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CPTP stage 4 > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

Describe Grand Mal epilepsy

A
  • tonic clonic
  • random frequency
  • loss of consciousness, bladder control
  • post ictal coma
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2
Q

Describe Petit Mal epilepsy

A
  • absence seizure
  • regular frequency (3Hz)
  • no motor symptoms
  • no post ictal coma
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3
Q

Describe Status Epilepticus

A
  • 30min continuous tonic clonc seizures, unconsciousness
  • fever sweating, hypertension
  • anoxia/hypoxia
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4
Q

Drugs for grand mal

A

Carbamazepine, phenytoin, valproate, lamotrigine, barbiturates

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5
Q

Drugs for petit mal

A

Ethosuxamide

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6
Q

Drugs for status epilepticus

A

Phenytoin, BZDs

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7
Q

Adjunct anti-epileptic drugs

A

Gabapentin, Vigabatrin, Tigabide

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8
Q

Phenobarbitone, pentabarbitone

Pharmacodynamics + clinical use

A

Positively modulate GABA-A receptor, increases postsynaptic GABAergic transmission

Clinical use:
Grand mal

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9
Q

BZDs: Clonazepam, clobazam, diazepam

Pharmacodynamics + clinical use

A
  • Positively modulate GABA-A receptor, increases postsynaptic GABAergic transmission
  • increases frequency of Cl channel opening

Clinical use:
status epilepticus

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10
Q

Valproate

Pharmacodynamics + clinical use

A

-Blocks repetitive firing from voltage gated Na channels

Clinical use:
Grand mal, partial

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11
Q

Carbamazepine

Pharmacodynamics + clinical use + significant side effects

A

-Blocks repetitive firing from voltage gated Na channels

Clinical use:
Grand mal, partial epilepsy, trigeminal neuralgia

Significant side effects:
Agranulocytosis, aplastic anaemia

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12
Q

Lamotrigine

Pharmacodynamics + clinical use

A

-Blocks repetitive firing from voltage gated Na channels

Clinical use:
Grand mal, partial

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13
Q

Phenytoin (hydantoin)

Pharmacodynamics + clinical use + significant side effects

A

-Blocks repetitive firing from voltage gated Na channels

Clinical use:
status epilepticus

Significant side effects:
nystagmus

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14
Q

Ethosuximide (succinimide)

Pharmacodynamics + clinical use

A

-Blocks T type calcium channels (involved in generation of 3Hz activity in thalamic neurons)

Clinical use:
Petit mal (ineffective against Grand Mal cos doesn't enhance GABA)
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15
Q

Vigabatrin

Pharmacodynamics + clinical use

A

-Blocks GABA metabolism (GABA transaminase inhibitor)

Clinical use:
adjunct therapy

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16
Q

Tigabide

Pharmacodynamics + clinical use

A

-Blocks GABA reuptake (blocks GABA transporter-1)

Clinical use:
adjunct therapy

17
Q

Gabapentin

Pharmacodynamics + clinical use

A

-GABA agonist

Clinical use:
adjunct therapy

18
Q

Which antipsychotic can cause agranulocytosis and aplastic anaemia

A

Carbamazepine

19
Q

Major side effects of anti-epileptic drugs:

GI

A
  • NnV

- Anorexia

20
Q

Major side effects of anti-epileptic drugs:

CNS

A
  • Ataxis
  • Dizziness
  • Drowsiness
  • Cognitive effects
21
Q

Major side effects of anti-epileptic drugs:

Psych

A
  • Psychosis
  • Agitation
  • Restlessness
  • Night tremors
  • Depression
  • Euphoria
22
Q

Major side effects of anti-epileptic drugs:

Mucosal/ Cutaneous

A
  • Rashes
  • Hair loss/ hirsutism
  • Gum hyperplasia
23
Q

Which anti-epileptics cause drug induced Parkinsonism

A
  • Valproate

- Lithium

24
Q

Describe a simple partial seizure

A

Person away of surroundings

25
Q

Describe a complex partial seizure

A

Person unaware of surroundings

26
Q

Describe a secondary generalised seizure

A

Partial seizure that evolved into generalised seizure

27
Q

Drugs for focal seizure

A
  • Carbamezapine

- Lamotrigine

28
Q

Which contraceptives would not work with anti-epileptics

A
  • Contraceptive patches (combined)
  • Progesterone-only pill
  • Implanon implant (progesterone-only)

Note: COCP must contain at least 50 micrograms oestrogen

29
Q

When should PR diazepam/ buccal midazolam be given to a pt

A
  1. Seizure lasting more than 5min

2. 3 or more seizure within 1h

30
Q

Why is diazepam not given IV

A

It will cause thrombophlebitis

31
Q

Features of sodium valproate teratogenicity

A
  • Spina bifida
  • Facial and skull malformations (including cleft lip, palate)
  • Malformations of limbs, heart, kidneys, urinary tract, sexual organs
  • Developmental problems
  • Increased risk of ASD, ADHD
32
Q

What antiepileptics are safe in pregnancy

A
  1. Levetiracetam

2. Lamotrigine

33
Q

Which anti epileptics cause cerebellar side effects

A

Phenytoin

Carbamazepine

34
Q

Which anti epileptics cause pancreatitis

A

Valproate

35
Q

Therapeutic range of phenytoin

A

10-20

CPTP stage 4 (21 decks)

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