Exam 3: Anticonvulsants Flashcards
Phenytoin
*MOA
*Uses
*SE
All MOA
*used for General tonic-clonic, Focal (all)
*Gingival Hyperplasia, Hirsutism, coma, seizure, death
Carbamazepine
*MOA
*Uses
Inhibits Na+ channels
*Used for General Tonic-Clonic, Focal
Locasamide
*MOA
*Uses
Inhibits the Na+ channels
*Focal seizures
Phenobarb
*MOA
*Uses
Exact MOA unknown; enhances GABA, decrease Glutamate
*Gen. Tonic-clonic, Focal
Lamotrigine
*MOA/Use
Ion channel blocker; Adjunct with focal seizures, absence
What Anticonvulsants are used for Focal and Gen. Tonic-Clonic Seizures
*6 of them
Phenytoin, Carbamazepine, Locasamide, Phenobarb, GABA Analogs, Lamotrigine
Ethosuxamide
*MOA
*Main Use
Ca++ channel inhibition
*Mainly used in Absence Seizures
GABA Analogs
*Names
*Uses
Gabapentin, Pregabalin = adjunct, neuralgia
Valproic Acid
*MOA
*Uses
All MOA
*Absence, T-C, Clonic
What anticonvulsants are used for Generalized Seizures
Ethosuxamide, Valproic Acids
Benzo’s
*MOA
*Uses
Increase GABA
*Status Epi, Absence
What is the difference between Tonic and Clonic
Tonic - Muscle Clenching
Clonic - Muscle Jerking
What Anticonvulsants can be used for absent seizures
Ethosuxamide, Valproic Acid, Benzos
Why must you be cautious when giving Phenytoin with Valproic Acid?
valproic acid can displace it from proteins, leading to more free-floating phenytoin; increased risk for toxicity
What are the 3 Main MOA for Anticonvulsants?
Modify Ion Conductance
Enhance Inhibition [GABA]
Inhibit Excitation [Glutamate]
When not to use Phenobarb
Generalized Seizures: Absence, atonic, infantile spasms
What are 4 Alt. Seizure Therapies that are non-pharmacologic
Keto
Marijuana
Crani
Vagus Nerve Stimulation
Physiologic Dependence vs Psychological Dependence
Physiologic - Body needs it or withdrawal
Psychological - Addiction/Mental Associated w/ Dopamine
Tolerance vs Dependence
Tolerance - More of the drug is needed to get the same initial effect
Dependence - Body is now reliant on the drug
What are 3 IV meds you can give for status epi?
Benzo [diazepam, lorazepam]
Fosphenytoin
Large Dose Phenobarb
What are the main treatment for Infantile Spasms
Phenobarb, Benzo to make them sleepy
Prednisone/GABA Analog [Vigabatrin]
Simple Focal Seizure
*LOC
*Where does it begin? 1 spot/all over?
Begins in specific area of the brain
Minimal Spread and does NOT effect LOC
Complex Focal Seizure
*LOC
*Where does it originate
*What can be seen with these
May effect LOC
Most from Temporal Lobes
Automatisms
What are Automatisms?
Lip smacking, swallowing, fumbling, scratching
Focal Seizures Secondarily Generalized
*Where do they begin?
*What do they look like
Simple or Complex then spread to rest of brain
LOOK like Tonic-Clonic
Generalized Seizures
*What might you see with these
*Where do they begin
Begin over the entire surface of brain
*Aura
*Tonic-Clonic
*Post-Ictal
