epileptic drugs FA Flashcards
1
Q
12 epilepsy drugs?
A
- phenytoin
- carbamazepine
- lamotrigine
- gabapentin
- topiramate
- phenobarbitol
- valproic acid
- ethosuximide
- Benzodiazepines (diazepam or lorazepam)
- Tiagabine
- Vigabatrin
- Levetiracetam
2
Q
phenytoin is used for what general condition? mech?
A
-epilepsy
increases Na+ channel inactivation
3
Q
In terms of partial (focal) epilepsy, is phenytoin used in simple epilepsy? in complex?
A
simple: yes
complex: yes
4
Q
In terms of Generalized epilepsy, is phenytoin used for tonic-clonic seizures?
absence seizures?
status epilepticus?
A
- tonic clonic: 1st line
- absence: no
- status epilepticus: 1st line prophylaxis
5
Q
what is the first line drug for status-epilepticus prophylaxis?
A
phenytoin
6
Q
what is the parenteral version of phenytoin?
A
Fosphenytoin
7
Q
what are the three first line drugs for Tonic-clonic seizures?
A
- phenytoin
- carbamazepine
- Valproic acid
8
Q
In terms of partial (focal) epilepsy, is Carbamezapine used in simple epilepsy? in complex?
A
- simple: 1st line
2. complex: 1st line
9
Q
what is the first line drug for simple partial (focal) seizures?
A
carbamezapine
10
Q
what is the first line drug for complex partial (focal) seizures?
A
carbamezapine
11
Q
In terms of Generalized epilepsy, is carbamezapine used for tonic-clonic seizures?
absence seizures?
status epilepticus?
A
- tonic clonic: 1st line
- absence: no
- status epilepticus: no
12
Q
mech of carbamazepine?
A
increase Na+ channel inactivation
13
Q
what is the 1st line drug for trigeminal neuralgia?
A
Carbamazepine
14
Q
Carbamezapine is a drug used for…
A
partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
15
Q
Lamotrigine is a drug used for…
A
partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
16
Q
lamotrigine mech…
A
blocks voltage-gated Na+ channels
17
Q
In terms of partial (focal) epilepsy, is lamotrigine used in simple epilepsy? in complex?
A
simple: yes
complex: yes
18
Q
In terms of Generalized epilepsy, is lamotrigine used for tonic-clonic seizures?
absence seizures?
status epilepticus?
A
tonic-clonic: yes
absence seizures: no
status epilepticus: no
19
Q
Gabapentin is a drug used for… (5)
A
- partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
- peripheral neuropathy
- postherpetic neuralgia
- migraine prophylaxis
- bipolar disorder
20
Q
Mechanism of Gabapentin?
A
designed as GABA analogue, but primarily inhibits high-voltage-activated Ca2+ channels
21
Q
In terms of Generalized epilepsy, is Gabapentin used for tonic-clonic seizures?
absence seizures?
status epilepticus?
A
tonic-clonic: yes
absence seizures: no
status epilepticus: no
22
Q
In terms of partial (focal) epilepsy, is Gabapentin used in simple epilepsy? in complex?
A
simple: yes
complex: yes
23
Q
Topiramate is a drug used for (2)
A
- partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
- migraine prevention
24
Q
what is the mechanism of Topiramate?
A
blocks Na+ channels, increases GABA action
25
In terms of partial (focal) epilepsy, is Topiramate used in simple epilepsy? in complex?
simple: yes
complex: yes
26
In terms of Generalized epilepsy, is Topiramate used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
27
Phenobarbitol is a drug used for
partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
28
In terms of Generalized epilepsy, is Phenobarbital used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
29
In terms of partial (focal) epilepsy, is Phenobarbital used in simple epilepsy? in complex?
simple: yes
complex: yes
30
what is the mechanism of phenobarbital?
increase GABA- A action
31
phenobarbital is first line for epilepsy in what population?
children
32
Gabapentin is a drug used for... (5)
1. partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
2. peripheral neuropathy
3. postherpetic neuralgia
4. migraine prophylaxis
5. bipolar disorder
33
Mechanism of Gabapentin?
designed as GABA analogue, but primarily inhibits high-voltage-activated Ca2+ channels
34
In terms of Generalized epilepsy, is Gabapentin used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
35
In terms of partial (focal) epilepsy, is Gabapentin used in simple epilepsy? in complex?
simple: yes
complex: yes
36
Topiramate is a drug used for (2)
1. partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
2. migraine prevention
37
what is the mechanism of Topiramate?
blocks Na+ channels, increases GABA action
38
In terms of partial (focal) epilepsy, is Topiramate used in simple epilepsy? in complex?
simple: yes
complex: yes
39
In terms of Generalized epilepsy, is Topiramate used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
40
which epilepsy drug is also used for peripheral neuropathy, postherpetic neuralgia, migraine prophylaxis and bipolar disorder?
Gabapentin
41
In terms of Generalized epilepsy, is Phenobarbital used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
42
In terms of partial (focal) epilepsy, is Phenobarbital used in simple epilepsy? in complex?
simple: yes
complex: yes
43
what is the mechanism of phenobarbital?
increase GABA- A action
44
phenobarbital is first line for epilepsy in what population?
children
45
Gabapentin is a drug used for... (5)
1. partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
2. peripheral neuropathy
3. postherpetic neuralgia
4. migraine prophylaxis
5. bipolar disorder
46
Mechanism of Gabapentin?
designed as GABA analogue, but primarily inhibits high-voltage-activated Ca2+ channels
47
In terms of Generalized epilepsy, is Gabapentin used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
48
In terms of partial (focal) epilepsy, is Gabapentin used in simple epilepsy? in complex?
simple: yes
complex: yes
49
Topiramate is a drug used for (2)
1. partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
2. migraine prevention
50
what is the mechanism of Topiramate?
blocks Na+ channels, increases GABA action
51
In terms of partial (focal) epilepsy, is Topiramate used in simple epilepsy? in complex?
simple: yes
complex: yes
52
In terms of Generalized epilepsy, is Topiramate used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
53
Phenobarbitol is a drug used for
partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
54
In terms of Generalized epilepsy, is Phenobarbital used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
55
In terms of partial (focal) epilepsy, is Phenobarbital used in simple epilepsy? in complex?
simple: yes
complex: yes
56
what is the mechanism of phenobarbital?
increase GABA- A action
57
phenobarbital is first line for epilepsy in what population?
children
58
Gabapentin is a drug used for... (5)
1. partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
2. peripheral neuropathy
3. postherpetic neuralgia
4. migraine prophylaxis
5. bipolar disorder
59
Mechanism of Gabapentin?
designed as GABA analogue, but primarily inhibits high-voltage-activated Ca2+ channels
60
In terms of Generalized epilepsy, is Gabapentin used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
61
In terms of partial (focal) epilepsy, is Gabapentin used in simple epilepsy? in complex?
simple: yes
complex: yes
62
Topiramate is a drug used for (2)
1. partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
2. migraine prevention
63
what is the mechanism of Topiramate?
blocks Na+ channels, increases GABA action
64
In terms of partial (focal) epilepsy, is Topiramate used in simple epilepsy? in complex?
simple: yes
complex: yes
65
In terms of Generalized epilepsy, is Topiramate used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
66
Phenobarbitol is a drug used for
partial (focal) epilepsy (simple and complex) and tonic-clonic epilepsy
67
In terms of Generalized epilepsy, is Phenobarbital used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
68
In terms of partial (focal) epilepsy, is Phenobarbital used in simple epilepsy? in complex?
simple: yes
complex: yes
69
what is the mechanism of phenobarbital?
increase GABA- A action
70
phenobarbital is first line for epilepsy in what population?
children
71
the mechanism of action of Valproic acid?
increase Na+ channel inactivation, increase GABA concentration
72
Valproic acid is first line for what type of seizures?
tonic-clonic seizures (along with phenytoin and carbamazepine)
73
Valproic acid is used for what? (2)
1. partial (focal) epilepsy (simple and complex) and general epilepsy (tonic-clonic (first line drug) and absence epilepsy)
2. myoclonic seizures
74
which epilepsy drug is also used for myoclonic seizures?
valproic acid
75
In terms of Generalized epilepsy, is valproic acid used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: first line
absence seizures: yes
status epilepticus: no
76
In terms of partial (focal) epilepsy, is Valproic Acid used in simple epilepsy? in complex?
simple: yes
complex: yes
77
which epilepsy drug is first line in children?
phenobarbital
78
which epilepsy drug is used for migraine prevention
Topiramate
79
which epilepsy drug is also used for peripheral neuropathy, postherpetic neuralgia, migraine prophylaxis and bipolar disorder?
Gabapentin
80
Ethosuximide treats what type of epilepsy?
Absence epilepsy (First line!)
81
what is the first line drug for absence epilepsy?
Ethosuximide
82
Benzodiazapines (diazepam or lorazepam) are 1st line for what type of epileptic disorder?
status epilepticus
83
1st line drugs for status epilepticus are...
Benzodiazapines (diazepam or lorazepam)
84
In addition to being the 1st line drug for status epilepticus, Benzodiazapines (diazepam or lorazepam) are used for what?
seizures of eclampsia (first line is MgSO4)
85
what is first line for seizures of eclampsia?
MgSO4
86
mechanism of Benzodiazapines (diazepam or lorazepam)?
increase GABA A receptor frequency
87
What is Tiagabine?
drug for simple and complex partial (focal) seizures
88
In terms of partial (focal) epilepsy, is Tiagabine used in simple epilepsy? in complex?
simple: yes
complex: yes
89
Mechanism of Tiagabine?
Inhibits GABA uptake
90
In terms of Generalized epilepsy, is Tiagabine used for tonic-clonic seizures?
absence seizures?
status epilepticus?
none, Tiagabine only works for partial (focal) epilepsy (both simple and complex)
91
What is Vigabatrin?
drug for simple and complex partial (focal) seizures
92
In terms of partial (focal) epilepsy, is Vigabatrin used in simple epilepsy? in complex?
simple: yes
complex: yes
93
Mechanism of Vigabatrin?
Irreversibly inhibits GABA transaminase ---> increases GABA
94
In terms of Generalized epilepsy, is Vigabatrin used for tonic-clonic seizures?
absence seizures?
status epilepticus?
none, Vigabatrin only works for partial (focal) epilepsy (both simple and complex)
95
What is Levetiracetam?
epileptic drug for simple and complex partial (focal seizures) and tonic-clonic seizures
96
In terms of partial (focal) epilepsy, is Levetiracetam used in simple epilepsy? in complex?
simple: yes
complex: yes
97
In terms of Generalized epilepsy, is Levetiracetam used for tonic-clonic seizures?
absence seizures?
status epilepticus?
tonic-clonic: yes
absence seizures: no
status epilepticus: no
98
mech of Levetiracetam?
Unknown-- may modulate GABA and glutamate release
99
4 side effects of benzos?
1. sedation
2. tolerance
3. dependence
4. Stevens Johnson Syndrome
100
Stevens Johnson Syndrome?
prodrome of malaise and fever followed by rapid onset of erythematous/purpuric macules (oral, occular, genital). Skin lesions progress to epidermal necrosis and sloughing.
101
prodrome of malaise and fever followed by rapid onset of erythematous/purpuric macules (oral, occular, genital). Skin lesions progress to epidermal necrosis and sloughing.
Stevens Johnson Syndrome
102
Stevens Johnson syndrome is the side effect of what 5 epileptic drugs?
```
benzodiazepines
Carbamazepine
Ethosuximide
Phenytoin
Lamorigine
```
103
8 side effects of Carbamazepine?
1. diplopia
2. ataxia
3. blood dyscrasias (agranulocytosis, aplastic anemia)
4. liver toxicity
5. teratogenesis
6. induction of cytochrome p450
7. SIADH
8. SJS (stevens johnson syndrome)
104
these are the side effects of what drug?
1. diplopia
2. ataxia
3. blood dyscrasias (agranulocytosis, aplastic anemia)
4. liver toxicity
5. teratogenesis
6. induction of cytochrome p450
7. SIADH
8. SJS (stevens johnson syndrome)
Carbamazepine
105
phenytoin has what 13 side effects?
1. nystagmus
2. diplopia
3. ataxia
4. sedation
5. gingival hyperplasia
6. hirsutism
7. megaloblastic anemia
8. teratogenesis (fetal hydantoin syndrome)
9. SLE-like syndrome
10. Induction of cytochrome p450
11. Lymphadenopathy
12. SJS
13. osteopenia
106
these are the side effects of what med:
1. nystagmus
2. diplopia
3. ataxia
4. sedation
5. gingival hyperplasia
6. hirsutism
7. megaloblastic anemia
8. teratogenesis (fetal hydantoin syndrome)
9. SLE-like syndrome
10. Induction of cytochrome p450
11. Lymphadenopathy
12. SJS
13. osteopenia
phenytoin
107
5 side effects of Ethosuximide?
1. GI stress
2. fatigue
3. HA
4. urticaria
5. SJS
108
what is the mnemonic EFGH?
Ethosuximide (epilepsy drug): Fatique, GI, HA (side effects)
109
these are the side effects of what drug?
1. GI stress
2. fatigue
3. HA
4. urticaria
5. SJS
Ethosuximide
110
4 side effects of phenobarbital?
1. sedation
2. tolerance
3. dependence
4. induction of cytochrome p450
111
these are the side effects of what epilepsy drug?
1. sedation
2. tolerance
3. dependence
4. induction of cytochrome p450
phenobarbital
112
5 side effects of valproic acid?
GI distress
rare but fatal hepatotoxicity (measure LFTs)
neural tube defects in fetus (spina bifida)
tremor
weight gain
113
these are side effects of what epileptic drug?
GI distress
rare but fatal hepatotoxicity (measure LFTs)
neural tube defects in fetus (spina bifida)
tremor
weight gain
Valproic acid
114
which epileptic drug is contraindicated in preg?
Valproic Acid- causes neural tube defects in fetus (spina bifida)
115
which epileptic drug do you have to test LFTs for? Why?
Valproic acid-- causes rare but fatal hepatotoxicity
116
side effects of Lamotrigine
SJS
117
4 side effects of topiramate
1. sedation
2. mental dulling
3. kidney stones
4. weight loss
118
these are the side effects of what anti-epileptic drug?
1. sedation
2. mental dulling
3. kidney stones
4. weight loss
topiramate
119
mech of phenytoin?
use-dependent blockade of Na+ channels ---> inhib glutamate release from excitatory presynaptic neurons
120
phenytoin is used for what two things?
```
tonic-clonic seizures
class IB antiarrhythmic
```
