Anticonvulsants for Pharmacology and Therapeutics

Question 1

What is an epileptic seizure?

Answer 1

Manifestation of an abnormal or excessive synchronised discharge of a set of cerebral neurones

Question 2

What are types of seizures

Answer 2

General

Partial

Question 3

5 types of general seizure

Answer 3

Tonic-clonic
Tonic
Myoclonic
Status eplipticus
Absence

Question 4

Features of tonic clonic seizures

Answer 4

Loss of conciousness
Muscle stiffening which leads to jerking
Deep sleep

Question 5

What happens in absence features

Answer 5

Brief staring with behavioural arrest

Question 6

What happens in tonic/atonic seizures

Answer 6

Sudden stiffening and loss of muscle control

Question 7

What happens in myoclonic seizures

Answer 7

Sudden and brief muscle contractions

Question 8

What happens in status epilepticus

Answer 8

Over 5 mins of continuous seizure

Question 9

Types of partial seizures

Answer 9

Simple

Complex

Question 10

What happens in simple partial seizure

Answer 10

Retained consciousness

Question 11

What happens in complex partial seizure

Answer 11

Impaired consciousness

Question 12

Difference between partial and general seizure

Answer 12

General simultaneously begins in both hemispheres of the brain whereas partial begins in particular area and may spread out

Question 13

2 ways to diagnose epilepsy

Answer 13

EEG

MRI

Question 14

Protein associated with docking of glutamate vesicle to presnaptic membrane

Answer 14

SVA2

Question 15

2 most significant glutamate receptors

Answer 15

NMDA

Kainate

Question 16

What state is VGSC in before it fully depolarises

Answer 16

Inactive

Question 17

Pharmacodynamics of carbamazepine

Answer 17

Stabilises inactive state of Na+ channel

Question 18

Pharmacokinetics of carbamazepine

Answer 18

Enzyme inducer
Onset of activity is 1 hour
16-30hr half life

Question 19

Issue of carbamazepine

Answer 19

Severe skin side effects if have HLA-B-1502 allele

Question 20

Pharmacodynamics of lamotrigine

Answer 20

Inactivates Na+ channels

Question 21

Pharmacokinetics of lamotrigine

Answer 21

Onset activity of 1 hour

24-34 hr half life

Question 22

What is lamotrigine used for

Answer 22

Tonic clonic and ascence seizures

Question 23

What is carbamazepine used for

Answer 23

Tonic clonic and partial seizures

Question 24

Pharmacodynamics of ethosuximide

Answer 24

T-type Ca channel antagonist

Question 25

Where is MOA of ethosuximide

Answer 25

Relay thalamic neurones

Question 26

Pharmacokinetics of ethosuximide

Answer 26

50hr half life

Question 27

What is ethosuximide used for

Answer 27

Abscence seizures

Question 28

Pharmacodynamics of levetiracetam

Answer 28

Binds to SVA2 protein

Question 29

Pharmacokinetics of levetiracetam

Answer 29

1 hour onset

half life 10hrs

Question 30

Use for levetiracetam

Answer 30

Myoclonic seizures

Question 31

Pharmacodynamics of topiramate

Answer 31

Inhibits NMDA and kainate receptors

Also affects VGSCs and GABA receptors

Question 32

Uses for topiramate

Answer 32

Myoclonic seizures

Question 33

Pharmacokinetics of topiramate

Answer 33

Fast onset of 1 hr

Long half life 20hrs

Question 34

4 targets of glutamate neurones in epilpesy

Answer 34

VGSCs
VGCCs
SVA2
Glutamate receptors

Question 35

What is different about GABA neurones

Answer 35

Tonic stimulation

Question 36

What happens when GABAa receptor activated

Answer 36

Hyperpolarisation from opened Cl- channel

Question 37

Metabolism of GABA

Answer 37

Uptaken by GAT or metabolised by GABA-transaminase to glutamate

Question 38

Pharmacodynamics of diazepam

Answer 38

GABA receptor agonist

Question 39

Pharmacokinetics of diazepam

Answer 39

Recta gel with rapid onselt and short half life

Question 40

Use of diazepams

Answer 40

Status elipticus

Question 41

Pharmacodynamics of sodium valproate

Answer 41

Inhibits GABA transaminase

Question 42

Pharmacokinetics of sodium valproate

Answer 42

Fast onset

Question 43

Use of sodim valproate

Answer 43

Used for all