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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
active metabolite of Carbamazepine?
Carbamazepine-10,11-epoxide
26
is Carbamazepine an auto induction drug?
True
27
uses of Carbamazepine
trigeminal neuralgia generalized tonic-clonic seizures partial seizures manic phase in bipolar disorder
28
Adverse effects of Carbamazepine
Steven-Johnson syndrome dose dependent GIT abnormalities dizziness blurred vision diplopia ataxia teratogenic - during first trimester of pregnancy
29
Since Carbamazepine is teratogenic, what conditions are seen on the baby?
spina bifida craniofacial abnormalities
30
what side effect will Oxcarbazepine produce?
Hyponatremia - low blood sodium levels
31
It is a medical emergency, allergic reaction to a medication which affects skin and mucous membrane. It also affects 10% of total BSA.
Steven-Johnson Syndrome
32
What are the branched chain fatty acid sodium channel blockers?
Valproic acid and Sodium Valproate
33
One of the oldest and the first broad spectrum antiseizure drugs
Valproic acid
34
Aside from blocking sodium channel, what are some of the MOA of Valproic acid?
It blocks NMDA receptors It increases GABA levels by preventing its degradation
35
Uses of branched chain fatty acid anti-seizure drug
Absence Seizures Bipolar Disorder (Acute mania) Generalized tonic-clonic seizures partial seizures myoclonic seizures prophylaxis for migraine
36
Adverse Effects of Valproic Acid
GI upset, weight gain, hair loss (reversible) Drowsiness, fine tremor Idiosyncratic hepatotoxicity (2 yrs below) Thrombocytopenia Teratogen (NTD - spina bifida)
36
Adverse Effects of Valproic Acid
GI upset, weight gain, hair loss (reversible) Drowsiness, fine tremor Idiosyncratic hepatotoxicity (2 yrs below) Thrombocytopenia Teratogen (NTD - spina bifida)
37
Is Valproic Acid a potent enzyme inducer or inhibitor?
inhibitor
38
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.
Spina bifida
39
What type of sodium channel blocker is Lamotrigine and Zonisamide?
Phenyltriazine
40
Uses of Lamotrigine and Zonisamide?
Partial Seizures Generalized tonic-clonic seizures myoclonic seizures Absence Seizures Bipolar Seizures
41
Adverse Effects of Lamotrigine and Zonisamide
Dizziness Ataxia Nausea Steven-Johnson Syndrome
42
MOA of Ethosuximide
It blocks voltage-gated T-type calcium channels in the thalamus
43
Uses of Ethosuximide
Generalized Absence Seizures
44
Adverse effect of Ethosuximide
GI upset (Nausea, Vomiting) Lethargy, Headache Behavioral Changes (euphoria)
45
What are the different GABA analogs?
Gabapentin Pregabalin
46
MOA of GABA analogs
blocks calcium channels which prevents glutamate release
47
USES OF GABA analogs
Neuropathic pain (postherpetic neuralgia) Partial seizures, migraine Fibriomyalgia (Pregabalin)
48
Adverse effects of Gabapentin and Pregabalin
Dizziness Ataxia Sedation Nystagmus Tremor
49
Its novel mechanism of action is modulation of synaptic neurotransmitter release through binding to the synaptic vesicle protein SV2A in the brain.
Levetiracetam
50
Uses of Levetiracetam
Generalized tonic-clonic seizures Partial seizures Juvenile myoclonic epilepsy
51
Adverse Effects of Levetiracetam
Dizziness Sedation Ataxia Weakness Irritability Hallucinations Psychosis
52
work by enhancing a very important neurotransmitter called GABA (gamma-aminobutyric acid) at the GABA A receptor
Benzodiazepines and Barbiturates
53
Increases the frequency of Cl channel opening
Benzodiazepines
54
Increases the duration of Cl channel opening
Barbiturates
55
What specific benzodiazepines are used to treat status epilepticus
Clorazepate Lorazepam Diazepam
56
What specific benzodiazepines is used to treat Lennox-Gastaut syndrome
Clonazepam
57
Adverse effects of Benzodiazepines
Anterogade Amnesia Decrease psychomotor skills Unwanted daytime sedation Tolerance Dependence
58
Uses of Barbiturates
Generalized tonic-clonic seizures Partial seizures status epilepticus insomnia DOC for infants
59
Adverse effects of Barbiturates
Unwanted daytime sedation Extension of CNS depressant action Tolerance Dependence
60
What are the active metabolite of primidone?
Phenobarbital
61
It increases synaptic GABA availability via inhibition of the GAT-1 GABA transporter on presynaptic neurons and glial cells.
Tiagabine
62
Uses of Tiagabine
Adjunct therapy for focal seizures
63
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.
Vigabatrin
64
Uses of Vigabatrin
Infantile spasms associated with tuberous sclerosis
65
What are antiseizure drugs that are monosaccharide derivatives?
Topiramate Felbamate
66
MOA of Topiramate and Felbamate
Multiple action on synaptic function: Sodium Channels GABAa receptor subtypes AMPA or Kainate receptors
67
Antiseizure drugs with the greatest number of mechanism of action
Monosaccharide derivatives (Topiramate, Felbamate)

PHARMACOLOGY LEC (MIDTERMS) (5 decks)

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