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845 IP Test 2 > Antiepileptics Masserano > Flashcards

Antiepileptics Masserano Flashcards

1
Q

Epilepsy definition

A

Two or more recurrent seizures unprovoked associated with an excessive neuronal discharge

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2
Q

Seizure recurrence evaluation

A
  1. Problems with compliance?
  2. Pharmacokinetic factors?
  3. Increase dose?
  4. Change med?
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3
Q

Focal seizures

A

Previously partial seizures and start in cells on one side of the brain

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4
Q

Generalized seizures

A

Previously primary generalized, start on both sides of the brain at onset

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5
Q

Focal aware seizures

A

Awareness remains intact even if the person is unable to respond or talk

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6
Q

Focal impaired awareness

A

If awareness is impaired or affected at any time during a seizure even if a person has a vague idea of what happened

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7
Q

Focal motor seizure

A

Some type of movement occurs during the event

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8
Q

Focal non-motor seizure

A

Other symptoms that occur first such as changes in sensation, emotion, or thinking

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9
Q

Auras

A

Describes the symptoms patients may feel before a seizure

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10
Q

Generalized motor seizure

A

Generalized tonic (stiffening) clonic (jerking) seizures

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11
Q

Generalized non-motor seizures

A

Absence seizures that involve brief changes in awareness, staring, and repeated movements like lip smacking

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12
Q

Impaired awareness onset

A

May begin as focal seizure that spreads to larger portion of the temporal lobe and impair consciousness

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13
Q

Absence or Petit Mal

A

No aura, focus, postictal state. Freeze behavior of blank stare where the thalamus is involved. Spike and dome on the EEG

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14
Q

Tonic-clonic or Grand Mal

A

Massive discharge of all the motor neurons in the cortex. Tonic = contraction of all voluntary muscles. Clonic = contraction and relaxation

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15
Q

Drugs that are effective in focal/generalized seizures

Prolong inactivation of Na channels

A 
Carbamazepine
Oxcarbazepine
Phenytoin
Zonisamide
Lamotrigine
Valproic acid
Topiramate
Rufinamide
Lacosamide
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16
Q

Enhance Neuronal GABA inhibition

A

Benzos, Barbiturates, vigabatrin, tiagabine

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17
Q

Reduce glutamate excitation

A

Keppra, felbamate, topiramate, perampanel

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18
Q

Inhibit Ca currents

A

Ehosuximide and valproic acid

Gaba

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19
Q

Enhances outward potassium currents

A

Ezogabine

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20
Q

Which drugs increase clearance of oral contraceptives

A

Phenytoin, carbamazepine, phenobarbital, oxcarbazepine.

Should receive supplemental vitamin D and calcium

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21
Q

Phenytoin and fosphenyotin therapeutic uses

A

Focal seizures, general tonic-clonic and status epilepticus, trigeminal neuralgia

22
Q

Valproic acid and phenyotin interxns

A

Competes for CYP2C9 and will inhibit warfarin metabolism and produce hypoprothombinemia

23
Q

Phenytoin toxicities

A 
Cerebellar-vestibular
Hirsutism
*Osteopenia*
Anemia
Steven-johnsons syndrome
Gingival hyperplasia: good dental hygiene is important
24
Q

Carbamazepine therapeutic uses

A

Focal seizures, generalized tonic-clonic, neuropathic pain, bipolar disorder

25
Q

Carbamazepine box warnings

A

Aplastic anemia and agranulocytosis

Serious dermatologic rxns (SJS)

26
Q

Lamotrigine therapeutic uses

A

Focal seizures
Primary tonic-clonic seizures
Add-on for focal seizures with secondary tonic-clonic seizures
Bipolar disorder

27
Q

Lamotrigine black box warning

A

Steven-johnsons syndrome

28
Q

Zonisamide therapeutic use

A

Add-on for focal seizures and can be used for generalized tonic-clonic

29
Q

Zonisamide contraindications

A

History of kidney stones

30
Q

Rufinamide therapeutic use

A

Adjunctive treatment of seizures associated with Lennox-gastaut syndrome in children 4 years and older

31
Q

Locasamide therapeutic use

A

focal seizures and is a CV with similarities to benzos

32
Q

Valproic acid MOA

A

Prolongs inactivation period of Na channels

Reduces Ca++ T currents

33
Q

Valproic acid therapeutic uses

A

Adjunct for all seizure types and sole treatment for focal seizures and complex absence seizures

34
Q

Depakote adverse effects

A

GI symptoms
Box warnings: hepatitis, teratogenic, pancreatitis
Pregnancy category D (X with migraines)

35
Q

Phenobarbital MOA

A

Facilitates GABAa receptor activity and potentiating the effects of GABA.

36
Q

Phenobarbital therapeutic uses

A

Focal and generalized tonic-clonic

Emergency control of certain acute convulsive episodes

37
Q

Tiagabine MOA and therapeutic use

A

Inhibits GABA transporter GAT-1 in both neurons and glia

Add-on for focal seizures

38
Q

Vigabatrin MOA

A

Irreversible inhibition of GABA transaminase

39
Q

Vigabatrin therapeutic uses

A

Add on for focal seizures and infantile spasms

40
Q

Vigabatrin box warnings

A

Vision loss

41
Q

Keppra MOA

A

Binds to synaptic vesicle protein 2A and acts on glutamate transmission

42
Q

Keppra therapeutic uses

A

Focal seizures
Myoclonic seizures
General tonic-clonic seizures

43
Q

Gabapentin MOA

A

reduce calcium by modulating the voltage gated calcium channel alpha1 subunit

44
Q

Topiramate MOA

A

AMPA/kainate antagonist

Prolongs inactivation period of Na+ channels

45
Q

Topiramate side effects and contraindications

A

Pregnancy category D and contraindicated for history of kidney stones

46
Q

Perampanel MOA

A

AMPA/glutamate receptor antagonist

47
Q

Perampanel black box warning

A

Psychiatric and behavioral adverse rxns

48
Q

Felbamate MOA

A

Antagonist of glycine binding site on NMDA receptor

49
Q

Felbamate Black box warnings

A

Aplastic anemia and hepatic failure

50
Q

Ethosuximide MOA

A

Ca++T currents in the Thalamus preventing oscillatory firing characteriistics of asbence seizures

845 IP Test 2 (2 decks)

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