elm 7.2

Question 1

phenytoin is structurally related to _______. it stabilizes ________ channels in the _______ state. it’s effective against ______ and ___ seizures, and can worsen ____ and ____ seizures

Answer 1

barbiturates
voltage gated sodium
inactivated
tonic-clonic
partial
absence
myoclonic

Question 2

what are some side effects of phenytoin?

Answer 2

teratogenic - birth defects
lupus
cerebellar atrophy
acne, hirsuitism
gingival overgrowth (gums)

Question 3

carbamazepine blocks _______ channels. it is the first line treatment for ____ seizures, and is useful in _____ seizures.

Answer 3

voltage-gated sodium
focal
tonic clonic

Question 4

carbemazepine auto-induces ______, which is an enzyme that metabolizes it

Answer 4

CYP3A4

Question 5

what are some side effects of carbamazepine?

Answer 5

teratogenic
risk of lupus
worsens JME, absence seizures
cognitive problems, mood changes

Question 6

lamotrigine is a _____ channel blocker, and is a first line treatment for ____ seizures. it is a second line treatment for ____ seizures. it can also be used to treat ________.

Answer 6

sodium
toni-clonic
absence
BPD

Question 7

lamotrigine side effects

Answer 7

sedation, sleep disturbances, rash
binds to eye pigment

Question 8

in epilepsy, we have too much ___, and too little ___

Answer 8

excitation
inhibition

Question 9

GAGAergic transmission is _____

Answer 9

inhibitory

Question 10

benzodiazepines potentiate actions of ____ receptors.

Answer 10

GABAa

Question 11

clobazam is an ____ medication that can be used to treat ____

Answer 11

adjunct
anxiety

Question 12

the side effects of benzodiazepines can be what

Answer 12

sedation, tolerance dependence
seizures on withdrawal

Question 13

barbiturates have a similar action to ______ but have worse side effects

Answer 13

benzodiazepines

Question 14

tiagabine is a ___ inhibitor and is an adjuvant medication for ____ seizures. it can also be used for _____ and _____

Answer 14

GAT1
partial
panic attacks
neuropathic pain

Question 15

what are some side effects of tiagabine?

Answer 15

sedation, dizziness
paraesthesias (pins and needles)
provokes seizures in non-epileptic patients
overdose

Question 16

vigabatrin is an irreversible ____ inhibitor, and an ____ medication. it can also be used for ____ and ____

Answer 16

GABAt
adjuvant
addictions
panic attacks

Question 17

what are some side effects of vigabatrin?

Answer 17

visual disturbances
depression, psychosis, sedation
teratogenic actions

Question 18

what are the three forms of sodium valproate?

Answer 18

sodium valproate
valproic acid
mixture = valproate semisodium

Question 19

what are some valproate side effects?

Answer 19

liver toxicity
teratogenic - folic acid antagonist
cognitive changes, brain structure changes with long term use

Question 20

gabapentin/pregabalin has structures similar to _____, but it is believed to act on ___ subunits of ___ channels

Answer 20

GABA
alpha2gamma
calcium

Question 21

pregabalin increases ____ levels

Answer 21

GAD

Question 22

when one of the AA (leucine, isoleucine) is bound, ___ channel complex is brought up to cell surface. when gabapentin binds, calcium channel complex is retained within cell and _________. the effect of these drugs is to_________ the number of calcium channel complexes on the surface

Answer 22

calcium
broken down
decrease

Question 23

what are the side effects of gabapentin / pregabalin?

Answer 23

sedation / dizziness
suicidal thoughts
abuse potential
seizures upon withdrawal

Question 24

ethosuximide blocks ___ type calcium channels and is the first choice drug for ___ seizures

Answer 24

T
absnece

Question 25

ethosuximide lacks the ____ seen with valproate

Answer 25

liver toxicity

Question 26

leviteracetam can be used for ___, ____ and _____ seizures

Answer 26

focal tonic-clonic myoclonic

Question 27

leviteracetam reduces ___ release

Answer 27

NT

Question 28

what is a syndrome that can be a side effect of leviteracetam?

Answer 28

stevens-johnson syndrome

Question 29

topiramate is used as an ___ treatment for ____ and ____ seizures

Answer 29

adjunct focal tonic-clonic

Question 30

what kind of diet can help with epilepsy?

Answer 30

ketogenic

Question 31

epilepsy surgery

Answer 31

hemispherectomy corpus callostomy

Question 32

what are some future treatments for epilepsy?

Answer 32

optogenetics - light gated channels or pumps to modify behaviour of neurons DREADDs - designer receptors exclusively activated by designer drugs

Question 33

Which category of controlled drugs is gabapentin in, under the Misuse of Drugs Act? a. Category A b. Category B c. Category C d. Category D

Answer 33

c

Question 34

Which of the following drugs is likely to worsen absence seizures? a. Carbamazapine b. Ethosuximide c. Lamotrigine d. Sodium valproate

Answer 34

a