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Pharm unit 3 > epilepsy > Flashcards

epilepsy Flashcards

0
Q

what do the 2 gaba analogs, that also block ca2+ influx into the presynaptic, treat?

A

used as a adjunct for partial complex epilepsy, also more commonly for neuropathic pain

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1
Q

2 GABA - analogs that also block presynaptic Ca2+ influx

A

gabapentin and pregabalin

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2
Q

which GABA analog is the absorption limited to intestinal AA transport (i.e. a Tm)?

A

gabapentin

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3
Q

which GABA analog has limited protein binding, and is not metabolized, and no interaction with other drugs; therefore few side effects (sedation)?

A

gabapentin (no organ toxicity)

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4
Q

the 4 voltage-gated Na channel stabilizer?

A
  1. phenytoin
  2. carbamazepine
  3. oxcarbamazepine
  4. lamotrigine

(PCOL)

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5
Q

what are the glutamate receptor blockers? (2)

A
  1. topiramate
  2. felbamate

(glue topless and feel circuits together!)

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6
Q

which one of the glutamate receptor blockers works via this mechanism? partial AMPA, Kainate Ca receptor blocker, with a secondary effect on voltage-gated Na channel and GABA system?

A

topiramate

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7
Q 
which one (voltage-gated Na channel stabilizers, gabaergic anti-epileptics, GABA analogs, Glutamate receptor blockers, synaptic vesicle binders, or voltage-gated Ca channel blockers) has the following SE: 
RASH, GINGIVAL HYPERPLASIA, HIRSUTISM, LUPUS-LIKE RX, AND CAN CAUSE CONTRACEPTIVE FAILURE, mild hepatotoxicity and myelosuppression but long term can cause cerebellar degeneration, peripheral neuropathy, and osteoporosis?
A

voltage-gated Na channel stabilizers:

phenytoin

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8
Q

how do the voltage-gated na channel stabilizers work?

A

stabilize inactive conformation of Na channel

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9
Q

which drug of the Na channel blockers is a liver enzyme inducer, highly protein bound, and must increase dose overtime bc of autoinduction?

A

carbamazepine,

phenytoin is also livery enzyme induce, protein bound. it is also assoc with limited IV infusion bc hypotension

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10
Q

which of the sodium channel blockers’s side effects are mostly due to epoxide metabolite?

A

carbamazepine

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11
Q

which drug is used for complex partial epilepsies? also useful for bipolar affective disorder and neuropathic pain?

A

carbamazepine

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12
Q

SE: rash (rarely stevens-johnson), mild myelosuppression, mild LFT inc, can cause contraceptive failure

A

carbamazepine, oxcarbamazepin, lamotrigine (this one needs to be slowly titrated and is indicated in children), phenytoin

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13
Q

which of the Na channel stabilizers can be used in children? used for primary generalized epilepsies, absence seizures, bipolar disorder, neuropathic pain

A

lamotrigine (kids love lamb)

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14
Q

which drug is effective against acute Tonic-clonic seizures, less effective for absence, myoclonic or atonic seizures?

A

phenytoin

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15
Q

Toxicity of the Na channel stabilizers ?

A

dizziness, sedation, ataxia, diplopia

16
Q

which Na channel stabilizer competes for excretion with Valproic acid, and is synergistic with it?

A

lamotrigine

17
Q

IV for status epilepticus, bilpolar tx, migraine, long-term cluster headache prophylaxis?

A

valproate

18
Q

3 GABAergic antiepileptics? (GABA-A system)

A

vigabatrin, tigabine, benzodiazapines

19
Q

which one of the gabaergic anti-epileptics acts at GABA-A receptors and its long term use is limited by tolerance?

A

benzodiazepines

But tigabine and vigabatrin also acts on GABA-A

20
Q

which of the gabaergics act by inhibiting GABA reuptake?

A

tigabine ( take a bin to storage stuff (thus increase concentration!))

21
Q

which gabaergic’s binds GABA transaminase to slow down intracellular breakdown of GABA?

A

vigabatrin (bats … nights…pretty slow…thus inc gaba)

22
Q

which drug is only effective against absence seizures?

A

ethosuximide

23
Q

ethosuximide (class and mech?)

A

voltage-gated Ca channel blocker, blocks T-type Ca channels in thalamo-cortical circuits

24
Q

SE: sedation, cognitive, “word finding”, kidney stones (bc of some carbonic anhydrase activity, modest weight loss, RARE acute angle closure GLAUCOMA, sedation

A

topiramate

25
Q

mild metabolic acidosis –> resp compensation –> mild alkalosis –> calcium ionization –> tingling. which drug does this and what do you use to prevent this?

A

topiramate, vitC (acidfies urine)

26
Q

what are the two glutamate receptor blockers again?

A

topiramate, felbamate

27
Q

NMDA receptor blocker with secondary effect at voltage-gated Na and Ca channels, GABA system

A

felbamate

28
Q

SE: aplastic anemia, acute hepatic failure, only use for medially refractory epilepsy….requires monitoring

A

felbamate

29
Q

synaptic vesicle binder

A

levetiracetam

30
Q

levetiracetam

A

binds synaptic vesicle protein 2 –> leads to les NT release

31
Q

SE: TCP, irritability, aphasia

A

levetiracetam

Pharm unit 3 (19 decks)

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