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)
Which drug possess a AE of Visual field loss
A) Phenytoin
B) Valproic acid
C) Vigabatrin
D) Felbamate
ANS: C) Vigabatrin
A) Phenytoin (gingival hyperplasia)
B) Valproic acid (inc weight)
C) Vigabatrin
D) Felbamate (aplastic anemia)
What is a potential adverse effect of topiramate use in women of childbearing age?
Topiramate use in women of childbearing age may lead to an increased risk of birth defects.
True or False: Antiepileptic drugs do not have any potential for causing allergic reactions.
False. Antiepileptic drugs have the potential to cause allergic reactions in some individuals.
Which antiepileptic drug class is known to have a risk of causing gingival hyperplasia?
Phenytoin, a hydantoin antiepileptic drug, is known to have a risk of causing gingival hyperplasia.
What is a potential adverse effect of lamotrigine use in patients with bipolar disorder?
Lamotrigine use in patients with bipolar disorder may lead to an increased risk of developing a rash, including severe skin reactions.
What is a potential adverse effect of Na+ channel blockers?
- Sedation, Dizziness
- Hyponatremia (↓Na) (Carbama, Oxcarba)
- Gingival hyperplasia & Hirsutism
(Phenytoin & Lamotrigine) - Weight loss (Topiramate)
- Weight gain (Valproic a)
Which of the following drugs is effective for the treatment of absence seizures?
A) Carbamazepine
B) Ethosuximide
C) Phenytoin
D) Perampanel
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.
Which of the following agents enhances GABA-mediated chloride influx?
A) Lamotrigine
B) Vigabatrin
C) Topiramate
D) Perampanel
Answer: B
A) Lamotrigine - Ca2+ channels.
C) Topiramate - Na+ channels & enhances GABA activity, but not specifically chloride influx.
D) Perampanel - AMPA &NMDA receptor antagonist.
List two potential adverse effects of Valproic acid.
Hepatitis
Nausea
Other side effects include weight gain and fetal abnormalities.
