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AU14 Pharmacology > Exam 2; Anti-Epileptic Agents > Flashcards

Exam 2; Anti-Epileptic Agents Flashcards

1
Q

Epilepsy is not a disease, but what

A

a condition; set of symptoms

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2
Q

True or False

epilepsy is generally not life threatening, the quality of life is greatly affected

A

True

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3
Q

What is an epileptic seizure

A

abnormal electrical activity originating in the brain; the brain equivalence of a heart arrthymia

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4
Q

What three things can an epileptic seizure result in

A

brief episodes of loss of consciousness
convulsive movements
disturbances of perception or behavior

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5
Q

What is a secondary cause of seizures

A

tumor/injury

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6
Q

What is a congenital cause of a seizure

A

site in the brain

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7
Q

What three different movements of ions can cause abnormal; focal activity in the brain

A

influx of Na
efflux of K
influx of Ca

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8
Q

Abnormal focal activity in the brain can lead to what

A

a spread of activity
inhibited by GABAergic neurons
activated by glutamate

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9
Q

This type of seizure lasts about 1-3 minutes

A

grand-mal (tonic-clonic)

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10
Q

What characterizes a grand mal seizure

A

severe muscle contraction
tonic; muscle contraction and extension
clonic; muscle twitching

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11
Q

What two things occur during a grand-mal seizure not related to muscle activity

A

aura; feeling like something is going to happen

loss of consciousness; confusion

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12
Q

These are 5-20 second lapses of consciousness; blank stare

A

petit-mal

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13
Q

Which group of people is most affected by petit-mal seizures

A

children
may end after puberty
a child could have hundreds of these a day

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14
Q

This is often the result of an injury of some kine; affects selective regions of the brain; defined by site of origin

A

partial seizures (40%)

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15
Q

What are the two types of generalized seizures (60%)

A

grand-mal

petit-mal

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16
Q

A simple partial seizure results in what

A

no loss of awareness

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17
Q

These partial seizures are in areas of the brain that control body motion

A

focal motor seizures

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18
Q

What are the two major symptoms of focal motor seizures

A

complex movements of the head and eyes

“march” starting in the finger and moving more proximally

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19
Q

What was the results of a sensory partial seizures

A

illusions
visual
auditory
olfactory

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20
Q

What are the results of behavioral partial seizures

A

laughter
nauseated
fearful
vocal patterns (like Tourette’s)

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21
Q

What two symptoms could be seen post-seizure

A

may have post-seizure numbness or blindness

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22
Q

A complex partial seizure results in what

A

loss of awareness

23
Q

What are three symptoms of complex partial seizures

A

starting followed by bizarre behaviors
alteration in feeling or behavior
associated with amnesia and confusion

24
Q

This is a medical emergency; when someone has long and repeated grand mal seizures

A

status epilepticus

25
Q

When someone undergoes status epileptics, what is occurring in their muscles

A

every muscle in their body is constricted

need to get oxygenated blood and therefor they die of cerebral asphyxiation

26
Q

All anti-seizure medications decrease what

A

neuronal firing rate

27
Q

anti-seizure medications may cause an increase in what

A

suicidal behavior

28
Q

anti-seizure agents may act on these three locations

A

GABA neurons
glutamate neurons
ion channels

29
Q

This drug inhibits Na channels in the brain, slowing the recovery rate of neurons

A

phenytoin

30
Q

What is the therapeutic index of phenytoin

A

it is relatively low; will see toxic effects

31
Q

Phenytoin is generally not what

A

a CNS depressant

can cause some sedation

32
Q

What three things can result from high doses of phenytoin

A

respiratory depression
cardiovascular collapse
may cause nausea and ataxia

33
Q

What two things can result from chronic use of phenytoin

A

gingival hyperplasia

vestibular effects; diplopia, ataxia, blurred vision

34
Q

What are two major toxicities of phenytoin

A

teratogenic (fetal hydantoin syndrome)

life-threatening rash (Steven-Johnson syndrome)

35
Q

This is the drug of choice for partial seizures, acts on Na channels; induces P450

A

carbamazepine

36
Q

What are some symptoms of carbamazepine toxicity

A 
blurred vision
diplopia
drowsiness
fetal defect (spina bifida)
aplastic anemia
37
Q

This is for all but petit mal, activates GABAergic neurons and induces P450

A

phenobarbital

38
Q

What are two toxicities of phenobarbital

A

sedation

drowsiness

39
Q

These drugs activate GABAergic neurons

A

benzodiazepines; diazepam

40
Q

This is a diuretic; carbonic anhydrase inhibitor which may increase CO2 in the brain leading to decreased activity

A

acetazolamide

41
Q

These are the DRUGS OF CHOICE to treat petit mal

A

succinimides, ethosuximide

42
Q

What is the mechanism of succinimides; ethosuximide

A

inhibits Ca channels in the CNS, slowing down neurotransmitters

43
Q

What are two side effects of succinimides

A

GI upset; nausea and vomiting

drowsiness

44
Q

This drug is used for all seizure types, it has multiple mechanisms

A

sodium valproate

45
Q

what are three mechanisms of sodium valproate

A

decreases GABA breakdown
increases GABA synthesis
may also act on Na and Ca channels

46
Q

What are 5 toxicities of sodium valproate

A 
GI upset
CNS sedation
tremors
potentially fatal hepatitis
perhaps fetal damage; drop in IQ
47
Q

These four agents to treat partial seizures activate GABA

A

topriamite
gabapentin
tigabine
vigabine

48
Q

These four agents to treat partial seizures act on Na

A

lamotrigine
zonisamie
rufinamide
lacosamide

49
Q

This agent to treat partial seizures acts on Ca

A

pregabalin

50
Q

This agent to treat partial seizures acts on K

A

ezogabine

51
Q

This agent to treat partial seizures blocks glutamate activity

A

perampanel

52
Q

This agent to treat partial seizures has an unknown mechanism

A

levetiracetam

53
Q

This is a high therapeutic benzodiazepine used to status epileptics; it suppresses neuronal activity without killing the patient

A

Diazepine

54
Q

What are four special considerations in the treatment of epileptic seizures

A

patient must be educated
patient must be always monitored
drugs taken for a long time
mixed type of seizures

AU14 Pharmacology (29 decks)

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