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Pharmacology > Epilepsy Drugs > Flashcards

Epilepsy Drugs Flashcards

1
Q

Ethosuximide mechanism of action

A

Blocks thalamic T-type Ca2+ channels

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2
Q

Side effects associated with ethosuximide

A

GI distress, fatigue, headache, urticaria, Stevens-Johnson syndrome

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3
Q

Used to treat status epilepticus

A
  1. Benzodiazepines (diazepam, lorazepam) – 1st line for acute situations
  2. Phenytoin (1st line for prophylaxis)
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4
Q

Benzodiazepine mechanism of action

A

Increased GABAA channel activity

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5
Q

Side effects of benzodiazepines

A

Sedation, tolerance, dependence, respiratory depression

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6
Q

Uses of phenytoin

A
  1. Simple partial seizures
  2. Complex partial seizures
  3. Generalized tonic-clonic seizures (1st line)
  4. Status epilepticus
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7
Q

Phenytoin mechanism of action

A

Increases Na+ channel inactivation

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8
Q

Side effects of phenytoin

A

Nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirsutism, peripheral neuropathy, megaloblastic anemia, teratogenesis (fetal hydantoin syndrome), SLE-like syndrome, induction of cytochrome P450, lymphadenopathy, Stevens-Johnson syndrome, osteopenia

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9
Q

Version of phenytoin for parenteral use

A

Fosphenytoin

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10
Q

Uses of carbamazepine

A
  1. Simple partial seizures (1st line)
  2. Complex partial seizures (1st line)
  3. Generalized tonic-clonic seizures (1st line)
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11
Q

Carbamazepine mechanism of action

A

Increased Na+ channel inactivation

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12
Q

Side effects associated with carbamazepine

A

Diplopia, ataxia, blood dyscrasias (agranulocytosis, aplastic anemia), liver toxicity, teratogenesis, induction of cytochrome P450, SIADH, Stevens-Johnson syndrome

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13
Q

1st line drug for trigeminal neuralgia

A

Carbamazepine

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14
Q

Uses of valproic acid

A
  1. Simple partial seizures
  2. Complex partial seizures
  3. Generalized tonic-clonic seizures (1st line)
  4. Absence seizures
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15
Q

Valproic acid mechanism of action

A
  1. Increased Na+ channel inactivation

2. Increased GABA concentration via inhibition of GABA transaminase

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16
Q

Side effects associated with valproic acid

A

GI distress, rare but fatal hepatotoxicity (measure LFTs), neural tube defects (e.g., spina bifida), tremor, weight gain

Remember: valproic acid is contraindicated in pregnancy

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17
Q

Uses of gabapentin

A
  1. Simple partial seizures

2. Complex partial seizures

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18
Q

Gabapentin mechanism of action

A

Primarily inhibits high-voltage-activated Ca2+ channels

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19
Q

Side effects of gabapentin

A

Sedation, ataxia

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20
Q

In addition to being used as an anti-epileptic agent, gabapentin is also used to treat…

A

Peripheral neuropathy and postherpetic neuralgia

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21
Q

In addition to being used as an anti-epileptic agent, valproic acid is also used to treat…

A

Myoclonic seizures and bipolar disorder.

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22
Q

Uses of phenobarbital

A
  1. Simple partial seizures
  2. Complex partial seizures
  3. Generalized tonic-clonic seizures
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23
Q

Phenobarbital mechanism of action

A

Increases GABAA channel activity

24
Q

Side effects of phenobarbital

A

Sedation, tolerance, dependence, induction of cytochrome P450, cardiorespiratory depression

25
1st line anti-epileptic drug in neonates
Phenobarbital
26
Uses of topiramate
1. Simple partial seizures 2. Complex partial seizures 3. Generalized tonic-clonic seizures
27
Topiramate mechanism of action
1. Blocks Na+ channels | 2. Increases GABA action
28
Side effects associated with topiramate
Sedation, mental dulling, kidney stones, weight loss
29
Which anti-epileptic drug is also used to prevent migraine?
Topiramate
30
Uses of lamotrigine
1. Simple partial seizures 2. Complex partial seizures 3. Generalized tonic-clonic seizures 4. Absence seizures
31
Lamotrigine mechanism of action
Blocks voltage-gated Na+ channels
32
Why must lamotrigine be titrated slowly?
To prevent Stevens-Johnson syndrome
33
Uses of levetiracetam
1. Simple partial seizures 2. Complex partial seizures 3. Generalized tonic-clonic seizures
34
Levetiracetam mechanism of action
Unknown; may modulate GABA and glutamate release
35
Uses of tiagabine
1. Simple partial seizures | 2. Complex partial seizures
36
Tiagabine mechanism of action
Increases GABA levels by inhibiting reuptake
37
Uses of vigabatrin
1. Simple partial seizures | 2. Complex partial seizures
38
Vigabatrin mechanism of action
Increases GABA levels by irreversibly inhibiting GABA transaminase
39
Give some examples of barbiturates
1. Phenobarbital 2. Pentobarbital 3. Thiopental 4. Secobarbital
40
Mechanism by which barbiturates work
Facilitate GABAA action by increasing duration of Cl- channel opening and thus decreasing neuron firing
41
In which condition are barbiturates contraindicated?
Porphyria
42
Clinical uses of barbiturates
Sedative for anxiety, seizures, insomnia, induction of anesthesia (thiopental)
43
Barbiturate toxicities include...
1. Respiratory and cardiovascular depression 2. CNS depression (can be exacerbated by EtOH use) 3. Dependence 4. Drug interactions (induces cytochrome P450)
44
Give some examples of benzodiazepine drugs
1. Diazepam 2. Lorazepam 3. Triazolam 4. Temazepam 5. Oxazepam 6. Midazolam 7. Chlordiazepoxide 8. Alprazolam
45
Mechanism by which benzodiazepines work
Facilitate GABAA action by increasing the frequency of Cl- channel opening; decreases REM sleep
46
Most benzodiazepines have long half-lives and active metabolites. Exceptions include...
1. Alprazolam 2. Triazolam 3. Oxazepam 4. Midazolam These drugs are short acting and their use is characterized by higher addictive potential.
47
Clinical uses of benzodiazepines
1. Anxiety 2. Spasticity 3. Status epilepticus (lorazepam and diazepam) 4. Detoxification (especially alcohol withdrawal--DTs) 5. Night terrors 6. Sleepwalking 7. General anesthetic (causes amnesia, muscle relaxation) 8. Hypnotic (used to treat insomnia)
48
Benzodiazepine toxicities
1. Dependence 2. Additive CNS depression effects with alcohol 3. Less risk of respiratory depression and coma than with barbs
49
Treat benzodiazepine overdose with...
Flumazenil (competitive antagonist at GABA receptor)
50
Can be used to treat absence seizures
1. Ethosuximide (first-line agent) 2. Valproic acid 3. Lamotrigine
51
List some nonbenzodiazepine hypnotics
1. Zolpidem 2. Zaleplon 3. Eszopiclone
52
Describe the mechanism by which nonbenzodiazepine hypnotics work.
Act via the BZ1 subtype of the GABA receptor. Effects are reversed by flumazenil.
53
Nonbenzodiazepine hypnotics are used to treat...
Insomnia
54
Side effects of nonbenzodiazepine hypnotics
Ataxia, headache, confusion, decreased risk of dependence as compared to benzodiazepine use
55
Unlike older sedative-hypnotics, nonbenzodiazepine hypnotics cause only modest...
Day-after psychomotor depression and few amnestic effects

Pharmacology (9 decks)

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