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BLOCK POSTING > EPILEPSY DRUGS > Flashcards

EPILEPSY DRUGS Flashcards

1
Q

What is epilepsy?

A

A chronic disorder characterized by recurrent seizures due to abnormal synchronized brain activity.

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2
Q

What percentage of patients achieve seizure control with antiepileptic drugs (AEDs)?

A

60-70% achieve adequate control with appropriately chosen AEDs.

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3
Q

When are antiepileptic drugs indicated?

A

When two or more seizures occur within a short interval (6 months - 1 year).

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4
Q

What are common seizure triggers?

A

Fatigue stress

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5
Q

What are the two major types of seizures based on etiology?

A

Primary (idiopathic) and secondary (symptomatic due to an identifiable cause).

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6
Q

What is the mechanism of seizure generation?

A

An imbalance between excitation (glutamate Na+

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7
Q

What is the main excitatory neurotransmitter in the brain? .

A

Glutamate

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8
Q

What is the main inhibitory neurotransmitter in the CNS? .

A

GABA

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9
Q

What are narrow-spectrum antiepileptics?

A

Drugs effective mainly for focal and secondary generalized seizures (e.g. phenytoin

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10
Q

What are broad-spectrum antiepileptics?

A

Drugs effective for both focal and generalized seizures (e.g. valproate

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11
Q

What is the mechanism of action of phenytoin?

A

Blockade of Na+ and Ca2+ channels reducing excitatory transmission and potentiating GABA.

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12
Q

How is fosphenytoin different from phenytoin?

A

Fosphenytoin is a water-soluble prodrug suitable for IV or IM use in status epilepticus.

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13
Q

What are indications for phenytoin?

A

Partial and generalized tonic-clonic seizures and status epilepticus (slow IV infusion).

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14
Q

What are common adverse effects of phenytoin?

A

Gingival hyperplasia hirsutism

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15
Q

What is carbamazepine primarily used for?

A

Partial seizures and tonic-clonic seizures; also used for bipolar disorder and trigeminal neuralgia.

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16
Q

What are the main adverse effects of carbamazepine?

A

GI upset
hyponatremia

17
Q

What is sodium valproate effective for?

A

A broad-spectrum AED for all types of epilepsy including generalized tonic-clonic

18
Q

What are major side effects of sodium valproate?

A

GI upset weight gain

19
Q

What is the primary indication for ethosuximide?

A

Absence seizures especially in children.

20
Q

What is the mechanism of action of ethosuximide?

A

Selective inhibition of T-type Ca2+ channels in thalamic neurons.

21
Q

What are common side effects of ethosuximide?

A

GI distress fatigue

22
Q

What is phenobarbital’s mechanism of action?

A

Potentiates GABA-A receptor activity prolonging Cl- channel opening and reducing excitability.

23
Q

What is phenobarbital used for?

A

Generalized tonic-clonic seizures partial seizures

24
Q

What are adverse effects of phenobarbital?

A

CNS depression cognitive impairment

25
Q

What is topiramate used for?

A

Partial generalized tonic-clonic

26
Q

What are major side effects of topiramate?

A

Cognitive dysfunction weight loss

27
Q

What is the primary mechanism of lamotrigine?

A

Blocks Na+ channels and inhibits release of excitatory amino acids (glutamate aspartate).

28
Q

What is lamotrigine commonly used to treat?

A

Partial and generalized tonic-clonic seizures Lennox-Gastaut syndrome

29
Q

What serious side effect is associated with lamotrigine?

A

Steven Johnson syndrome (severe skin reaction).

30
Q

What is levetiracetam’s unique mechanism?

A

Binds to SV2A protein to modulate neurotransmitter release and stabilize neuronal activity.

31
Q

What are indications for levetiracetam?

A

Partial-onset generalized tonic-clonic

32
Q

What is the treatment approach for status epilepticus?

A

Initial benzodiazepine (lorazepam or diazepam) followed by phenytoin or phenobarbital if needed.

33
Q

What is the preferred approach to AED therapy?

A

Monotherapy as it reduces adverse effects and drug interactions.

34
Q

When can AED therapy be discontinued?

A

After 2+ years of seizure freedom with a favorable prognosis (single drug

35
Q

What precautions are needed when AEDs are used during pregnancy?

A

Use the lowest effective dose supplement with folate

36
Q

What AEDs are typically considered safe for breastfeeding?

A

Carbamazepine
phenytoin

BLOCK POSTING (17 decks)

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