Epilepsy Flashcards
Three types of partial seizures (one hemisphere)
- Simple (Sensory disturb under a minute, retained consciousness)
- Complex (1-2 min, aura, lost consciousness)
- 2ndary generalized (turns into generalized)
Six types of generalized seizure
- Tonic/Clonic (grand mal)
- Absence
- Myoclonic + Clonic
- Tonic
- Atonic
- Status epilepticus
Some etiologies of seizures
Stress, Head trauma, Infection, Fever, Tumors, Brain Malformations, Genetic Factors
5 Main kinda of glutamatergic anti-seizure drug classes
VG Na Channel VG Ca Channel K Channels AMPAR NMDAR
Important details on VG Na Channel drugs. Examples?
Slow recovery from inactivation, preventing high frequency spiking.
Phenytoin, Carbamazepine, Lamotrigine, Lacosamide
Important details on VG Ca channel drugs. Examples?
Drugs diminsh excitability, esp. at synapse
Ethosuximide, lamotrigine, gabapentin, pregabalin
Important details on K Channels
K channel opener, prolongs refractory period, stop high freq.
Retigabine
What do AMPAR receptor drugs do. Name some
Blocking to diminish excitability
Phenobarbitol, topiramate, Lamotrigine
What do NMDAR receptor drugs do. name one
block will diminish excitability, inhib. LTP
Felbamate
Why do anticonvulsants appear to selectively suppress firing in parts of the brain
They interact with specific stages of the voltage fated sodium channel. With each contraction they are able to build up.
How does voltage-dependent block work?
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.
Three main types of GABAergic anti-seizure drugs.
- GAT-1 - blocking transporter permits GABA buildup
- GABA-T transaminase that breaks down GABA
- GABAAR - benzos act at allosteric site, augmenting Cl-
Name a GAT-1 anti-seizure drug
Tiagabine
Name a GABA-T drug
Vigabatrin
Name a GABA AR example
benzos
“Standard” Epilepsy drugs
Phenytoin Carbamazepine Ethosuximide Phenobarbital benzos Valproate
How does Ethosuximide work?
Specifically blocks T-Type Ca2+ channels
Only useful for absence seizures
Two main types of Benzos used for seizures. Whats the difference
Diazepam – 46 hr half life
Lorazepam – longer half life
What types of seizures do you give a benzo for?
Status epilepticus
Seizure Clusters
Phenobarbitol is used to treat which seizure conditions
Partial Seizures
Tonic Clonic
GABApentin mechanisms of action. used for?
Blocks presynaptic voltage gated Ca channels, enhance GABA levels
Used for partial, generalized, and gen. t/c seizures
Lamotrigine. MOA and reason why
Blocs voltage gated sodium channels as well as L type Ca channels, suppressing excitatory activity
used for Partial, myoclonic, and absence seizures
Tiagabine. MOA and indication
blocks GAT1, resulting in increased GABA, inhibiting post-synaptic.
Partial seizures + psychiatric disorders
Topiramate. MOA and Indication
Blocks VG Na channels, potentiates GABA, antagonizes Glu
Partial + Tonic/Clonic Seizures
Valproate. MOA and Indication
DRUG OF CHOICE FOR UNAMBIGUOUS IDIOPATHIC EPILEPSY
Blocks repetitive via VG Na channels, blocks NMDA, enhances GABAused for absence and generalized T/C
Downsides of Valproate
Teratogenic (spinal bifida)
Avoid in liver disease patients
Myoclonic + Tonic Clonic – who treats both?
Felbamate
Myoclonic + Absence – who treats both?
Clonazepam
Absence + Tonic/Clonic – who treats both?
Gabapentin
Myoclonic + T/C + Absence – who treats them all
Valproate
Lamotrigine
Adverse effects of phenytoin
GINGIVAL HYPERPLASIA
Diplopia, ataxia, hirsuitism, teratogenic
Adverse effects of carbamazepine
Nausia, ataxia, teratogenic
Adverse effects of ethosuximide
GI, sleep disturbances
Drowsiness
Depression
Adverse effects of lamotrigine
Seriosu rash (w. valproate) Myoclonus
Adverse effects of Tiagabine
Somnolence, headache, depression, SEIZURES
Adverse effects of Phenobarbitol
Sedation + Teratogenic
