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Pharm Penultimate Exam > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

Three types of partial seizures (one hemisphere)

A
  1. Simple (Sensory disturb under a minute, retained consciousness)
  2. Complex (1-2 min, aura, lost consciousness)
  3. 2ndary generalized (turns into generalized)
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2
Q

Six types of generalized seizure

A
  1. Tonic/Clonic (grand mal)
  2. Absence
  3. Myoclonic + Clonic
  4. Tonic
  5. Atonic
  6. Status epilepticus
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3
Q

Some etiologies of seizures

A

Stress, Head trauma, Infection, Fever, Tumors, Brain Malformations, Genetic Factors

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4
Q

5 Main kinda of glutamatergic anti-seizure drug classes

A 
VG Na Channel
VG Ca Channel
K Channels
AMPAR
NMDAR
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5
Q

Important details on VG Na Channel drugs. Examples?

A

Slow recovery from inactivation, preventing high frequency spiking.

Phenytoin, Carbamazepine, Lamotrigine, Lacosamide

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6
Q

Important details on VG Ca channel drugs. Examples?

A

Drugs diminsh excitability, esp. at synapse

Ethosuximide, lamotrigine, gabapentin, pregabalin

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7
Q

Important details on K Channels

A

K channel opener, prolongs refractory period, stop high freq.

Retigabine

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8
Q

What do AMPAR receptor drugs do. Name some

A

Blocking to diminish excitability

Phenobarbitol, topiramate, Lamotrigine

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9
Q

What do NMDAR receptor drugs do. name one

A

block will diminish excitability, inhib. LTP

Felbamate

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10
Q

Why do anticonvulsants appear to selectively suppress firing in parts of the brain

A

They interact with specific stages of the voltage fated sodium channel. With each contraction they are able to build up.

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11
Q

How does voltage-dependent block work?

A

Nerves that are depolarized are better at being blocked than hyperpolarized ones. The hyerpolarized potential unbinds the lidocaine. In a depolarized nerve, lidocaine can’t funny unbind allowing the continued suppression of activity form this nerve.

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12
Q

Three main types of GABAergic anti-seizure drugs.

A
  1. GAT-1 - blocking transporter permits GABA buildup
  2. GABA-T transaminase that breaks down GABA
  3. GABAAR - benzos act at allosteric site, augmenting Cl-
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13
Q

Name a GAT-1 anti-seizure drug

A

Tiagabine

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14
Q

Name a GABA-T drug

A

Vigabatrin

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15
Q

Name a GABA AR example

A

benzos

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16
Q

“Standard” Epilepsy drugs

A 
Phenytoin
Carbamazepine
Ethosuximide
Phenobarbital
benzos
Valproate
17
Q

How does Ethosuximide work?

A

Specifically blocks T-Type Ca2+ channels

Only useful for absence seizures

18
Q

Two main types of Benzos used for seizures. Whats the difference

A

Diazepam – 46 hr half life

Lorazepam – longer half life

19
Q

What types of seizures do you give a benzo for?

A

Status epilepticus

Seizure Clusters

20
Q

Phenobarbitol is used to treat which seizure conditions

A

Partial Seizures

Tonic Clonic

21
Q

GABApentin mechanisms of action. used for?

A

Blocks presynaptic voltage gated Ca channels, enhance GABA levels
Used for partial, generalized, and gen. t/c seizures

22
Q

Lamotrigine. MOA and reason why

A

Blocs voltage gated sodium channels as well as L type Ca channels, suppressing excitatory activity

used for Partial, myoclonic, and absence seizures

23
Q

Tiagabine. MOA and indication

A

blocks GAT1, resulting in increased GABA, inhibiting post-synaptic.

Partial seizures + psychiatric disorders

24
Q

Topiramate. MOA and Indication

A

Blocks VG Na channels, potentiates GABA, antagonizes Glu

Partial + Tonic/Clonic Seizures

25
Q

Valproate. MOA and Indication

A

DRUG OF CHOICE FOR UNAMBIGUOUS IDIOPATHIC EPILEPSY

Blocks repetitive via VG Na channels, blocks NMDA, enhances GABAused for absence and generalized T/C

26
Q

Downsides of Valproate

A

Teratogenic (spinal bifida)

Avoid in liver disease patients

27
Q

Myoclonic + Tonic Clonic – who treats both?

A

Felbamate

28
Q

Myoclonic + Absence – who treats both?

A

Clonazepam

29
Q

Absence + Tonic/Clonic – who treats both?

A

Gabapentin

30
Q

Myoclonic + T/C + Absence – who treats them all

A

Valproate

Lamotrigine

31
Q

Adverse effects of phenytoin

A

GINGIVAL HYPERPLASIA

Diplopia, ataxia, hirsuitism, teratogenic

32
Q

Adverse effects of carbamazepine

A

Nausia, ataxia, teratogenic

33
Q

Adverse effects of ethosuximide

A

GI, sleep disturbances
Drowsiness
Depression

34
Q

Adverse effects of lamotrigine

A 
Seriosu rash (w. valproate)
Myoclonus
35
Q

Adverse effects of Tiagabine

A

Somnolence, headache, depression, SEIZURES

36
Q

Adverse effects of Phenobarbitol

A

Sedation + Teratogenic

Pharm Penultimate Exam (12 decks)

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