Antiseizure Medications

Question 1

Name 4 drugs that inhibit VSSC to treat tonic-clonic seizures.

Answer 1

phenytoin
carbamezapine
lamotrigine
topiramate

Question 2

What promotes the spread of abnormal neuronal activity in seizures?

Answer 2

Enhancement of excitatory neurotransmitters (glutamate)

deficiency of inhibitory neurotransmitters (GABA)

Question 3

Name the 2 types of generalized seizures.

Answer 3

tonic-clonic (grand mal)

absence

Question 4

Name the 3 types of partial seizures.

Answer 4

simple partial
complex partial
secondary generalized

Question 5

What is a partial seizure?

Answer 5

sz with a focal beginning

Question 6

What is a generalized seizure?

Answer 6

sz without a focal beginning

Question 7

What is a tonic clonic/grand mal sz?

Answer 7

EEG = high amplitude spikes; 15-40 cycles/sec
loss of postural control
LOC
tonic phase (rigid extension) –> clonic phase (contraction)
loss of GABA inhibitory tone, propagation
due to decreased GABA tone over large area / increased response to glutamate / Na+-
channel excitation

Question 8

EEG = high amplitude spikes; 15-40 cycles/sec
loss of postural control
LOC
tonic phase (rigid extension) –> clonic phase (contraction)
loss of GABA inhibitory tone, propagation
due to decreased GABA tone over large area / increased response to glutamate / Na+-
channel excitation

Answer 8

tonic clonic/grand mal sz

Question 9

What is an absence/petit mal sz?

Answer 9

childhood –> age 20
EEG = 3 cycles/sec
staring spells
oscillatory stimulation of thalamic-cortical circuitry;
inappropriate activation of low-threshold T-type Ca++ channels

Question 10

childhood –> age 20
EEG = 3 cycles/sec
staring spells
oscillatory stimulation of thalamic-cortical circuitry;
inappropriate activation of low-threshold T-type Ca++ channels

Answer 10

absence/petit mal sz

Question 11

What is a simple partial sz?

Answer 11

NO LOC

usually of cortical origin in restricted region (focal start)

Question 12

NO LOC

usually of cortical origin in restricted region (focal start)

Answer 12

simple partial sz

Question 13

What is a complex partial sz?

Answer 13

sz with LOC

Involves limbic as well as temporal / frontal cortex (emotional)

Question 14

sz with LOC

Involves limbic as well as temporal / frontal cortex (emotional)

Answer 14

complex partial sz

Question 15

Are generalized or partial sz’s more difficult to treat?

Answer 15

partial

Question 16

Name 3 drugs for treating generalized tonic-clonic sz’s.

Answer 16

Valproic acid OR
Lamotrigine OR
Levetiracetam

Question 17

Name 3 drugs for treating partial sz’s.

Answer 17

Carbamazepine (or Oxcarbazepine) OR
Lamotrigine OR
Levetiracetam

Question 18

Name 2 drugs for treating absence sz’s.

Answer 18

ethosuxamide OR

valproic acid

Question 19

Name 3 drugs for treating Atypical Absence, Myoclonic, Atonic sz’s.

Answer 19

Valproic acid OR
Lamotrigine OR
Levetiracetam

Question 20

What is status epilepticus?

Answer 20

state of recurrent major motor seizures between which patient does not regain consciousness
untreated –> death in 5-20%of patients from respiratory arrest or circulatory collapse

Question 21

state of recurrent major motor seizures between which patient does not regain consciousness
untreated –> death in 5-20%of patients from respiratory arrest or circulatory collapse

Answer 21

status epilepticus

Question 22

Which 2 antiseizure drugs have the highest risk of fetal malformations?

Answer 22

Valproate and phenobarbital

Question 23

____, ____, and ____ can cause vitamin K deficiency and hemorrhage in a newborn.

Answer 23

Phenytoin, carbamazepine, and phenobarbital

Question 24

Phenytoin, carbamazepine, and phenobarbital can cause _____ and ______ in a newborn.

Answer 24

vitamin K deficiency and hemorrhage