epilepsy Flashcards
What is the first-line medication for temporal lobe epilepsy?
( most common type of epilepsy )
What is a side effect of this?
Carbamazepine
Generally well tolerated; Stevens-Johnson syndrome (rare) skin condition.
When would IV phenytoin be used ?
- For status epileptic after benzodiazepines haven’t worked.
What is GABA ?
Main Inhibitory nuertrasmitter in brain.
What is glutamate ?
Min excitable neurotransmitter in the brain.
Whats the main type of medication used in status epiliptus ?
Benzodiazepines - eg lorezapam
Not preferred for long term maintanance due to dependancy and sedation.
How to HVA calcium channel blockers work ?
Give an exmaple
Works by decreasing Ca2+ entry and thus inhibiting synaptic vesicle release, they reduce neurotransmitter release. e.g. prevent glutamate from being released.
Pregablin and Gabapentin
How do LVA Ca2+ channel blockers work ?
What seizure does it work for ?
Give an example.
LVA (T-type) calcium channels are activated at much smaller depolarisations than HVA channels, opening at membrane potentials around -65 to -50mV.
Works for ABSENCE SEZIURES
Ethosuximide
What drug works to stop gaba being taken up by the GABA transported when its released from the synaptic cleft ?
Tiagabine
What is a synaptic vescicle proten 2a inhibitor ?
Levetiracetam (KEPPRA)
heavily used
What synaptic vesicle protein 2a (SV2A) does is not clear, but it is involved in normal vesicle activity, either loading with neurotransmitter or exocytosis. Levetiracetam binds to SV2A and inhibits it. Let’s just say it’s a synaptic vesicle inhibitor.
++tthis is saftety drug for pregnant women
What is the safest anti-epileptic medication for pregnanct women to take ?
Levetiracetam (KEPPRA)
Least chance of birth defects
How do Glutamate receptor antagonists work?
What is it called?
What type of seiure can it be used for ?
Block excitatory neurotransmission at glutamate receptors; AMPA main fast excitatory glutamate receptor.
Perampanel
Used for partial and tonic-clonic seizures
Lamotrigine
Lamotrigine is an important AED that is commonly prescribed. It has relatively low teratogenicity compared to most AEDs although probably not as low as levetiracetam.
Used for all types of epilepsy
Stevens-Johnson syndrome
WHat drugs are at high risk for teratogenicity ?
What epilepsy medication is most common used in uk
What medications are most common for
- generalised tonic clonic
- Absence
- Focal
