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P&T > Epilepsy > Flashcards

Epilepsy Flashcards

0
Q

Seizure in which a large population of neurons in both hemispheres is involved immediately at the start of the seizure

A

generalized seizure

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1
Q

Seizure in which abnormal firing is limited to a specific area in 1 hemisphere

A

partial seizure

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2
Q

AED that has a weak effect on Na+ channels, increases GABA and decreases Ca2+ channel activity

A

Valproic Acid

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3
Q

AED that acts on Na+ channels as well as decreases glutamate release

A

Lamotrigine

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4
Q

AED that acts on Na+ channels as well as is a GABA agonist and a glutamate antagonist

A

Topiramate

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5
Q

Drug that acts on Na+ channels as well as Ca2+ channels

A

Zonisamide

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6
Q

6 AEDs that mainly act on Na+ channels

A
  1. Carbamazepine
  2. Oxcarbazepine
  3. Eslicarbazepine
  4. Phenytoin
  5. Lacosamide
  6. Rufinamide
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7
Q

Enzyme that synthesizes GABA from glutamate

A

glutamate decarboxylase

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8
Q

Inotropic GABA receptor that is a Cl- channel that is inhibitory of synaptic transmission

A

GABA-A

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9
Q

Metabotropic GABA receptor that inhibits neurotransmitter release

A

GABA-B

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10
Q

AED that is a product of rational drug design and decreases GABA reuptake through GABA transporters into neurons and glial cells

A

Tiagabine

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11
Q

AED that is an irreversible inhibitor of GABA transaminase, which is responsible for GABA metabolism

A

Vigabatrin

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12
Q

Black box warning on vigabatrin

A

irreversible concentric focal field loss

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13
Q

AED that also has sedative properties that binds to GABA-A receptor and increases its response to GABA

A

Phenobarbital

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14
Q

Class of AEDs that enhance the inhibitory action of GABA

A

Benzodiazepines

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15
Q

AED that is a Ca2+ channel inhibitor and is mainly used in absence seizures

A

Ethosuximide

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16
Q

2 AEDs that have a high affinity for the alpha2-delta binding site on voltage-gated Ca2+ channels and decrease the Ca2+-dependant release of neurotransmitters, including glutamate and NE

A

Gabapebtin and pregabalin

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17
Q

AED that binds with high affinity to synaptic vesicle protein (SV2A)

A

Levetiracetam

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18
Q

AED that is a K+ channel opener or stabilizer, stabilizing the resting membrane potential

A

Ezogabine

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19
Q

AED that is a non-competitive AMPA receptor antagonist

A

Perampanel

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20
Q

The hormonal influence on seizures in women who are menstrating

A

catamenial influence

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21
Q

Sudden, uncontrollable electrical discharges in normal brain activity

A

seizure

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22
Q

Recurrent, unprovoked seizures

A

Epilepsy

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23
Q

The most prevalent form of epilepsy

A

complex partial seizures

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24
Q

Seizure that involves loss of consciousness and tonic-clonic movements and often involves tongue bitting or incontinence

A

Grand mal seizure

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25
Q

Seizure that involves a brief episode (2-15 sec.) of staring, unable to respond

A

Absence seizure

26
Q

Seizure that involves brief, bilateral jerk of neck, shoulders and legs

A

myoclonic seizure

27
Q

Seizure that involves brief, bilateral stiffening of the body

A

tonic seizure

28
Q

Seizure that involves sudden loss of muscle tone and people tend to drop things

A

atonic seizure

29
Q

A seizure lasting for >30 min or with no recovery

A

status epilepticus

30
Q

Treatment options for status epilepticus

A

IV benzodiazepines, phenytoin or phenobarbital

31
Q

AED that has saturable metabolism, meaning a small increase in dose may cause a greater than expected increase in drug conc.

A

Phenytoin

32
Q

Toxicities in phenytoin

A

nystagmus, ataxia, gingival hyperpasia, osteomalacia

33
Q

AED in which the liver has auto-induction to and becomes more efficient at clearing the drug over time

A

Carbamazepine

34
Q

Toxicities with carbamazepine

A

dizziness, diplopia, leukopenia, osteomalacia

35
Q

Toxicities with oxcarbazepine

A

dizziness, diplopia, ataxia, hyponatremia

36
Q

Toxicities in lacosamide

A

diplopia, HA, dizziness, nausea

37
Q

AED that is metabolized by CYP3A4 but still has no clinically significant drug interactions

A

lacosamide

38
Q

Uses of carbamazepine outside of epilepsy

A

bipolar disorder, pain

39
Q

Use of lamotrigine outside of epilepsy

A

bipolar disorder

40
Q

Toxicities with lamotrigine

A

sedation, diplopia, ataxia, nausea, rash

41
Q

AED in which estrogen increases its clearance

A

lamotrigine

42
Q

Toxicities in topiramate

A

difficulty concentrating, kidney stones, weight loss

43
Q

Uses of topiramate outside of epilepsy

A

migraine prophylaxis, weight loss

44
Q

AED that is a sulfonamide

A

Zonisamide

45
Q

Toxicities with zonisamide

A

somnolence, dizziness, kidney stones, weight loss

46
Q

Toxicities with phenobarbital

A

sedation, paradoxical hyperactivity, osteomalacia

47
Q

Toxicities with ethosuximide

A

sedation, GI

48
Q

Toxicities with valproic acid

A

sedation, N/V, weight gain, hair loss, tremor, thrombocytopenia (check for bruising)

49
Q

Uses of valproic acid outside of epilepsy

A

migraine prophylaxis, bipolar disorder

50
Q

AED that has saturable absorption

A

Gabapentin

51
Q

Toxicities with gabapentin

A

fatigue, dizziness, ataxia

52
Q

Uses of gabapentin outside of epilepsy

A

post-herpetic neuralgia, diabetic peripheral neuropathy, restless leg syndrome

53
Q

Toxicities with pregabalin

A

dizziness, ataxia, weight gain

54
Q

Uses of pregabalin outside of epilepsy

A

post-herpetic neuralgia, diabetic peripheral neuropathy, firomyalgia, anxiety (off-label)

55
Q

Toxicities with levetiracetam

A

somnolence, dizziness, behavioral changes

56
Q

Toxicities in ezogabine

A

dizziness, fatigue, diplopia, ataxia, urinary retention

57
Q

Black box warning for ezogabine

A

bluish discoloration of skin and ocular toxicity

58
Q

Toxicities with perampanel

A

dizziness, somnolence, irritability, ataxia, weight gain

59
Q

Black box warning for perampanel

A

suicidality and homocidality

60
Q

4 AEDs that are 1st generation

A
  1. Phenobarbital
  2. Phenytoin
  3. Carbamazepine
  4. Valproic acid
61
Q

1st generation AEDs that are enzyme inducers

A

phenobarbital
phenytoin
carbamazepine

62
Q

1st generation AED that is an enzyme inhibitor

A

vaproic acid

P&T (18 decks)

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