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PHARMACOLOGY LEC (MIDTERMS) > ANTISEIZURE DRUGS > Flashcards

ANTISEIZURE DRUGS Flashcards

1
Q

is a chronic disorder of brain function characterized by the recurrent and unpredictable occurence of seizure

A

epilepsy

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2
Q

finite episodes of brain dysfunction resulting from abnormal discharge of cerebral neurons

A

seizure

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3
Q

an imbalance of inhibitory and excitatory process of the brain, where excitatory usually predominates

A

seizures

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4
Q

what type of seizure begins in a local cortical site usually on 1 hemisphere of the brain

A

focal onset seizure

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5
Q

what type of seizure involves both the hemisphere of the brain

A

generalized onset seizures

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6
Q

what type of seizure is characterized by a brief loss of consciousness (4-20 secs) with no warning and immediate resumption of consciousness (no postictal period)?

A

PETIT MAL OR GENERALIZED ABSENCE SEIZURES

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7
Q

what phase will the patient experience loss of awareness and sustained contraction of muscles throughout the body

A

tonic phase

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8
Q

what phase is a period of altering relaxation and muscle contraction usually lasting for 3 minutes

A

clonic phase

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9
Q

a type of seizure characterized by a loss of awareness and sustained contractions of muscles throughout the body, followed by periods of muscle contraction altering with periods of relaxation followed by a postictal period (3 minutes)

A

tonic clonic seizures or grand mal

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10
Q

what type of seizure in which a patient can has a preservation of consciousness, he/she can describe in full detail the attack, and is aware

A

simple partial seizure or
focal aware seizure

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11
Q

a type of seizure in which a patient has purposeless movements such as lip smacking or hand wringing that usually last for 30 secs to 2 minutes, patient us unaware

A

complex partial seizures or
focal impaired awareness seizure

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12
Q

uses of phenytoin and fosphenytoin

A

generalized tonic-clonic seizures
partial seizures
status epilepticus

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13
Q

common adverse effects of phenytoin and fosphenytoin

A

nystagmus
diplopia
ataxia

others:
gingival hyperplasia
Hirsutism
Vitamin D metabolism abnormalities
Teratogenic

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14
Q

is phenytoin an enzyme inducer or inhibitor?

A

inducer

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15
Q

it is a water soluble prodrug of phenytoin

A

fosphenytoin

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16
Q

MOA of phenytoin

A

blocks voltage gated sodium channels which inhibits generation of action potentials

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17
Q

Why is phenytoin preferred as chronic medication for the prevention of status epilepticus?

A

because it is non-sedating at therapeutic doses

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18
Q

Why phenytoin can disrupt thyroid function?

A

because it has high affinity for thyroid binding globulin

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19
Q

At a lower dose, it follows _________ kinetics. But as the dose increases, it follows ___________ kinetics

A

first order kinetics

zero-order kinetics

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20
Q

a condition in which a patient experiences double vision?

A

diplopia

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21
Q

a condition in which a patient has poor muscle control leading to clumsy movements

A

ataxia

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22
Q

is a vision condition in which the eyes make repetitive, uncontrolled movements

A

nystagmus

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23
Q

a medical emergency when patients experience more than 5 minutes of seizures

A

status epilepticus

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24
Q

what type of sodium blocking channel are Carbamazepine and Oxcarbazepine?

A

Tricyclic

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25
Q

active metabolite of Carbamazepine?

A

Carbamazepine-10,11-epoxide

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26
Q

is Carbamazepine an auto induction drug?

A

True

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27
Q

uses of Carbamazepine

A

trigeminal neuralgia
generalized tonic-clonic seizures
partial seizures
manic phase in bipolar disorder

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28
Q

Adverse effects of Carbamazepine

A

Steven-Johnson syndrome
dose dependent GIT abnormalities
dizziness
blurred vision
diplopia
ataxia
teratogenic - during first trimester of pregnancy

29
Q

Since Carbamazepine is teratogenic, what conditions are seen on the baby?

A

spina bifida
craniofacial abnormalities

30
Q

what side effect will Oxcarbazepine produce?

A

Hyponatremia - low blood sodium levels

31
Q

It is a medical emergency, allergic reaction to a medication which affects skin and mucous membrane. It also affects 10% of total BSA.

A

Steven-Johnson Syndrome

32
Q

What are the branched chain fatty acid sodium channel blockers?

A

Valproic acid and Sodium Valproate

33
Q

One of the oldest and the first broad spectrum antiseizure drugs

A

Valproic acid

34
Q

Aside from blocking sodium channel, what are some of the MOA of Valproic acid?

A

It blocks NMDA receptors
It increases GABA levels by preventing its degradation

35
Q

Uses of branched chain fatty acid anti-seizure drug

A

Absence Seizures

Bipolar Disorder (Acute mania)
Generalized tonic-clonic seizures
partial seizures
myoclonic seizures
prophylaxis for migraine

36
Q

Adverse Effects of Valproic Acid

A

GI upset, weight gain, hair loss (reversible)
Drowsiness, fine tremor
Idiosyncratic hepatotoxicity (2 yrs below)
Thrombocytopenia
Teratogen (NTD - spina bifida)

36
Q

Adverse Effects of Valproic Acid

A

GI upset, weight gain, hair loss (reversible)
Drowsiness, fine tremor
Idiosyncratic hepatotoxicity (2 yrs below)
Thrombocytopenia
Teratogen (NTD - spina bifida)

37
Q

Is Valproic Acid a potent enzyme inducer or inhibitor?

A

inhibitor

38
Q

is a condition that affects the spine and is usually apparent at birth. It is a type of neural tube defect (NTD). It can happen anywhere along the spine if the neural tube does not close all the way.

A

Spina bifida

39
Q

What type of sodium channel blocker is Lamotrigine and Zonisamide?

A

Phenyltriazine

40
Q

Uses of Lamotrigine and Zonisamide?

A

Partial Seizures

Generalized tonic-clonic seizures
myoclonic seizures
Absence Seizures
Bipolar Seizures

41
Q

Adverse Effects of Lamotrigine and Zonisamide

A

Dizziness
Ataxia
Nausea
Steven-Johnson Syndrome

42
Q

MOA of Ethosuximide

A

It blocks voltage-gated T-type calcium channels in the thalamus

43
Q

Uses of Ethosuximide

A

Generalized Absence Seizures

44
Q

Adverse effect of Ethosuximide

A

GI upset (Nausea, Vomiting)
Lethargy, Headache
Behavioral Changes (euphoria)

45
Q

What are the different GABA analogs?

A

Gabapentin
Pregabalin

46
Q

MOA of GABA analogs

A

blocks calcium channels which prevents glutamate release

47
Q

USES OF GABA analogs

A

Neuropathic pain (postherpetic neuralgia)
Partial seizures, migraine
Fibriomyalgia (Pregabalin)

48
Q

Adverse effects of Gabapentin and Pregabalin

A

Dizziness
Ataxia
Sedation
Nystagmus
Tremor

49
Q

Its novel mechanism of action is modulation of synaptic neurotransmitter release through binding to the synaptic vesicle protein SV2A in the brain.

A

Levetiracetam

50
Q

Uses of Levetiracetam

A

Generalized tonic-clonic seizures
Partial seizures
Juvenile myoclonic epilepsy

51
Q

Adverse Effects of Levetiracetam

A

Dizziness
Sedation
Ataxia
Weakness
Irritability
Hallucinations
Psychosis

52
Q

work by enhancing a very important neurotransmitter called GABA (gamma-aminobutyric acid) at the GABA A receptor

A

Benzodiazepines and Barbiturates

53
Q

Increases the frequency of Cl channel opening

A

Benzodiazepines

54
Q

Increases the duration of Cl channel opening

A

Barbiturates

55
Q

What specific benzodiazepines are used to treat status epilepticus

A

Clorazepate
Lorazepam
Diazepam

56
Q

What specific benzodiazepines is used to treat Lennox-Gastaut syndrome

A

Clonazepam

57
Q

Adverse effects of Benzodiazepines

A

Anterogade Amnesia
Decrease psychomotor skills
Unwanted daytime sedation
Tolerance
Dependence

58
Q

Uses of Barbiturates

A

Generalized tonic-clonic seizures
Partial seizures
status epilepticus
insomnia

DOC for infants

59
Q

Adverse effects of Barbiturates

A

Unwanted daytime sedation
Extension of CNS depressant action
Tolerance
Dependence

60
Q

What are the active metabolite of primidone?

A

Phenobarbital

61
Q

It increases synaptic GABA availability via inhibition of the GAT-1 GABA transporter on presynaptic neurons and glial cells.

A

Tiagabine

62
Q

Uses of Tiagabine

A

Adjunct therapy for focal seizures

63
Q

was rationally designed to have a specific effect on brain chemistry by inhibiting the GABA-degrading enzyme, GABA transaminase, resulting in a widespread increase in GABA concentrations in the brain.

A

Vigabatrin

64
Q

Uses of Vigabatrin

A

Infantile spasms associated with tuberous sclerosis

65
Q

What are antiseizure drugs that are monosaccharide derivatives?

A

Topiramate
Felbamate

66
Q

MOA of Topiramate and Felbamate

A

Multiple action on synaptic function:

Sodium Channels
GABAa receptor subtypes
AMPA or Kainate receptors

67
Q

Antiseizure drugs with the greatest number of mechanism of action

A

Monosaccharide derivatives (Topiramate, Felbamate)

PHARMACOLOGY LEC (MIDTERMS) (5 decks)

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