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MOHD4: Exam 4 Drugs > Anticonvulsants and Treatment of Epilepsy > Flashcards

Anticonvulsants and Treatment of Epilepsy Flashcards

1
Q

T/F: Primary epilepsy is treated chronically with antiepileptic drugs, often for life.

A

True

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2
Q

T/F: Secondary epilepsy is more common than primary epilepsy.

A

False. Primary epilepsy is more common (70%)

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3
Q

Which of the following is TRUE about simple partial epilepsy?
A. Impairment of consciousness
B. May spread throughout entire cortex
C. Autonomic symptoms include abnormal epigastric sensations or sweating
D. Does not have any focal motor symptoms.

A

C.

A. NO impairment
B. Does NOT spread
D. Focal motor symptoms include convulsive jerking

Also has sensory (paresthesias or tingling) and psychic disturbances (light flashes, buzzing)

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4
Q

Type of partial epilepsy that has impaired consciousness

A

Complex partial

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5
Q

Most common type of generalized seizure

A

Tonic-clonic (grand-mal)

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6
Q

Name the seizure:

Sudden loss of consciousness, falling, rigid extension of trunk and limbs, arrest of respiration

A

Tonic

Lasts

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7
Q

Name the seizure:

Rhythmic contraction of arms and legs lasting 2-3 minutes

A

Clonic

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8
Q

Name the seizure:

EEG has 3 Hz/second

A

Absence seizure

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9
Q

Name the seizure:
Brief, abrupt loss of consciousness
Unaware of onset
Stares and exhibits rapid eye-blinking for 3-5 s

A

Absence seizure

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10
Q

Name the seizure:

Short episodes of muscle contractions that may reoccur for several minutes

A

Myoclonic

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11
Q

T/F: Myoclonic seizures result in reversible neurologic damage w/ treatment.

A

False: Result in permanent neurologic damage from hypoxia, urema, encephalitis, drug poisoning

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12
Q

Name of seizure:

Generalized tonic-clonic convulsions of short duration

A

Febrile

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13
Q

Which of the following is FALSE about Status epilepticus?
A. Repeated seizures w/o recovery between them.
B. Lasts at least 30 minutes
C. Medical emergency
D. Leads to cardiovascular collapse, permanent brain damage, systemic hypoxia, academia and hyperpyrexia.
E. Consciousness is regained between seizures.

A

E. Consciousness is NOT regained between seizures

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14
Q

Glutamate is a ____ neurotransmitter

A

excitatory

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15
Q

GABA is a ____ neurotransmitter

A

inhibitory

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16
Q 
Which of the following does NOT inhibit voltage-gated Na+ channels?
A. Carbamazepine
B. Phenytoin
C. Ethosuximide
D. Lamotrigine
E. Valproic Acid
A

C. Ethosuximide inhibits voltage gated Ca2+ channels.

Valproic Acid inhibits both Na+ and Ca2+ channels

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17
Q

Name the drug:

Blocks GABA reuptake to keep GABA in synaptic cleft for longer

A

Tiagabine

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18
Q

Name the drug(s):

Enhances repolarization by keeping GABA bound Cl- channels open longer

A

Barbituates

Benzodiazepines

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19
Q

Name the type of drugs:
Phenobarbital
Primidone

A

Barbiturates

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20
Q

Name benzodiazepines (3)

A

Diazepam
Lorazepam
Clonazepam

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21
Q

Name the drug(s):

Prevent metabolism of GABA to keep GABA in presynaptic terminal for prolonged action

A

Vigabatrin

Valproate

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22
Q

Name the drug:

Drug of choice for initial therapy of epilepsy in adults

A

Phenytoin

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23
Q

Which of the following is TRUE about phenytoin?
A. Increases its own metabolism during chronic administration
B. Could be used for absence seizure
C. Used as emergency treatment of status epilepticus via IM injection
D. Used orally for chronic treatment

A

D

A. Carbamazepine has this feature.
Phenytoin can be saturated at high doses
B. Do NOT use for absence seizure. Can actually precipitate it.
C. via IV

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24
Q

Prodrug and rapidly converted to phenytoin via IM and IV

A

Fosphenytoin

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25
Phenytoin enhances metabolism of what drugs (2)?
Doxycycline | Cyclosporine
26
Drug that stimulate phenytoin metabolism
Carbamazepine
27
Drugs (2) that inhibit phenytoin metabolism
Chloramphenicol | Sulfonamide
28
Mechanism of Carbamazepine
Blocks voltage-activated Na+ channels
29
Which of the following about Carbamazepine is TRUE? A. IV administration B. Fast absorption C. Rapid penetration into brain D. Can become saturated in its metabolism
C A. Oral administration B. Slow absorption D. Increases its own metabolism during chronic administration (10-15 hours 1/2 life)
30
T/F: Carbamazepine is highly bound to plasma protein.
True
31
Drug of choice for myoclonic seizures
Valproic acid (Valproate)
32
2nd line drug for treating tonic-clonic and absence seizures due to hepatotoxicity
Valproic acid (Valproate)
33
``` Which of the following is TRUE about Valproic Acid? A. Effective via IV B. Slowly absorbed C. Low level of plasma protein binding D. Metabolized by liver P-450 enzymes ```
D A. Orally effective B. Rapid absorbed C. High level of plasma protein binding
34
Diavalproex =
sodium valproate + valproic acid | Improves GI tolerance
35
Drug of choice to treat absence seizures
Ethosuximide
36
Mechanism of ethosuximide
Blocks voltage-activated T-type Ca2+ channels in thalamic neurons
37
``` Which of the following is FALSE about Ethosuximide? A. Well absorbed orally B. High level of plasma protein binding C. Long half-life time (30-60 hrs) D. Mostly metabolized by hepatic enzymes ```
B. NOT bound to plasma proteins
38
Used to treat simple partial, recurrent tonic-clonic and febrile seizures in children
Barbiturates: | Phenobarbital, Primidone
39
What 2 drugs can be combined with barbiturates to allow for smaller doses?
Carbamazepine | Phenytoin
40
Mechanism of barbiturates
Facilitate activation of GABA receptors to increase inhibitory tone
41
Which of the following is TRUE about barbiturates? A. Poorly absorbed orally B. Freely penetrates brain C. Inactivated by renal microsomal system D. Activates Na+ channels
B A. Well absorbed orally C. by hepatic microsomal system D. Facilitate activation of GABA receptors
42
Drug of choice for acute treatment of status epilepticus
Diazepam, lorazepam (Benzodiazephines)
43
Drug of choice to treat anxiety
Benzodiazephines
44
T/F: Benzodiazepine can be used chronically to treat anxiety.
False. Tolerance develops after 1-6 months so use acutely. | Can be used to treat anxiety.
45
Clonazepam used to treat
myoclonic and absence seizures
46
Lamotrigine used to treat
Simple or complex partial seizure | Generalized tonic-clonic seizure
47
Name the drugs: Inhibit release glutamate Blocks voltage activated Na+ channel
Lamotrigine
48
(2) Drugs that decrease Lamotrigine half-life Drug that increases Lamotrigine half-life
Decrease: Carbamazepine, phenytoin Increase: Valproic acid
49
Gabapentin used to treat
Simple, complex partial seizure | Generalized tonic-clonic seizure
50
``` Which of the following is TRUE about Gabapentin? A. Metabolized by liver B. Highly bound to plasma proteins C. Eliminated by kidneys D. Lots of drug interactions ```
C A. Not metabolized --> does NOT induce hepatic enzymes B. NOT bound to plasma protein D. Negligible drug interactions
51
Pregabalin used to treat
Simple and complex partial seizures
52
Name the drugs: Block Ca2+ channels Inhibit release of glutamate
Gabapentin | Pregabalin
53
Name the drug: Blocks Na+ channels Increases activity of postsynaptic GABA receptors
Topiramate
54
Topiramate used to treat
Simple and complex partial seizures | Generalized tonic-clonic seizures
55
Name the drug: | Broad spectrum for treating partial and generalized seizures (tonic-clonic, myoclonic)
Levetiracetam
56
Name the drug: | Modifies glutamate and GABA release via binding to synaptic protein SV2A
Levetiracetam
57
Name the drug with the following side effect: | Gingival hyperplasia
phenytoin
58
Name the drug with the following side effect: | Hepatotoxicity
Valproic acid | Carbamazepine
59
Name the drug with the following side effect: | Megaloblastic anemia
Phenytoin | Primidone
60
Name the drug with the following side effect: | Thrombocytopenia
Valproic acid | Pregabalin
61
Name the drug with the following side effect: | Teratogenic effects
Phenytoin Carbamazepine Valproic acid Phenobarbital

MOHD4: Exam 4 Drugs (5 decks)

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