Epilepsy Flashcards
What is epilepsy
Recurrent seizures
More than 2 - 24 hours apart
What is epilepsy a result of?
Imbalances between excitatory GLUTAMATE and Inhibititory GABA neurotransmitters
AND
excessive ACh, NA, 5HT levels
Are isolated seizures or seizures secondary to reversible causes- also referred to as epilepsy?
No!
Epidemiology of epilepsy
5% will have seizures
2,3 times mortality rate
Symptoms of partial (focal onset) epilepsy?
One hemisphere
No Define symptoms
Symptoms of
Generalised onset epilepsy
Both hemispheres
Bilateral motor symptoms
- absence
- tonic (muscle rigidity
- clonic ( rhythmic movements
- mycologist (Jerk
- tonic-clonic
- atonic (muscle flaccidity
Treatment of immediate seizures
Benzodiazepine
Pharmacoltherpay and MOA
- Modulation of voltage gates cation channels
- Modulation of voltage gates cation channels
- Na channel: phenytoin, carbamezapine, oxcarbamezepine, lamptrigine, topiramate
- Ca channel: ethosuxamide, pregablin, zonisamide
Pharmacotherapy and MOA
- Enhance GABAnergic system
GABA RECEPTOR ACTIVATION
= barbiturates, felbamate
GABA POTENTIATION
= barbiturates, benzodiazepines
GABA REUPTAKE INHIBITOR
= tiagabine
GABA METABOLISM INHIBITOR
= vigabatrin
Pharmacotherapy and MOA
- Decrease glutamate transmission
NMDA RECEPTOR INHIBITON
= felbamate
AMPA RECEPTOR INHIBITION
= perampanel
KAINATE NON-NMDA inhibition
= topiramate
GLUTAMATE RELEASE INHIBITOR
= lamotrigine, zonisamide
First line drugs for epilepsy
- Carbamezapine
- Sodium valporate
(Tetrogenicity = ceiling dose of 600mg for females)
Second line drugs for epilepsy
- Lamotrigine
= For partial and general onset - Oxcarbazepine
= partial and gen. Tonic,clonic - Ethozuxamide
ABSENCE SEIZURES(1ST) - Levetiracetam
TONIC-CLONIC SEIZURES (1ST) - VIGABATRIN
refractory epilepsy
Bone health in epilepsy
Long term adverse effect is increases bone turnover
Use Vit D and Calcium
