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PHAR123 > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

What is a seizure?

A

rapid, synchronous, uncontrolled spread of electrical activity due to abnormal function of ion channels and dysregulation of neural networks

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2
Q

What is epilepsy?

A

conditions in which a person has a tendency to recurrent seizures

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3
Q

True or false: men have more seizures than women

A

false
no significant differences by sex

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4
Q

What is the age that has the greatest prevalence of epilepsy?

A

18-44 yrs
75% are diagnosed before age of 30

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5
Q

How many cases of epilepsy enter long-term remission with treatment?

A

65-85%

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6
Q

What are the causes of epilepsy?

A

may be genetic
may be secondary to tumors, infection, head injury, lack of oxygen, metabolic factors, alcohol abuse and stroke
in >50% cases, the cause is unknown

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7
Q

Describe the new classification of seizure types.

A

focal onset
-motor or non-motor (focal to bilateral, tonic-clonic)
generalized onset
-motor (tonic-clonic, other motor), non-motor (absence)
unknown onset
-motor (tonic-clonic, other motor), non-motor (absence)

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8
Q

What is generalized epilepsy?

A

starts on both sides (hemispheres) of the brain

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9
Q

What are the different phases of epilepsy?

A

tonic: stiffening of muscles
atonic: limp muscles
clonic: repeated jerking movements
absence: interruption of consciousness, with blank stare, possibly some motor symptoms

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10
Q

What are the motor symptoms of epilepsy?

A

may be tonic, clonic or aclonic, or brief muscle twitching (myoclonus)
may also be automatisms or repeated automatic movements, like clapping of hands, lipsmacking or chewing, pacing in circles

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11
Q

What are the non-motor symptoms of epilepsy?

A

changes in senations, emotions, thinking or cognition, autonomic functions (such as GI sensations, waves of heat or cold, goosebumps, heart racing, etc) or lack of movement

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12
Q

Describe what occurs do the different lobes of the brain during seizures.

A

frontal lobe:
-loss of motor control, change in behavior, or change in language expression
occipital lobe:
-changes in vision
parietal lobe:
-numbness/tingling, burning or cold sensations
temporal lobe:
-odd smell or taste, changes in hearing, panic

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13
Q

Differentiate between excessive excitation and not enough inhibition.

A

excessive excitation:
-inward Na and Ca currents
-excitatory neurotransmitters: glutamate, aspartate
not enough inhibition:
-inward Cl and outward K currents
-inhibitor neurotransmitters: GABA

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14
Q

What is surround inhibition?

A

focuses signals via stimulating inhibitory GABAergic neurons to block excitation lateral to the main stimulus

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15
Q

What are the drugs used for partial seizures?

A

carbamazepine
lamotrigine
oxcarbazepine
sodium valproate

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16
Q

What are the drugs used for tonic-clonic seizures?

A

carbamazepine
lamotrigine
sodium valproate

17
Q

What are the drugs used for myoclonic seizures?

A

sodium valproate

18
Q

What are the drugs used for absence seizures?

A

ethosuximide
sodium valproate

19
Q

What are the drugs used for atonic seizures?

A

sodium valproate
lamotrigine
clonazepam

20
Q

What is the MOA of sodium channel blockers?

A

blocks voltage-gated sodium channels by selectively binding to the channel in the inactive state and slowing its rate of recovery
enhanced Na channel inactivation

21
Q

What are examples of sodium channel blockers?

A

phenytoin
carbamazepine
lamotrigine
lacosamide

22
Q

What are the two types of calcium channels?

A

T type (slow) calcium channels
-usually inactive in the awake state
-used for absence seizures (ethosuximide)
high-voltage activated calcium channel
-controls entry of calcium into the presynaptic nerve terminal and regulates neurotransmitter release such as glutamate and norepinephrine
-these drugs also have other effects
-used mainly for focal seizures as adjunct therapy
-gabapentin, pregabalin

23
Q

What are examples of calcium channel blockers?

A

ethosuximide
valproic acid
gabapentin
pregablin

24
Q

Differentiate between AMPA and NMDA.

A

AMPA: glutamate receptor (excitatory), also ion channel for Na and K
NMDA: glutamate receptor (excitatory), also ion channel for Na, K, and Ca

25
Q

Why do we titrate doses of antiseizure medications?

A

avoid adverse effects

26
Q

True or false: many antiseizure drugs have drug-drug interactions that need to be checked before initiating therapy

A

true

27
Q

What are the drugs that inhibit glutamate receptors and SV2A?

A

levetiracetam (SV2A)
felbamate (NMDA)
lamotrigine (NMDA)
topiramate (NMDA)

28
Q

What are the drugs that enhance GABA-mediated inhibition?

A

benzodiazepines (-pam)
barbiturates (phenobarbital)
vigabatrin

PHAR123 (15 decks)

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