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CNS > Antiepileptics > Flashcards

Antiepileptics Flashcards

1
Q

What is the 3 main MOA of Anti-epileptics?

A

•Block Na+ channels
•Block T-type Ca2+ channel
•Enhancement of GABA

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2
Q

Which class of anti-epileptics includes drugs like phenytoin and carbamazepine?

A

Class I: Sodium channel blockers

  • Carbamazepine
  • Oxcarbazepine
  • Lamotrigine
  • Phenytoin
  • Lacosamide
  • Valproic acid
  • Topiramate
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3
Q

What are the 5 major classes of anti-epileptics & its indications?

A

1) Na+ channel blocker
- all types of seizure except absence seizure
2) Ca2+ channel blockers
- all types of seizures
3) SV2A Modulators
- partial & generalized
4) NMDA&AMPA receptor antagonist
- Severe epilepsy (Lennox-Gastaut syndrome)
5) GABAergic agents
- All types seizure except absence

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4
Q

Which anti-epileptic drug (w examples) is commonly used for absence seizures?

A

Ca2+ channel blockers:

  • Ethosuximide
  • Lamotrigine
  • Valproic acid
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5
Q

What is the primary target of anti-epileptics in the class of Calcium channel blockers?

A

T-type calcium channels

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6
Q

Which anti-epileptic drug is known for its teratogenic effects and should be avoided in pregnancy?

A

Valproic acid

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7
Q

What is the drug class & main mechanism of action of Lamotrigine?

A

Blocks voltage-gated sodium channels
stabilizing hyperexcitable neuronal membranes, reducing neuronal firing.

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8
Q

Which class of anti-epileptics includes drugs like levetiracetam and brivaracetam?

Common AE?

A

SV2A Modulators

AE:
- Headache
- Vomiting
- Sleepiness
- Nose & throat inflamm

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9
Q

MOA of SV2A Modulators

A
  • Binds to synaptic vesicle protein 2A (SV2A), impair release of glutamate, reducing excitatory neurotransmission.
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10
Q

MOA of AMPA & NMDA antagonist

A
  • Inhibit excitatory neurotransmission by blocking AMPA and NMDA receptors, reducing glutamate-mediated excitatory postsynaptic potentials.
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11
Q

Which of the following drugs is primarily classified as a Na+ channel blocker?
A) Oxcarbazepine
B) Ethosuximide
C) Levetiracetam
D) Perampanel

A

Ans: Oxcarbazepine

Na+ blockers:
- Carbamazepine - Lacosamide
- Lamotrigine - Phenytoin
- Topiramate - Valproic acid

B) Ethosuximide - Ca2+
C) Levetiracetam - SV2A
D) Perampanel - AMPA & NMDA

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12
Q

What is the primary classification of Lamotrigine?
A) GABAergic Agent
B) Na+ Channel Blocker
C) Ca2+ Channel Blocker
D) SV2A Modulator

A

Ans: B) Na+ Channel Blocker

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13
Q

Which of the following is an example of a calcium channel blocker?
A. Phenytoin
B. Ethosuximide
C. Topiramate
D. Vigabatrin

A

Answer: B. Ethosuximide

  • Zonisamide
  • Ethosuximide
  • Lamotrigine
  • Topiramate
  • Valproic acid
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14
Q

Which drug is classified as an SV2A modulator?
A. Lacosamide
B. Brivaracetam
C. Valproic acid
D. Lamotrigine

A

Answer: B. Brivaracetam & Levetiracetam

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15
Q

Which of the following is an AMPA receptor antagonist?
A. Felbamate
B. Ethosuximide
C. Lamotrigine
D. Perampanel

A

Answer: D. Perampanel & Felbamate

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16
Q

Which of the following is a GABAergic agent?
A. Topiramate
B. Tiagabine
C. Oxcarbazepine
D. Zonisamide

A

Answer: B. Tiagabine

  • Benzodiazepines
  • Phenobarbital
  • Vigabatrin
  • Tiagabine
17
Q

Which drug is primarily used for absence seizures?
A. Phenytoin
B. Ethosuximide
C. Valproic acid
D. Lacosamide

A

Answer: B. Ethosuximide

A. Phenytoin: Used for generalized tonic-clonic seizures.
C. Valproic acid: Broad-spectrum but not specifically for absence seizures.
D. Lacosamide: A sodium channel blocker used for partial seizures.

18
Q

Which drug is known for its NMDA receptor antagonistic properties?
A. Felbamate
B. Levetiracetam
C. Oxcarbazepine
D. Lamotrigine

A

Answer: A. Felbamate
Notes:

B. Levetiracetam: An SV2A modulator, not an NMDA antagonist.
C. Oxcarbazepine: A sodium channel blocker.
D. Lamotrigine: Primarily acts as a sodium channel blocker.

19
Q

Question 8: Which of the following is NOT a sodium channel blocker?
A. Phenytoin
B. Carbamazepine
C. Zonisamide
D. Lacosamide

A

Answer: C. Zonisamide (Ca2)

A. Phenytoin: A well-known sodium channel blocker.
B. Carbamazepine: Another classic sodium channel blocker.
D. Lacosamide: A sodium channel blocker with a unique mechanism.

20
Q

What is a common adverse effect of Benzodiazepines when used as antiepileptic agents?

A) Liver toxicity
B) Sedation
C) Rash
D) Weight gain

A

Correct Answer: B) Sedation
Notes:

A) Liver toxicity: More common with valproic acid and carbamazepine.
B) Sedation: A common effect due to the central nervous system depressant activity of benzodiazepines.
C) Rash: Can occur with drugs like lamotrigine or carbamazepine.
D) Weight gain: More often associated with valproic acid.

21
Q

Which medication may lead to Aplastic anemia as an adverse effect?

A) Topiramate
B) Felbamate
C) Lacosamide
D) Valproic Acid

A

Answer: B) Felbamate

A) Topiramate (Ca2+): sedation & fetal defect
B) Felbamate (AMPA antagonist)
C) Lacosamide (Na+): nausea, sedation, dizziness
D) Valproic Acid: Nausea, weight gain, fetal d.

22
Q

Which drug from Na+ channel blockers can cause gingival hyperplasia as a side effect?
A) Carbamazepine
B) Topiramate
C) Phenytoin
D) Valproic acid

A

ANS: C) Phenytoin

A) Carbamazepine -> Hyponatremia (↓Na)
B) Topiramate -> Weight loss
D) Valproic acid -> Weight gain

23
Q

What is a serious potential adverse effect of valproic acid use in young children?

A

Hepatotoxicity is a serious potential adverse effect of valproic acid use in young children.

24
Q

Which antiepileptic drug class is associated with a risk of causing Aplastic anemia?

A

Felbamate (NMDA&AMPA receptor antagonist)

25
Q

Which drug possess a AE of Visual field loss
A) Phenytoin
B) Valproic acid
C) Vigabatrin
D) Felbamate

A

ANS: C) Vigabatrin

A) Phenytoin (gingival hyperplasia)
B) Valproic acid (inc weight)
C) Vigabatrin
D) Felbamate (aplastic anemia)

26
Q

What is a potential adverse effect of topiramate use in women of childbearing age?

A

Topiramate use in women of childbearing age may lead to an increased risk of birth defects.

27
Q

True or False: Antiepileptic drugs do not have any potential for causing allergic reactions.

A

False. Antiepileptic drugs have the potential to cause allergic reactions in some individuals.

28
Q

Which antiepileptic drug class is known to have a risk of causing gingival hyperplasia?

A

Phenytoin, a hydantoin antiepileptic drug, is known to have a risk of causing gingival hyperplasia.

29
Q

What is a potential adverse effect of lamotrigine use in patients with bipolar disorder?

A

Lamotrigine use in patients with bipolar disorder may lead to an increased risk of developing a rash, including severe skin reactions.

30
Q

What is a potential adverse effect of Na+ channel blockers?

A
  • Sedation, Dizziness
  • Hyponatremia (↓Na) (Carbama, Oxcarba)
  • Gingival hyperplasia & Hirsutism
    (Phenytoin & Lamotrigine)
  • Weight loss (Topiramate)
  • Weight gain (Valproic a)
31
Q

Which of the following drugs is effective for the treatment of absence seizures?
A) Carbamazepine
B) Ethosuximide
C) Phenytoin
D) Perampanel

A

Answer: B

A) Carbamazepine - All types of seizures except absence seizures.
B) Ethosuximide - A Ca2+ channel blocker, specifically used for absence seizures.
C) Phenytoin - Used for all types of seizures except absence seizures.
D) Perampanel - Used for severe epilepsy like Lennox-Gastaut syndrome.

32
Q

Which of the following agents enhances GABA-mediated chloride influx?
A) Lamotrigine
B) Vigabatrin
C) Topiramate
D) Perampanel

A

Answer: B

A) Lamotrigine - Ca2+ channels.
C) Topiramate - Na+ channels & enhances GABA activity, but not specifically chloride influx.
D) Perampanel - AMPA &NMDA receptor antagonist.

33
Q

List two potential adverse effects of Valproic acid.

A

Hepatitis
Nausea
Other side effects include weight gain and fetal abnormalities.

CNS (5 decks)

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