C2 - antiepileptics

Question 1

Zolmitriptane

Answer 1

A: triptane
B: agonist of serotonin R 5HT1D and 5HT1B
-> intracranial vasoconstriction 
-> anti-inflammatory 
C: migraine

Question 2

Carbamazepine

Answer 2

A: antiepileptic, CYP-450 inductor (drug interactions)
B: inhibits uptake&release of Norepinephrine
blocks Na+ channels
-> reduce excitement of neurons
C: epilepsy: grand mal, partial/facial
manic episodes of bipolar disease

Question 3

Phenobarbital

Answer 3

A: Antiepileptic, Barbiturate, sedative, CYP-450 inductor(drug interactions)
B: direct activation of GABA R
C: isomnia, epilepsy 2nd line for grand mal

Question 4

Valproic acid

Answer 4

A: antiepileptic
B: increases levels of GABA in brain (Na+ and Ca2+ blocker)
C: epilepsy: grand mal, partial/facial, petite mal
manic episodes of bipolar disease
-> very teratogenic!

Question 5

Gabapentine

Answer 5

A: Antiepileptic (new)
B: GABA analogue
C: epilepsy: partial/facial

Question 6

Pregabaline

Answer 6

A: antiepileptic (new)
B: acting like GABA,
blocking glutamate,
Inhibits Ca2+ influx on presynaptic neuron
-> analgetic, anxiolytic, sedative
C: partial/facial epilepsy, neuralgia, anxiety

Question 7

Lamotrigine

Answer 7

A: antiepileptic (new)
B: delays release of Glutamic acid and blocks Na+ channels
-> anticonvulsive
C: epilepsy: grand mal, partial/facial, petite mal
prophylaxis of depressive episodes in bipolar disease

Question 8

Ethosuximide

Answer 8

A: antiepileptic, succimide
B: blocking Ca2+ channels
C: petit mal epilepsy

Question 9

Trihexyphenidyl

Answer 9

A: antiparkinson, anticholinergic
B: anticholinergic, blocks muscarinic R
C: 1st line for tremor, also against side effects of anispychotics (extrapiramidal side effects)

Question 10

Selegiline

Answer 10

A: Aniparkinson, MAO-inhibitor
B: inhibits MAO-B irreversible
and blocks dopamin degeneration
C: symptomatic treatment of parkinson
adjunctive therapy for patients with decreased response to levodopa-carbidopa
mono therapy in newly diagnosed parkinson

Question 11

Levodopa/Benzerazid

Answer 11

Levodopa:
A: antiparkinson
B: crosses blood brain barrier (BBB) and converts to dopamin

Benzerazid:
A: decarboxylase inhibitor
B: decarboxylase is converting levodopa into dopamine. We need dopamine in CNS against parkinson BUT NOT in periphery (it causes side effects in periphery). Benzerazid does NOT cross BBB, thus it lets levodopa time to cross the BBB without being converted to dopamine too early (in periphery)
C: 1st line symptomatic treatment of early parkinson (most effective!)
1st line tremor treatment
idiopathic parkinson

Question 12

Pramiracetam

Answer 12

A: nootropic drug, GABA derivative
B: imitate metabolic effects of GABA & normalize impaired cerebral function
C: cerebrovascular insufficiency,
improves memory & learning, cognitive impairment (especially in elderly), atherosclerosis of cerebral BV

Question 13

Piracetam

Answer 13

A: nootropic drug, GABA derivative
B: imitate metabolic effects of GABA & normalize impaired cerebral function
increases cellular metabolism and oxygen supply of brain tissue
C: cerebrovascular insufficiency,
improves memory & learning, cognitive impairment (especially in elderly), atherosclerosis of cerebral BV

Question 14

Phenibute

Answer 14

A: nootropic drug
B: GABA-B agonist (not GABA-A like benzodiazepines)
-> anxiolytic, neuroleptic
C: anxiety and insomnia in soviet union, dietary supplement (= increasing cell metabolism) in EU

Question 15

Memantine

Answer 15

A: NMDA-antagonist
B: non-competitive NMDA-R antagonist (glutamate R excitation is reason for Alzheimer)
C: symptomatic treatment of medium-severe Alzheimer