increased GABA-mediated inhibition
Sodium valproate pharmacokinetics
- Fast onset of activity within 1 hour
- Half life of 12 hours
Sodium valproate uses
Treats all forms of epilepsy
