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PharmQ1Questions > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

What are the clinical manifestations of epilepsy?

A

Alterations f consciousness, motor, sensory, automatic or psychic events

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2
Q

Which drugs can causes seizures?

A

Antimicrobials, anesthetics and analgesics, immunosuppressant, theophylline, sedative hypnotic drug withdrawal, drugs of abuse, flumazenis

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3
Q

What is the most common neurologic disorder in children?

A

seizures

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4
Q

Seizures originate from what matter?

A

Gray

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5
Q

What does prolonged seizure activity result in?

A

Lactic acidosis, rhabdomylosis, hyperkalemia, hyperthermia, and hypoglycemia,

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6
Q

What are some causes of 2ndary epilepsy ?

A

Tumor, head injury, hypoglycemia, meningitis, rapid ETOH withdrawal

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7
Q

Does focal or generalized account for 80% of

A

Focal

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8
Q

What are the automatic symptoms of focal seizures?

A

Pallor, flushing, vomit, sweat, vertigo, tachycardia

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9
Q

What is a prodrome?

A

Awareness of an impending seizure

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10
Q

What is an aura?

A

Simple focal

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11
Q

What are examples of automatisms

A

Lip smacking, chewing, swallowing, abnormal tongue mvmt, thrashing, fumbling or snapping

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12
Q

Drugs that modulate GABA receptors affect what?

A

Arousal and attention, memory formation, anxiety, sleep, muscle tone,

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13
Q

What are the 3 ways anticonvulsants work in the brain?

A

Prolonged inactivation of voltage sensitive Na channel

Enhanced GABA-mediated inhibition
Reduced glutamate

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14
Q

What AEDs affect voltage gated Na channels

A

Carbamazopinem, oxcarbazepine, phenytoin, lamotraine, zanisamide, lacosamide, rufinamide, eslicarbazepine

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15
Q

Is carbamazepine indicated in absence seizures

A

NO

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16
Q

Phenytoin blocks NA channels and affects what other system?

A

2nd messenger

17
Q

Lamotrigine is used in what type of seizure?

A

Absence

18
Q

Which if the NA channel AEDs cannot be given to ppl with a sulfa allergy?

A

Zonisamide

19
Q

T/F- lacosamide is 100% absorbed orally?

A

TRUE

20
Q

Which AED specifically inhibits Ca channels? What is it indicated for?

A

Ethosuximide

DOC(drug of choice) for absence seizures

21
Q

What are the GABA affecting AEDs

A

Phenobarbital, vigabatrin, benzos, tiagabine, clobazam

22
Q

Which of the GABA affecting AEDs is an irreversible inhibitor of GABA transaminase?

A

Vigabatrin

23
Q

Which drugs affect Glutamate receptors?

A

AMPA/ NMDA antagonists,

24
Q

When are NMDA antagonists strictly used? What can this lead to? Is this a black box warning?

A

Refractory Lennox- gastault syndrome

Aplastic anemia and liver failure
YES

25
Q

What are the most important factors in choosing a drug

A

Tolerability and long term safety

26
Q

After how many years can AEDs be discontinued?

A

Seizure free 2-5 years and have a normal neuro exam and IQ

27
Q

If drugs are discontinued, how should you stop them?

A

Titrate off over several months

28
Q

What are the 3 phases for treating SE?

A

Initial assessment and supportive care, initial therapy with a benzo, urgent therapy that achieves LT control with non-benzo AED

29
Q

1st and 2nd line tx for SE

A

Benzo, then nonbenzo AED

30
Q

How do benzos work

A

Act as positive allosteric modulators by enhancing channel gating presence of GABA

31
Q

When are benzos not indicated?

A

If sz has already stopped or for maintenance therapy

32
Q

Why is lorazepam preferred to diazepam secondary to DOA?

A

Diazepam is highly liophilic and quickly redistributes out of the brain to other fat stores

33
Q

Which benzo can be given IM

A

Midazolam

34
Q

What is given second line if sz continues after 2-3 doses of benzos

A

Hydatoins, LOADING dose

35
Q

Phenytoin is an antiarrhythmic and a what?

A

Teratogen- fetal hydatoin syndrome

36
Q

What is a 3rd line agent given if sz persists despite 2-3 doses of benzos and a loading dose of hydantoin? Could be 2nd line if hydatoins are contraindicated

A

Phenobarbital

better with pediatrics

PharmQ1Questions (13 decks)

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