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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
Q

Gabapentin/Pregabalin

A
  • don’t work well for seizures

- modify release of GABA

26
Q

Topiramate (Topamax)

A

Like phenytoin (sodium channels) and enhances GABA activity

27
Q

Ethosuximide (Zarontin) MOA

A

Reduces calcium currents in thalamic neurons

28
Q

How does Ethosuximide (zarontin) differ in adults and children?

A

Half life very long in adults and not as effective , shorter and more effective in children

29
Q

Valproic Acid MOA

A

blocks calcium currents, blocks sodium channels, and increases GABA production
- can increase the concentration of other drugs

30
Q

ADRS of valproic acid

A

Hepatotoxicity
Thrombocytopenia
TERATOGEN= SPINABIFIDA

31
Q

What two Benzos are used in seizures?

A

Lorazepam
Diazepam
Both have rapid onset
used in status epolepticus

32
Q

Zonisamide (Zonegram) MOA

A

suppresses neuronal transmission by inhibiting sodium and calcium channels with no effect on GABA

33
Q

Clonazepam and Clorazepate

A

used in absence, myoclonic and infantile spasme

-clorazepate- adjunct- converted to diazepam

34
Q

Status Epilepticus Seizure Treatment

A

Diazepam or lorazepam

Fosphenytoin

35
Q

Which Antiseizure meds are asociated with birth abnormalities?

A

Penytoin
phenobarbital
carbazepine

36
Q

Epileptic Treatment Guidelines for pregnant patients

A

1) avoid valproic acid, and polytherapy during 1st trimester
2) avoid polytherapy during whole pregnancy
3) avoid phenytoins, carbazepine, and penobarbitol

37
Q

Birth defects caused by phenytoin

A

cleft palate and poor cognition

38
Q

birth defects associated with carbazepine

A

posterior cleft pallet

39
Q

Birth defects associated with phenobarbital

A

cardiac malformations, poor cognition

40
Q

Stopping seizure meds

A
  • 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
Q

Antiepileptic drugs and Suicide

A

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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