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Pharm-Neuro > Antiepileptic Drugs > Flashcards

Antiepileptic Drugs Flashcards

1
Q

simple partial seizure

A

No alteration of consciousness

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2
Q

complex partial seizure

A

altered conciousness, behavior changes

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3
Q

secondarily generalized seizure

A

loss of conciousness

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4
Q

Tonic Clonic - grand mal

A

spasms

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5
Q

tonic

A

increased tone

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6
Q

myoclonic

A

jerking

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7
Q

atonic

A

loss of muscle tone

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8
Q

absence - petit mal

A

brief loss of conciousness

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9
Q

General pharmokinetics of anti seizure meds

A

-have to neter CNS
-supress abnormal electrical impulses
-long 1/2 lives
check blood serum for levels

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10
Q

Phenytoin

A

old anticonvulant
non sedating
oral
zero order kinitics

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11
Q

Fosphenytoin

A

IV phenytoin

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12
Q

MOA

A

Sodium Channel Blocker

binds to and inactivates the Na+ channel in the neuron, so the neuron cannot be activated.

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13
Q

The types of Phenytoin ADRs

A

1) dose related
2) long term
3) idosyncratic rxns (SJS)

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14
Q

Four Dose Related ADRs of Phenytoin

A

Nystagmus
Diplopia
Ataxia
Sedation

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15
Q

Long Term ADRs of Phenytoin

A

Gingival Hyperplasia
Coarse facial features
mild peripheral neuropathy
Osteomalacia

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16
Q

Carbamazepine

A

only oral

similar to phenytoin

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17
Q

Carbamazepine MOA

A

affects sodium channels and blocks them, prevent abnormal pulse propagation

18
Q

Carbamazepine ADRS

A

Aplastic anemia thrombocytopenia
anemia
leucopenia (most common)
Asians 10x more at risk for SJS

19
Q

Prodrug of carbamazepine

A

Oxcarbazepine

20
Q

One of the oldest anticonvulsants is called…

A

Phenobarbital

Not used anymore because dosing is high and it causes sedation

21
Q

Phenobarbital MOA

A

increases Gaba mediated CL influx

22
Q

Lamotrigine (Lamictal) MOA

A

Anti seizure med

Sodium Channel Blocker, deceases glutamate and aspartate release, & delays repetitive firing of neurons

23
Q

ADR Lamotrigine (Lamictal)

A

Rash: potentially life threatening in 1-2%, esp. pediatric patients

24
Q

Levetiracetam (Keppra) MOA

A

Anti seizure med
Inhibits calcium channels to slow neuronal transmission, facilitates GABA to delay transmission and modifies neurotransmitter release

25
Gabapentin/Pregabalin
- don't work well for seizures | - modify release of GABA
26
Topiramate (Topamax)
Like phenytoin (sodium channels) and enhances GABA activity
27
Ethosuximide (Zarontin) MOA
Reduces calcium currents in thalamic neurons
28
How does Ethosuximide (zarontin) differ in adults and children?
Half life very long in adults and not as effective , shorter and more effective in children
29
Valproic Acid MOA
blocks calcium currents, blocks sodium channels, and increases GABA production - can increase the concentration of other drugs
30
ADRS of valproic acid
Hepatotoxicity Thrombocytopenia TERATOGEN= SPINABIFIDA
31
What two Benzos are used in seizures?
Lorazepam Diazepam Both have rapid onset used in status epolepticus
32
Zonisamide (Zonegram) MOA
suppresses neuronal transmission by inhibiting sodium and calcium channels with no effect on GABA
33
Clonazepam and Clorazepate
used in absence, myoclonic and infantile spasme | -clorazepate- adjunct- converted to diazepam
34
Status Epilepticus Seizure Treatment
Diazepam or lorazepam | Fosphenytoin
35
Which Antiseizure meds are asociated with birth abnormalities?
Penytoin phenobarbital carbazepine
36
Epileptic Treatment Guidelines for pregnant patients
1) avoid valproic acid, and polytherapy during 1st trimester 2) avoid polytherapy during whole pregnancy 3) avoid phenytoins, carbazepine, and penobarbitol
37
Birth defects caused by phenytoin
cleft palate and poor cognition
38
birth defects associated with carbazepine
posterior cleft pallet
39
Birth defects associated with phenobarbital
cardiac malformations, poor cognition
40
Stopping seizure meds
- try to stop once seizure free for 2-5 years | - reduce by 1/3 one months, than another third the second month and then stop
41
Antiepileptic drugs and Suicide
twice the risk of suicidal behavior or ideation. Increased risk was seen at 1 week and continued thru week 24 Black Box Warning

Pharm-Neuro (6 decks)

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