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Monash Pharmacology > Antiepileptics > Flashcards

Antiepileptics Flashcards

1
Q

First line drug for petit mal seizures

Second line

A

Valproate and ethosuximide- 1 st line

Clobazam (benzo) -2nd line

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2
Q

First line drug for tonic clonic seizures

Second line

A

Valproate - 1st line

Phenobarbitone- 2nd line

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3
Q

First and second line for complex partial seizures

A

Carbamazepine- 1st

Taigabine- 2nd

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4
Q

What are the 3ways GABA can be targeted? Give one drug as an example each.

A
  1. Inhibit GABA transaminase - valproate
  2. Block transporter for GABA reuptake - tiagabine
  3. Modulate GABA receptor activity via allosteric receptor - Benzo (midazolam) barbiturate (phenobarbitone)
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5
Q

Mx action valproate/ vigabatrin

A

Inhibit GABA transaminase (GABA-T) which metabolises GABA - valproate

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6
Q

Mx action of tiagabine

A
  1. Block transporter for GABA reuptake - tiagabine
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7
Q

Action of diazepam/ clonazepam/ clobazam/ midazolam.

A

Modulate GABA receptor activity via allosteric receptor - Benzo (midazolam) barbiturate (phenobarbitone)

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8
Q

Action of phenobarbitone and primidone

A

Modulate GABA receptor activity via GABA a allosteric receptor - Benzo (midazolam) barbiturate (phenobarbitone)

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9
Q

Carbamazepine, phenytoin and gabapentin act on:

A

Target Na channels of high frequency firing neurons- active in seizures - without interfering with low firing normal state neurons

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10
Q

Ca channel targets can be targeted dependent on voltage. What are two examples ?

A 
Low voltage - T type (assoc. with petit mal) : ethosuximide
High voltage (assoc. with partial) : levetiracetem
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11
Q

Phenytoin S/E

A

Gum hypertrophy
Acne
Hirsutism

Most anti epileptics: sedation and skin rashes
Most anti epileptics interfere with liver enzyme CYP450- promoting or inhibiting it’s ability to metabolise other drugs

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12
Q

Carbamazepine S/E:

A

Bone marrow depression

Most anti epileptics: sedation and skin rashes
Most anti epileptics interfere with liver enzyme CYP450- promoting or inhibiting it’s ability to metabolise other drugs

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13
Q

Valproate S/E:

A

Weight gain
Alopecia

Most anti epileptics: sedation and skin rashes.
Most anti epileptics interfere with liver enzyme CYP450- promoting or inhibiting it’s ability to metabolise other drugs

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14
Q

Most anti epileptics interfere with liver enzyme CYP450- promoting or inhibiting it’s ability to metabolise other drugs

A

Inducer of cyp450- phenobarbitone phenytoin carbamazepine

Inhibitor of cyp450- valproate

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15
Q

Pregnancy contraindications of phenytoin and valproate

A

Phenytoin- palate deformity, heart defects. (Folate/Vit K)

Valproate - spins bodies

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16
Q

Three categories of seizures are?

A

Partial
Generalised : tonic clonic (spasms)
Absent/ petit mal (vacant, kids)

Monash Pharmacology (13 decks)

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