Epilepsy And Anti-Epileptic Drugs Flashcards
What is the Jacksonian March?
Seizure affecting specific muscle groups spreading to other groups nearby as excitation in the brain neurones starts to spread to adjacent neurones.
Give two symptoms that can follow a seizure.
Postictal confusion
Todd’s paralysis
Urinary incontinence
Tongue biting
What do you look for on an EEG to asses risk of seizure recurrence?
Unequivocal epileptiform acitvity
Give some Na channel blockers given in epilepsy.
Lamotrigine Sodium valproate Carbamazepine Topiramate Phenytoin
Name 2 calcium channel blockers given in epilepsy.
Sodium valproate
Ethosuximide
What is the MOA of Gabapentin?
Improved utilisation of the GABA precursor glutamate
Name 2 drugs involved in the allosteric enhancement of GABA action at the synaptic junction.
Phenobarbital (barbiturate)
Midazolam (benzodiazepine)
Vigabatrin MOA?
Levetiracetam MOA?
GABA transaminase inhibitor preventing breakdown of GABA
Bind to SV2A glycoprotein to inhibit pre-synaptic
Give two side effects that can occur with all antiepileptic drugs.
Fatigue
Dizziness
Ataxia
Diplopia
Which anti epilpetic drug is associated with weight loss?
Weight gain?
Topiramate
Sodium valproate, carbamezepine, Gabapentin
Give two inducers and 1 inhibitor of CYP enzymes (AEDs)
Carbamazepine
Phenytoin
Sodium valproate
What is the first line treatment for generalised or tonic-clonic seizures?
Sodium valproate or Lamotrigine
When should withdrawal from anti-epileptics be considered?
What should you bear in mind?
Seizure free for 2 years atleast.
Increased risk of seizure
- Since childhood
- More than one drug
- Myoclonic or tonic clonic seizures
- Abrnomal EEG in the last year
- Known underlying brain damage
Give three withdrawal features of antiepileptics.
Anxiety, restlessness, recurrent seizures
Give some ADRs of phenytoin.
Naseau CNS dysfunction (confusion, nystagmus ataxia) Decreased consciousness Coma Arrythmias Gingival hyperplasia Hirsutism
