Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Brain Power: Neuropharmacology > Epilepsy > Flashcards

Epilepsy Flashcards

You may prefer our related Brainscape-certified flashcards:
The Brain flashcards
1
Q

Identify the site where the following drugs act
Either gluatminergic/GABAergic synapes, presynaptic /postsynaptic
1. Phenytoin, CBZ, LTG, Lacosamide
2. Ethusiximide, LTG, Gabapentin, Pregabalin
3. Levetiracetam
4. Lacosamide
5. Felbamate
6. Topiramate, Perampanel

A

ALL are glutaminergic

  1. PreS VG Na channel
  2. PreS VG Ca++ channel
  3. PreSSV2A synaptic vesicle proteins
  4. PreS Collapsin response mediator protein 2 (CRMP2)
  5. PostS NMDA
  6. PostS AMPA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Identify the site where the following drugs act
Either glutamatergic/GABAergic synapes, presynaptic /postsynaptic
1. Tiagabine
2. Vigabatrin
3. Benzos and Barbiturates

A

ALL act in the GABAergic synapse

  1. PreS GABA transporter
  2. PreS GABA transaminase
  3. PostS GABA A receptor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is AKA diphenylhydantoin?

A

Phenytoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does phenytoin affect Na channels?

A

Binds to and Prolongs the inactivated state of the Na channel resulting in decreased glutamate release– PreSynaptic Glutaminergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the advantages of fosphenytoin over phenytoin?

A

Can be given IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does uremia affect phenytoin?

A

Low protein levels causes more unbound fraction of the drug.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Besides gingival hyperplasia and hirsutism what other adverse effects do we expect from phenytoin? Think cerebellar and eye movements

A

Ataxia, nystagmus, diplopia

But also remember osteomalacia from abnormal vitamin D metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the most common dose related adverse effects of CBZ?

A

Diplopia and ataxia

Hyponatremia, aplastic anemia, leukopenia, agranulocytosis and unsteadiness also occurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the advantage of eslicarbazepine over CBZ and OxCBZ?

A

Once a day dosing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What derivative of barbituric acid is a treatment option for essential tremor and is converted to Pb?

A

Primidone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Besides binding to the GABA receptor what is the other important MOA of Pb?

A

Similar to phenytoin on Na channels presynaptic glutaminergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the therapeutic level of

  1. Phenobarbital
  2. Carbamazepine
  3. Phenytoin
  4. Valproic acid
A
  1. 10-40mcg per ml
  2. 4-8 mcg
  3. 10-20 mcg per ml
  4. 50-100mcg per ml
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the deadly side effects of felbamate?

A

heptitis and aplastic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does the binding of pregabalin and gabapentin to Ca++ channels prevent seizures?

A

Decrease in Ca++ entry in the presynaptic terminal results in decrease in the release of glutamate in the synaptic cleft.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How are pregabalin and gabapentin metabolized?

A

Trick question. They ARE NOT metabolized– rather excreted unchanged in the urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 2 MOA of Lacosamide?

A
  1. Binds the SLOW inactivation of the voltage gated Na channels– PREFERENTIALLY AFFECTS DEPOLARIZED NEURONS
  2. Binds to collapsin response mediator protein CRMP-2
17
Q

Besides the blockade of Na channels how else does lamotrigine function?

A

Inhibits Ca++ channels N and P/Q types

18
Q

How does valproate affect lamotrigine levels?

A

Causes a TWOFOLD INCREASE in the drug’s half life

19
Q

What drug was designed to inhibit GAT-1 thereby increasing GABA available?

A

Tiagabine

20
Q

What are the MOA of Topiramate?

A
  1. Na blocking
  2. L-type Ca channels
  3. GABA postentiation on receptor
  4. Decreases the excitatory effect of kainate on glutamare receptors
21
Q

What drug inhibits GABA-T the enzyme responsible for the degradation of GABA?

A

Vigabatrin

22
Q

What AED causes peripheral visual field defects in 30-50% of patients?

A

Vigabatrin

23
Q

What type of Calcium channels does ethusuximide affect?

A

T-type Ca channels that are thought to provide a pacemaker current in the thalamic neurons responsible for generating rhythmic cortical discharge

24
Q

Enumerate all the MOA of Valproic acid

A
  1. Blocakde of NMDA receptors
  2. Facilitate Glutamic Acid Decarboxylase for GABA synthesis
  3. Inhibit GAT 1 to increase GABA as well
  4. Na channel blocker
25
Q

How does VA affect liver enzymes?

A

Inhibit– increasing lamotrigine, phenytoin, pb, CBZ

26
Q

What are the idiosyncratic reactions observed with Valproic acid?

A
  1. Heptotoxicity needing L-carinitine supplementation

2. Thrombocytopenia

27
Q

What are the two drugs for treatment of infantile spasms?

A

Corticotropin and Vigabatrin

28
Q

What is the MOA of zonisamide?

A

Also by Na block and T type Calcium block

29
Q

What is the only AED drug that works by facilitating the potassium channel in the presynaptic nerve terminal?

A

Retigabine

30
Q

Stiripentol that acts by enhancing GABA transmission by prolonging the opening of Cl- channels in the brain is used for what epilepsy syndrome?

A

Severe myoclonic epilepsy of infancy or DRAVET syndrome

31
Q

How would topiramate affect birth control pills?

A

less effective birth control

32
Q

What is the common moa of zonisamide and ethusuximide? Go beyond the affected ion.

A

Reducing low threshold t type calcium currents affecting thalamic rhythmic cortical dc respnsible for absence (specific for ethusuximide)

Brain Power: Neuropharmacology (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions