Anticonvulsants (lec 3)

Question 1

Seizures are result of?

Answer 1

abnormal d/c of electrical activity in cerebral neurons

(U) originate in cerebral cortex

Question 2

Epilepsy is?

Answer 2

neuro disorder w/ recurrent seizures

Question 3

Partial Seizures:

Originate?

Simple?

Complex?

Partial w/ 2° tonic-clonic?

Answer 3

Origin in one area of brain

Simple: 20-90 sec,
focal jerking, no LOC

Complex: <2 min, ∆ or LOC,
automatic mvmt

Part w/: LOC, contraction/relax

Question 4

Generalized Seizures:

Originate?

Tonic-Clonic?

Answer 4

Whole brain, reciprocal firing of thalamus/cortex

Tonic-clonic = grand mal
LOC
Initial rigidity -> tremor -> clonic jerking -> stupor/confusion

Question 5

Absence (petit mal) seizure?

Answer 5

Sudden onset
Brief
Loss awareness but not consciousness
(P) mild clonic mvmt

Question 6

Myoclonic seizure?

Answer 6

Brief spams or rigid

(U) 2° to other seizure disorders

Question 7

Atonic seizure?

Answer 7

Sudden loss of postural tone

Question 8

GABA neurotrans role in seizures?

Answer 8

Inhibitory activity prevents general and partial seizures

∴ block of GABA receptors causes seizures

Question 9

Goal of Tx for seizures?

Answer 9

Inhibit GABA metabolism,

Stim GABA receptors

Question 10

Anticonvulsants affect contraceptives how?

Effects on fetus?

Answer 10

decrease effectiveness

increase defects

Question 11

Anticonv adjustments for preggos?

Answer 11

gradual w/d
monotherapy
lower dose
folate supp
VitK supp in month 9

Question 12

Stevens-Johnsons Synd is?

Life threatening w/ what drugs?

Answer 12

Autoimm rxn ->
Toxic epidermal necrolysis

Phenytoin/Dilantin,
Lamotrigine,
Carbamezapine/tegretol,
Calproate/valproic acid
Phenobarbital