CNS Anti Epileptic Drugs

Question 1

Anti-epileptic drugs

Answer 1

According to mode of action a) Enhancement GABAergic activity
B) Na+ channel modifier
C) Ca++ channel modifier
Acc to clinical uses = a) 1st line drug b) 2nd line drugs

Acc to types of epilepsy = a) partial seizure \ b) Tonic clonic seizure \ c) absence seizure \ d) myoclonic seizure \ e) Status epilepticus

Question 2

Anti epileptic/ seizure drugs Acc to mode of action

Answer 2

A] ENHANCEMENT OF GABAergic ACTIVITY
Benzodiazepine = Diazepam , Clonazepam
Barbiturate = Phenobarbitones
Gabapentin
Vigabartin

B] NA+ CHANNEL MODIFIER
Phenytoin
Mephenytoin
Na- valproate
Carbamazepine
Oxcarbamazepine
Topiramate

C]CA++ CHANNEL MODIFIER
Ethosuximide
Phensuximide
Methsuximide
Trimethedion

Question 3

Acc to clinical uses // AE drugs

Answer 3

1st line drugs
Phenytoin
Valporic acid
Diazepam
Lorazepam
Carbamazepine
Ethosuximide

2nd line drugs
Phenobarbitone
Lamotrigine
Clonazepam
Gabapentin
Vigabartin
Topiramate

Question 4

Acc to types of seizures

Answer 4

1)PARTIAL SEIZURE (simple + complex)
Carbamazepine , Phenytoin , Na valproate

2) TONIC CLONIC SEIZURE ( grand mal )
Carbamazepine , Phenytoin , Na valproate

3) ABSENCE SEIZURE (petit mal )
Ethosuximide , Na valproate

4) MYOCLONIC SEIZURE
Ethosuximide , Clonazepam

5) STATUS EPILEPTICUS
Diazepam , Phenobarbitone

Question 5

A/E of phenytoin

Answer 5

Hypersensitivity
Sedation
Diplopia
Ataxia
Nystagmus
Osteomalcia
Megaloblastic anemia
Peripheral neuropathy

Question 6

M/A of carbamazepine

Answer 6

Carbamazepine ==> Blocks voltage sensitive Na+ channel ==> (-)generation of rapidly repetitive action potential ==> anti epileptic action

Question 7

Clinical uses of carbamazepine

Answer 7

Partial seizure
Generalised tonic clonic seizure
Trigeminal neuralgia
Diabetic neuropathy
Mania

Question 8

A/e of carbamazepine

Answer 8

Diplopia
Ataxia
Drowsiness
GIT upset
Aplastic anemia
Steven Johnson syndrome

Question 9

Anti epileptic M/A of Na Valporate

Answer 9

Na Valporate = 1) Blocks voltage sensitive Na+ channel ==> (-) generation of rapidly repetitive action potential ==> Anti epileptic action

(2) increase GABA concentration in the brain ==> increase GABA mediated CNS depression ==> Anti epileptic action Action

Question 10

A/E of Na Valporate

Answer 10

Nausea
Vomitting
Epigastic pain
Heart burn
Fine tremor
Hepatotoxicity
Thrombocytopenia
Teratogenecity = Spina Bifida , Orofacial abnormalities , Digital abnormalities