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Pharma Tbilisi > Antiepileptics > Flashcards

Antiepileptics Flashcards

1
Q

Genetic causes of seizures?

A

Juvenile myoclonic epilepsy

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2
Q

Metabolic causes of seizures?

A

Hyponatremia

Hypernatremia

Hypomagnesemia

Hypocalcemia

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3
Q

Infectious causes of seizures?

A

Meningoencephalitis

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4
Q

Is breast feeding contraindicated in antiepileptic treatment?

A

No

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5
Q

How is childhood absence epilepsy identified?

A

Sudden impairment in consciousness

No change in body/motor tone

Only lasts a few seconds

Usually remits by puberty

No post-ictal confusion

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6
Q

Treatment of childhood absence epilepsy? Mechanism?

A

Ethosuximide

Calcium channel blocker

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7
Q

What is pre-eclampsia?

A

Hypertension, proteinuria and oedema

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8
Q

What is eclampsia?

A

Pre-eclampsia plus seizures

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9
Q

Treatment of eclampsia?

A

MgSO4

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10
Q

How are seizures broken?

A

First line treatment is benzodiazepines, lorazepam is the drug of choice

Also often administer phenytoin pr forphenytoin to prevent recurrent seizures

After these two step if patient is still seizing then give phenobarbital

Often will then give general anaesthesia and intubate

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11
Q

Na inactivating antiepileptics?

A

Phenytoin

Carbamazepine

Lamotrigine

Valproic acid

(So all the main ones)

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12
Q

GABA activating antiepileptics

A

Phenobarbital

Valproic acid

TiaGABine

ViGABAtrin

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13
Q

Feature of older antiepileptics?

A

Liver inducers

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14
Q

Drug for absence seizures?

A

Ethosuximide

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15
Q

Which antiepileptucs are teratogenic?

A

All of them

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16
Q

Uses of carbamazepine?

A

Partial and generalised seizures drug of choice

Also bipolar disorder

Also trigeminal neuralgia

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17
Q

Drug of choice for epilepsy in pregnant women?

A

Carbamazepine

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18
Q

Relevance of the liver enzyme inducing effects of carbamazepine?

A

Need dose adjustment over time

Affects other drugs

19
Q

Side effects of carbamazepine?

A

Bone marrow suppression

Liver toxicity

SIADH (low Na)

Stevens-Johnson syndrome

20
Q

Necessary for patient taking carbamazepine?

A

Monitor blood drug level

21
Q

What is Stevens-Johnson syndrome?

A

Extensive skin lesions

Skin necrosis and sloughing

22
Q

What is the drug of choice for childhood absence seizures?

A

Ethosuximide

23
Q

Mechanism of ethosuximide?

A

Calcium channel blocker

24
Q

What other drug is used for absence seizures in general?

A

Valproate

25
Q

Side effects of ethosuximide

A

Interacts with valproic acid decreasing ethosuximide clearance

Lethargy or fatigue

26
Q

Side effect of phenobarbital?

A

CNS/myocardial/resp depression

27
Q

Drugs that induce cyp450?

A

Carbamazepine

Phenobarbital

Phenytoin

28
Q

Phenytoin side effects

A

Gingival hyperplasia

Coarsening of facial features

Vit D issues - osteomalacia

Hairiness

29
Q

Drug particularly bad in pregnancy?

A

Valproate

30
Q

Big danger with valproate

A

Hepatotoxicity

31
Q

Side effects of lamotrigine?

A

Somnolence

Stevens-Johnson syndrome

32
Q

How do gabapentin and pregabalin work?

A

Analogs of GABA

33
Q

Hiw does vigabatrin work?

A

Inhibits GABA aminotransferase

34
Q

Mechanism of tiagabine?

A

Inhibits GABA uptake

35
Q

Benefits of newer drugs

A

A broader spectrum of activity

Well tolerated

36
Q

How are drugs for generalised tonic-clonic seizures related to those used for partial seizures?

A

They are the same

37
Q

Drugs effective against absence seizures

A

Ethosuximide

Valproate

Clonazepine

38
Q

Treatment strategy for myoclonic syndromes?

A

Valproate

Alternatively lamotrigine and topiramate

39
Q

Treatment strategy for infantile spasms?

A

Intramuscular corticotropin (ACTH analog like cosyntropine)

Repository corticotropin for injection

Clonazepam or nitrazepam

Vigabatrin

40
Q

Treatment strategy for status epilepticus

A

Diazepam or lorazepam

Fosphenytoin, I/V valproate

Phenobarbital

Intubation and ventilation

Muscular relaxants

General anaesthesia

41
Q

Common other uses of antiepileptic drugs?

A

Migraines - valproate, topiramqte

Neuropathic pain - carbamazepine, gabapentin, pregabalin

42
Q

Greatest teratogenicity?

A

Phenytoin - fetal hydantoin syndrome

Valproate - spina bifida and fetal valproate syndrome

43
Q

Difference between fetal hydantoin syndrome and fetal valproate syndrome?

A

Broad forehead and limb and heart defects and spina bifoda and hypospadias in the latter

Pharma Tbilisi (12 decks)

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