Brain_FCs_Seizures Pharm Flashcards
1
Q
Panic Disorder
A
Clonazepam
2
Q
Contraindicated in Porphyria
A
Phenobarbitol
3
Q
Irritability in children
A
Phenobarbitol
4
Q
Not sedating (not CNS depressant)
A
Phenytoin
5
Q
Many drug interactions, induces CYP3A4
A
Phenytoin
6
Q
Metabolized to stable, active epoxide
A
Carbamazepine
7
Q
Induce CYP enzymes
A
Phenytoin, Carbamazepine
8
Q
AEs include vertigo & blurred vision
A
Carbamazepine
9
Q
Used in bipolar disorder
A
Carbamazepine, Valproic acid, Lamotrigine
10
Q
Used in neuropathic pain syndromes
A
Carbamazepine, Gabapentin
11
Q
AEs include hypersensitivity rxns
A
Ethosuximide (SLE, urticarial), Topiramate (in persons w/ sulfonamide allergy)
12
Q
AEs include GI Sx (Nausea, vomiting, anorexia)
A
Ethosuximide
13
Q
AEs include dizziness
A
Ethosuximide, Lamotrigine
14
Q
Common AE includes hepatotoxicity
A
Valproic acid
15
Q
Used as prophylaxis of migraine
A
Valproic acid, Topiramate
16
Q
Tolerance to sedative & anticonvulsant effects
A
Clonazepam
17
Q
Useful in panic disorder
A
Clonazepam
18
Q
Only approved in combination
A
Gabapentin & Levetiracetam
19
Q
Decreases Glutamate release
A
Lamotrigine
20
Q
Slows recovery rate of Na+ channels
A
Phenytoin, Carbamazepine, Valproic acid (& Ca++), Lamotrigine, Topiramate
21
Q
AEs include skin rashes
A
Lamotrigine, Ethosuximide
22
Q
AEs include nervousness
A
Topiramate
23
Q
Potentiates GABA @ GABAA receptors
A
Phenobarbitol, Topiramate
24
Q
Induces metabolism of estrogen
A
Topiramate
25
Used for weight loss
Topiramate (in combo w/ phentermine)
26
Commonly used as mood stabilizer
Lamotrigine
27
Minimal toxicity to which pt develops tolerance in few wks
GABApentin (Neurontin)
28
Status Epilepticus Tx
Diazepam or Pentobarbitol or Thiopental (which often causes apnea, hypotension --- then, a longer acting anticonvulsant like Phenytoin is given)
29
Phenobarbitol treats what?”
Generalized Tonic-Clonic, Partial
30
Phenytoin treats what?”
Generalized Tonic-Clonic & Partial
31
Carbamazepine treats what?”
Generalized Tonic-Clonic, Partial seizures, Bipolar disorder, Neuropathic pain syndromes
32
Ethosuximide treats what?”
Absence
33
Valproic acid treats what?”
All seizures, Bipolar disorder, Prophylaxis of migraine
34
Clonazepam treats what?”
All, except Generalized Tonic-Clonic
35
Diazepam treats what?”
Status Epilepticus (drug of choice)
36
Gabapentin treats what?”
Partial seizures (in combo), Neuropathic pain syndromes
37
Lamotrigine treats what?”
Partial, Generalized Tonic-Clonic, Bipolar disorder
38
Levetiracetam treats what?”
Partial, Myoclonic, Generalized Tonic-Clonic
39
Carbamazepine AEs
Sedation, ataxia, vertigo, blurred vision
40
Short acting barbiturates (2)? Use?
Thiopental & Methohexital. Used as intravenous anesthetics
41
Phenobarbitol MOA
Inc's binding of GABA to GABA(a) receptor. Also inc's binding of benzodiazepines to benzodiazepine receptor
42
Phenobarbitol onset & half-life
Slow onset, long half-life
43
Phenobarbitol: tolerance develops to _____
sedation
44
Phenytoin MOA
slows rec. rate of Na+ channels
45
Phenytoin toxicity
GRAB Her suit
46
Carbamazepine MOA
slows rec. rate of Na+ channels
47
Ethosuximide MOA
Antagonizes Ca currents in thalamus
48
Ethosuximide AEs
(CNS): Sedation, dizziness, headache: (GI): Nausea, vomiting, anorexia; (Hypersensitivity): Urticaria, SLE, S-J syndrome, decreases bone marrow
49
Valproic acid MOA
slows rec. rate of Na+ channels & Antagonizes Ca currents in thalamus
50
Valproic acid AEs
Hepatotoxicity
51
GABApentin AEs
Sedation & ataxia to which tolerance develops
52
Lamotrigine Aes
Sedation, dizziness, ataxia (tolerance to all 3), & skin rashes (S-J)
53
Levetiracetam Aes
Sedation, ataxia
54
Topiramate Aes
Sedation & nervousness to which tolerance develops & hypersensitivity in persons w/ sulfa allergy
55
Topiramate MOA
Slows recovery rate of Na+ channels & potentiates GABA @ GABA(a) receptors
56
Topiramate treats what?
Partial, Generalized Tonic-Clonic, prophylaxis of migraine, weight loss (in combo w/ phentermine)
57
Risk factors for reoccurence of seizures includes epilepsy onset before or after childhood?
After
58
Status Epilepticus 1st line Tx
Lorazepam IV
59
Temporal lobe epilepsy --> Type of seizure?
Complex partial seizure with automatisms
60
Tx for epilepsy includes how many drugs?
Monotherapy
61
Seizure med that's only used for focal seizures?
Carbamazepine
62
Causes of seizures in infancy (0-2 yrs)
Intracranial birth injury, acute metabolic insult, congenital malformations/genetic disorders
63
Causes of seizures in childhood (2-10 yrs)
Idiopathic
64
Causes of seizures in adolescence (10-18 yrs)
Idiopathic, Trauma
65
Causes of seizures in early adulthood (18-35 yrs)
Trauma, Drug/alcohol withdrawal
66
Causes of seizures in middle age (35-60)
Brain tumor, Trauma
67
Causes of seizures in older age (>60 yrs)
Stroke, Degenerative disease, Brain tumor
68
Evaluation of patient w/ seizure
HISTORY & PE, Neuroimaging, EEG, (LP)
69
Differential diagnosis of seizures (5)
Syncope, Cerebrovascular disorders, Migraine, Sleep disorders, Psychogenic disturbances
70
1 Commonly found lesion after resective surgery for medically refractory partial epilepsy?
Medial Temporal Sclerosis
71
6 ligand-gated ion channels (all others are G protein-coupled receptors)
Nicotinic ACh, GABA(a), most glutamate, aspartate, glycine, 5HT(3)
72
Ligand gated ion channels: Ion channel is a ____
tetramer or pentamer
73
Ligand gated ion channels: each subunit has _____ transmembrane domains
four
74
ACh blockade often causes _____ (3 things)
Sedation, Amnesia, Antiemetic activity
75
What increases affinity of GABA receptor for GABA?
Endozepine
76
Baclofen MOA
GABA(b) agonist
77
Baclofen effect/use
Centrally-acting muscle relaxant
78
Excessive activity of _____ ass'd w/ neuronal death
NMDA receptor
79
NMDA antagonists produce ____ (2 things)
Analgesia & Dissociative anesthesia
80
Dopamine prevalent in what 3 structures of brain?
Basal ganglia, nucleus accumbens, amygdala
81
Neurotransmitter important in regulating movement & behavior
Dopamine
82
Dopamine antagonists effective in ____ (2 conditions) & have a ______ effect
Mania & Schizophrenia ; antiemetic effect
83
CNS alpha-1 adrenoceptor agonists (NE) effects
Increase alertness, arousal, mood. Decrease appetite
84
CNS alpha-2 adrenoceptor agonists (NE) effects
Antihypertensive & Sedation
85
CNS beta-1 adrenoceptor agonists (NE) effects
increase mood
86
5HT(1) agonists effect
migraine & anxiety
87
5HT(2) agonists effect
Cause hallucinations
88
5HT(2) antagonists effect
Treat psychoses & migraine
89
5HT(3) antagonists effect
Treat severe nausea
90
Histamine receptor effects (H1-H4)
H1: Allergy, H2: Gastric secretion, H3 agonist: Sleep, H3 antagonist: Wakefulness & Anticonvulsant, H4: Hematopoietic cells
91
Enkephalins
Primarily in spinal cord. Endogenous δ-opioid agonists
92
Dynorphins
endogenous κ-opioid agonists. κ-opioid receptor most prevalent opioid receptor in CNS
93
Most prevalent opioid receptor in CNS
k-opioid receptor
94
Endorphins
endogenous μ-opioid agonists
95
Endorphins effect
Decrease BP both centrally & peripherally
96
Where are glycine receptors primarily located?
Brain stem & spinal cord
97
Inhibition of ______ release is an important mechanism of opioid analgesia
substance P
