Exam 3: Anticonvulsants

Question 1

Phenytoin
*MOA
*Uses
*SE

Answer 1

All MOA
*used for General tonic-clonic, Focal (all)
*Gingival Hyperplasia, Hirsutism, coma, seizure, death

Question 2

Carbamazepine
*MOA
*Uses

Answer 2

Inhibits Na+ channels
*Used for General Tonic-Clonic, Focal

Question 3

Locasamide
*MOA
*Uses

Answer 3

Inhibits the Na+ channels
*Focal seizures

Question 4

Phenobarb
*MOA
*Uses

Answer 4

Exact MOA unknown; enhances GABA, decrease Glutamate
*Gen. Tonic-clonic, Focal

Question 5

Lamotrigine
*MOA/Use

Answer 5

Ion channel blocker; Adjunct with focal seizures, absence

Question 6

What Anticonvulsants are used for Focal and Gen. Tonic-Clonic Seizures
*6 of them

Answer 6

Phenytoin, Carbamazepine, Locasamide, Phenobarb, GABA Analogs, Lamotrigine

Question 6

Ethosuxamide
*MOA
*Main Use

Answer 6

Ca++ channel inhibition
*Mainly used in Absence Seizures

Question 7

GABA Analogs
*Names
*Uses

Answer 7

Gabapentin, Pregabalin = adjunct, neuralgia

Question 8

Valproic Acid
*MOA
*Uses

Answer 8

All MOA
*Absence, T-C, Clonic

Question 9

What anticonvulsants are used for Generalized Seizures

Answer 9

Ethosuxamide, Valproic Acids

Question 9

Benzo’s
*MOA
*Uses

Answer 9

Increase GABA
*Status Epi, Absence

Question 10

What is the difference between Tonic and Clonic

Answer 10

Tonic - Muscle Clenching
Clonic - Muscle Jerking

Question 10

What Anticonvulsants can be used for absent seizures

Answer 10

Ethosuxamide, Valproic Acid, Benzos

Question 11

Why must you be cautious when giving Phenytoin with Valproic Acid?

Answer 11

valproic acid can displace it from proteins, leading to more free-floating phenytoin; increased risk for toxicity

Question 12

What are the 3 Main MOA for Anticonvulsants?

Answer 12

Modify Ion Conductance
Enhance Inhibition [GABA]
Inhibit Excitation [Glutamate]

Question 13

When not to use Phenobarb

Answer 13

Generalized Seizures: Absence, atonic, infantile spasms

Question 14

What are 4 Alt. Seizure Therapies that are non-pharmacologic

Answer 14

Keto
Marijuana
Crani
Vagus Nerve Stimulation

Question 15

Physiologic Dependence vs Psychological Dependence

Answer 15

Physiologic - Body needs it or withdrawal
Psychological - Addiction/Mental Associated w/ Dopamine

Question 15

Tolerance vs Dependence

Answer 15

Tolerance - More of the drug is needed to get the same initial effect
Dependence - Body is now reliant on the drug

Question 16

What are 3 IV meds you can give for status epi?

Answer 16

Benzo [diazepam, lorazepam]
Fosphenytoin
Large Dose Phenobarb

Question 17

What are the main treatment for Infantile Spasms

Answer 17

Phenobarb, Benzo to make them sleepy
Prednisone/GABA Analog [Vigabatrin]

Question 18

Simple Focal Seizure
*LOC
*Where does it begin? 1 spot/all over?

Answer 18

Begins in specific area of the brain
Minimal Spread and does NOT effect LOC

Question 19

Complex Focal Seizure
*LOC
*Where does it originate
*What can be seen with these

Answer 19

May effect LOC
Most from Temporal Lobes
Automatisms

Question 20

What are Automatisms?

Answer 20

Lip smacking, swallowing, fumbling, scratching

Question 21

Focal Seizures Secondarily Generalized
*Where do they begin?
*What do they look like

Answer 21

Simple or Complex then spread to rest of brain
LOOK like Tonic-Clonic

Question 22

Generalized Seizures
*What might you see with these
*Where do they begin

Answer 22

Begin over the entire surface of brain
*Aura
*Tonic-Clonic
*Post-Ictal