anticonvulsants Flashcards
generalised vs focal/partial seizures
occurs in both hemispheres of brain vs particular area of brain (may then spread out)
types of generalised seizures
STAMT- status epilepticus (more than 5 mins of continous seizure), tonic/atonic (sudden muscle stiffening), absence seizures (brief staring without any control), myoclonic (sudden brief muscle contractions), tonic-clonic (loss of conciousness, the muscle stiffening, then jerks/switches, then loss of conciousness, then regain conciousness)
types of partial/focal seizures
simple retains conciousness, complex does NOT
diagnosis of epilepsy
EEG to look at activity, MRI to see underlying damage
neurotransmission of glutamate- ions, synaptic protein and glutamate receptors
Na+ causes depolarisation, K+ causes repolarisation, and Ca2+ goes in to vesicle exocytosis: SV2A protein docks the vesicle onto presynaptic membrane, then glutamate is released and binds to NMDA and Kainate receptors
VG Na+ blockers- mechanism, half life, onset, which used for partial seizures
CARBAMAZEPINE and LAMOTRIGINE- both inactivate Na+ channel- : carbamazepine used for partial seizures as well
VGCC blockers- half life, what used for
ethosuximide- inhibits T-type Ca2+ channels: used for only absence seizures
exocytosis blocker- mechanism, half life, what used for
LEVETIRACETUM- binds to SVA2 protein: short half life: used for only myoclonic+ partial
receptor blocker- mechanism, onset/half life, what used for
TOPIRAMATE- inhibits both receptors: used for only myoclonic
reuptake of GABA
taken up by GABA transporter (GAT0 and broken by GABA transaminase
enhancement of GABA receptor- how administered, onset, and what used for
DIAZEPAM- used as a rectal gel due to very fast onset- used for status epilepticus
less reuptake of GABA: mechanism, and what used for
valproate- inhibits GABA transaminase: used for ALL types
what drugs used for status
diazepam only
what drug used for tonic/atonic
valproate
what drug used for absence
valproate, ethosuzimide, lamotrigine
