anticonvulsants: exam 2

Question 1

seizure

Answer 1

brief, temporary disturbance in the electrical activity of the brain
- a single episode

Question 2

epilepsy

Answer 2

group of disorders characterized by abnormal electrical discharge from CNS neurons in the form of imbalance between excitatory and inhibitory impulses
- more than 1 seizure

Question 3

examples of excitatory neurotransmitters

Answer 3

glutamate and aspartate

Question 4

examples of excitatory receptors

Answer 4

NMDA and AMPA

Question 5

examples of inhibitory neurotransmitters

Answer 5

GABA

Question 6

examples of inhibitory receptor

Answer 6

GABA-R

Question 7

epileptic brain contains either too much _____ and or too little ____ signals

Answer 7

excitatory, inhibitory

Question 8

petit mall, these may cause you to lose focus, blink rapidly or stare out into space

Answer 8

absence seizure

Question 9

grand mal, cause you to cry out, fall to the ground, or experience strong muscle jerking

Answer 9

tonic clonic seizure

Question 10

this type of seizure affect a small part of brain

Answer 10

simple focal seizure

Question 11

this type of seizure involved multiple areas of the brain and can cause confusion and disorientation for a few seconds/minutes

Answer 11

complex focal seizures

Question 12

these seizures begin as a focal seizure in one part of the brain and progress to a generalized one

Answer 12

secondary generalized seizures

Question 13

staus epilepticus

Answer 13

brain damage, death, EMS needed

Question 14

How do anti-seizure drugs work?

Answer 14

enhance inhibitory signals, and block excitatory signals

enhance GABA, inhibit glutamate, NMDA, and AMPA signaling and make it harder for neurons to fire AP

Question 15

How to block action potentials

Answer 15

1. enhance Cl- channels
2. block Na+ channels
3. enhance K+ channels

Question 16

mechanism of phenobarbital

Answer 16

enhance binding of GABA to post synaptic receptors and increase the time that GABA A- activated Cl channels are open

Question 17

what is a side effect of a barbiturate?

Answer 17

osteomalacia

Question 18

mechanism of hydantoins

Answer 18

reversible binding to inactivated Na+ channels, stabilize Na+ channels in an inactivated state

Question 19

examples of hydantoins

Answer 19

phenytoin or dilantin

Question 20

factors that can alter phenytoin protein binding

Answer 20

1. hypoalbuminemia
2. end stage renal disease
3. presence of displacing drugs

*cause and increase in unbound free drug

Question 21

toxicity of hydantoins can cause what syndrome?

Answer 21

fetal hydantoin syndrome and osteomalacia

Question 22

gingival overgrowth can occur due to what?

Answer 22

phenytoin

Question 23

mechanism of ethosuximide

Answer 23

reduce Ca influx through T type Ca channels

Question 24

mechanism of carbamazepine

Answer 24

reversible binding to inactivated Na channels. Stabilize Na+ channels in an inactivated state

Question 25

mechanism of action valproic acid

Answer 25

1. binding to inactivated Na+ channels 2. reduce Ca influx through T type channels *broad spectrum antiepileptic and enhance GABA activity

Question 26

toxicity of valproic acid causes what?

Answer 26

spina bifida and neural tube defects

Question 27

what are the 3 functions of GABA drugs?

Answer 27

1. increased GABA receptor activation 2. inhibits GABA transaminase 3. Inhibits GABA transporter 1

Question 28

mechanism of benzodiazepines

Answer 28

increase GABA receptor activation * used for status epilepticus*

Question 29

mechanism of ganaxolone

Answer 29

steroid binding site on the GABA receptor

Question 30

what is ganaxolone used to treat?

Answer 30

infantile spasms

Question 31

mechanism of vigabatrin

Answer 31

inhibits GABA transaminase

Question 32

mechanism of Gabapentin

Answer 32

binds and inhibits L type Ca channels

Question 33

mechanism of tiagabine

Answer 33

inhibits GABA transporter 1

Question 34

true/false: Gabapentin does NOT interact with GABA receptors

Answer 34

true

Question 35

what is gabapentine used to treat besides epilepsy?

Answer 35

trigeminal neuralgia

Question 36

mechanism of lamotrigine

Answer 36

binding to inactivated Na channels

Question 37

mechanism of levetiracetam

Answer 37

synaptic vesicle glycoprotein (SV2A) inhibition which modulates glutamate release

Question 38

what drug should be used if a pt has a seizure during a dental apt?

Answer 38

diazepam or midazolam intra buccal, IV or IM