Antiepileptics Flashcards
What is the 3 main MOA of Anti-epileptics?
•Block Na+ channels
•Block T-type Ca2+ channel
•Enhancement of GABA
Which class of anti-epileptics includes drugs like phenytoin and carbamazepine?
Class I: Sodium channel blockers
- Carbamazepine
- Oxcarbazepine
- Lamotrigine
- Phenytoin
- Lacosamide
- Valproic acid
- Topiramate
What are the 5 major classes of anti-epileptics & its indications?
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&A receptor antagonist
- Severe epilepsy (Lennox-Gastaut syndrome)
5) GABAergic agents
- All types seizure except absence
Which anti-epileptic drug (w examples) is commonly used for absence seizures?
Ca2+ channel blockers:
- Ethosuximide
- Lamotrigine
- Valproic acid
What is the primary target of anti-epileptics in the class of Calcium channel blockers?
T-type calcium channels
Which anti-epileptic drug is known for its teratogenic effects and should be avoided in pregnancy?
Valproic acid
What is the drug class & main mechanism of action of Lamotrigine?
Blocks voltage-gated sodium channels
stabilizing hyperexcitable neuronal membranes, reducing neuronal firing.
Which class of anti-epileptics includes drugs like levetiracetam and brivaracetam?
Common AE?
SV2A Modulators
AE:
- Headache
- Vomiting
- Sleepiness
- Nose & throat inflamm
MOA of SV2A Modulators
- Binds to synaptic vesicle protein 2A (SV2A), impair release of glutamate, reducing excitatory neurotransmission.
MOA of AMPA & NMDA antagonist
- Inhibit excitatory neurotransmission by blocking AMPA and NMDA receptors, reducing glutamate-mediated excitatory postsynaptic potentials.
Which of the following drugs is primarily classified as a Na+ channel blocker?
A) Oxcarbazepine
B) Ethosuximide
C) Levetiracetam
D) Perampanel
Ans: Oxcarbazepine
Na+ blockers:
- Carbamazepine - Lacosamide
- Lamotrigine - Phenytoin
- Topiramate - Valproic acid
B) Ethosuximide - Ca2+
C) Levetiracetam - SV2A
D) Perampanel - AMPA & NMDA
What is the primary classification of Lamotrigine?
A) GABAergic Agent
B) Na+ Channel Blocker
C) Ca2+ Channel Blocker
D) SV2A Modulator
Ans: B) Na+ Channel Blocker
Which of the following is an example of a calcium channel blocker?
A. Phenytoin
B. Ethosuximide
C. Topiramate
D. Vigabatrin
Answer: B. Ethosuximide
- Zonisamide
- Ethosuximide
- Lamotrigine
- Topiramate
- Valproic acid
Which drug is classified as an SV2A modulator?
A. Lacosamide
B. Brivaracetam
C. Valproic acid
D. Lamotrigine
Answer: B. Brivaracetam & Levetiracetam
Which of the following is an AMPA receptor antagonist?
A. Felbamate
B. Ethosuximide
C. Lamotrigine
D. Perampanel
Answer: D. Perampanel & Felbamate
Which of the following is a GABAergic agent?
A. Topiramate
B. Tiagabine
C. Oxcarbazepine
D. Zonisamide
Answer: B. Tiagabine
- Benzodiazepines
- Phenobarbital
- Vigabatrin
- Tiagabine
Which drug is primarily used for absence seizures?
A. Phenytoin
B. Ethosuximide
C. Valproic acid
D. Lacosamide
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.
Which drug is known for its NMDA receptor antagonistic properties?
A. Felbamate
B. Levetiracetam
C. Oxcarbazepine
D. Lamotrigine
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.
Question 8: Which of the following is NOT a sodium channel blocker?
A. Phenytoin
B. Carbamazepine
C. Zonisamide
D. Lacosamide
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.
What is a common adverse effect of Benzodiazepines when used as antiepileptic agents?
A) Liver toxicity
B) Sedation
C) Rash
D) Weight gain
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.
Which medication may lead to Aplastic anemia as an adverse effect?
A) Topiramate
B) Felbamate
C) Lacosamide
D) Valproic Acid
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.
Which drug from Na+ channel blockers can cause gingival hyperplasia as a side effect?
A) Carbamazepine
B) Topiramate
C) Phenytoin
D) Valproic acid
ANS: C) Phenytoin
A) Carbamazepine -> Hyponatremia (↓Na)
B) Topiramate -> Weight loss
D) Valproic acid -> Weight gain
What is a serious potential adverse effect of valproic acid use in young children?
Hepatotoxicity is a serious potential adverse effect of valproic acid use in young children.
Which antiepileptic drug class is associated with a risk of causing Aplastic anemia?
Felbamate (NMDA&A receptor antagonist)
