Drugs For Seizures Flashcards
Seizure Definition
Electrical disturbances in the brain which affect consciousness, motor activity, and sensation
Can occur in one area=focus
Epilepsy
Any disorder w/ recurrent sizures
Convulsions
Involuntary muscle spasms
All convulsions are sz but not vice versa
Causes of Seizures
Metabolic disorders Infectious diseases Truama Vascular diseases Pediatric disorders/disease Neoplastic disease
Sz drugs can interfere with hormonal contraception T/F
True
Generalized Seizures
Absence-few sec/ day dreaming
Atonic-few sec/ stumbling for no reason
Tonic-clonic- aura preceding/ intense muscle contraction(tonic) followed by alternating contrqction/ relaxation (clonic) - deep sleep after
Special Syndromes (Seizures)
Febrile seizure- pediatric seizure due to rapid inc of body temp.
Myclonic seizure- large jerking movements
Status epilepticus- med emergency/ can lead to death
Epilepsy Treatment
Start with low dose and work up to efficacy to avoid and monitor toxicity
Must taper on/off
Action Potential Review
Depolarization- Na+ into neuron
Repolarization- K+ out of neuron
Hyperpolarization- either neg ions(Cl-) flow into neuron or too many positive (K+) flow out
Anti-epileptic/antiseizure MOA
Inc Cl- influx (chloride channel agonist) -GABA receptors open Cl- channels/ “pumps the brakes”
Dec Na+ influx (Na+ channel antagonist)- “slow down acceleration”
Block glutamate (glutamate antagonist) which prevents influx of positive ions
Block Ca+ influx (Ca channel blocker) prevent vesicle fusion/release of neurotransmitters
Major exitatory neurotransmitter in CNS
Glutamate
Non-Drug approach to Epilepsy
Ketogenic diet
Antiseizure Drugs
Barbiturates Benzodiazepines GABA potentiators Hydantoins Phenytoin-related
Barb- Phenobarbital (Luminal) MoA
GABA receptor agonist/inc chloride influx
CNS depressant
Benzo- diazepam(Valium)
Lorazepam(Ativan) MoA
GABA chloride channel agonists/hyperpolarize neuron to prevent AP
CNS depressant
GABA potentiators (gaba in name) Drugs
Gabapentin (gralise)
Pregabalin (lyrica)
Topiramte (topamax)
GABA poteniators MOA
unclear, but dec neuronal excitability/ CNS depressant
Designed as GABA ag but bind to Ca+
Tx: neuropathic pain
Hydantoins Drugs/MoA
Phenytoin(Dilantin)
Desensitize Na+ channels which prevents repetitive neuronal firing
Phenytoin-related Drugs/MoA
Valproic acid (depakene)
Carbamazepine (tegretol)
Lamotrigine (Lamictal)
Levetiracetam (Keppra)
Similar to phenytoin (Na+ channel antagonist)
Valporic acid (Depakene) Moa
Na+ channel desensitization
+GABA
-Ca+ channel
Reacts with a lot of drugs
Carbamazepine (Tegretol) MOA
Na+ channel desensitization
Less side effects than phenytoin
Lamotrigine (Lamictal) moa
Na+ channel desensitization
*First line for partial, absence, and tonic clonic sz amd can be used for bipolar
Levetiracetam (Keppra) moa
Unclear but (-) Ca+ channels; prevent vesicle release
Fewer adverse affects
Succinimides drugs/moa
Ethosuximide (zarontin)
Dec Ca+ influx to prevent AP
