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PathoPhysiology > Exam Two - Antiseizure Drugs > Flashcards

Exam Two - Antiseizure Drugs Flashcards

1
Q

tonic-clonic

A

grand mal

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2
Q

absence

A

petit mal - early childhood onset

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3
Q

myoclonic

A

awake, brief - onset teens/adults

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4
Q

clonic

A

more impaired consciousness vs myoclonic

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5
Q

tonic

A

“tone”

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6
Q

Atonic

A

fainting goat

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7
Q

focal

A

involve a portion of ONE hemisphere, may progress to bilateral tonic clonic though

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8
Q

General Antiepileptic drugs side effects

A

nausea
vomiting
ataxia
sedation
pregnancy (teratogenicity)
rashes
weight changes
mood/psychosis/suicial ideations
Drug interactions may worsen side effects

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9
Q

Benzo MOA?

A

bind GABA inhibitory receptors and decrease firing rate

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10
Q

What is the main use for benzo?

A

urgent/acute injectable use to break a seizure

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11
Q

lamotrigine (lamictal) MOA?

A

multiple:
blocks NA+ and high-voltage depending CA++ channels

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12
Q

Lamotrigine uses

A
  • usually a reasonable choice!
    common monotherapy
  • absense, focal, generalized and LG SZ
  • psych use for bipolar disorder
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13
Q

DDI of lamotrigine?

A

inducers will decrease lamotrigin levels
divalproex (VPA) will increase levels

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14
Q

you must titrate _______ slowly

A

lamotrigine

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15
Q

levetiracetam MOA

A

unique: binds SV2A protein (decrease release of excitatory NT glutamate during high-frequency firing, partially inhibits N-type Ca channels in neuronal cells

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16
Q

use of levetracetam

A

focal and generalized Sz. probably most common monotherapy - reasonable test-taking choice if stuck

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17
Q

side effects of levetiracetam

A

psychiatric/mood changes, depression, nervousness, dizziness

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18
Q

How many side effects does levetiracetam have?

A

few!

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19
Q

brivaracetam

A

use in focal onset sz

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20
Q

valproic acid/divalproex MOA

A

various, block Na channels, inhibit GABA and others?

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21
Q

valproic acid/divalproex use?

A

lots! focal and generalized sz, also used in bipolar

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22
Q

valproic acid/divalproex side effects?

A

GI, tremor, hyperammonemia, pancreatitis, alopecia, thrombocytopenia

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23
Q

which drugs causes these risks in pregnancy: cognitive defects (low IQ), neural tube defects, digital abnormalities?

A

valproic acid/divalproex

24
Q

phenytoin/fosphenytoin MOA?

A

block Na channels

25
Q

“hydantoins”

A

phenytoin/fosphenytoin

26
Q

phenytoin/fosphenytoin uses?

A

focal and generalized tonic-clonic sz

27
Q

phenytoin/fosphenytoin side effects

A

ataxia
nausea
vomiting
gingical hyperplasia
hirsutism
nystagmus

28
Q

fetal hydantoin syndrome associated with which drug?

A

phenytoin/fosphenytoin

29
Q

phenytoin/fosphenytoin has a non-linear PK which means small dose changes = ……

A

big level changes

30
Q

DDIs of phenytoin/fosphenytoin

A

inducer of CYP2C and 3A

31
Q

ethosuximide MOA?

A

inhibits low threshold Ca channels (T-type)

32
Q

ethosuximide uses?

A

absence SZ!!

33
Q

ethosuximide side effects?

A

nausea
vomiting
headache
dizziness

34
Q

carbamazepine, oxcarbazepine, eslicarbazepine MOA?

A

Na channel inhibitor

35
Q

carbamazepine, oxcarbazepine, eslicarbazepine uses?

A

focal sz, tonic-clonic, trigeminal neuralgia, bipolar disorder

36
Q

carbamazepine, oxcarbazepine, eslicarbazepine side effects?

A

nausea
vomiting
dizziness
leukopenia
hyponatremia
rash
SJ (high in asians)

37
Q

topiramate MOA?

A

multiple: inhibit Na channels, inhibit high voltage Ca channels (L type), carbonic anhydrase inhibitor, NMDA actions? GABA?

38
Q

stupormax?

A

topiramate

39
Q

topiramate uses?

A

broad-spectrum, focal sz, tonic-clonic, L-G and migraine prophylaxis

40
Q

topiramate side effects??

A

COGNITIVE SIDE EFFECTS IN OVER 20% OF PATIENTS, risk of cleft palate if used in 1st trimester
nausea
vomiting
dizziness
paresthesias

41
Q

phenobarbital MOA?

A

barbiturate, modulate GABA receptors, reduce excitatory responses

42
Q

phenobarbital uses?

A

focal, generalized tonic-clonic, myoclonic, neonatal sz

43
Q

phenobarbital side effects?

A

LOTS
nausea
vomiting
dizziness
sedation
dependence
congenital defects - esp cardiac if used in pregnancy

44
Q

_________ converted to phenobarbital in-vivo!

45
Q

cenobamate MOA?

A

block Na channels, modulate GABA

46
Q

cenobamate uses?

A

focal sz - good efficacy

47
Q

cenobamate side effects?

A

dizziness
fatigue
dress - may reduce OCP efficacy!

48
Q

fenfluramine MOA?

A

increase serotonin

49
Q

fenfluramine uses?

A

davet and lennox-gastaut

50
Q

fenfluramine side effects?

A

agitation, insomnia, fatigue, heart valve issues, increased BP

51
Q

which is a repurposed drug? That is, it used to be an appetite suppressant and was pulled from the market due to heart value issues?

A

fenfluramine

52
Q

Which drugs interact with birth control?

A

phenytoin
phenobarbital
primidone
topiramate
carbamazepine
oxcarbazepine
cenobamate

53
Q

Which sz drugs cause risk to fetus?

A

valproic acid/divalproex
topiramate
phenytoin
phenobarbital
primidone

54
Q

list of sodium channel blockers

A

lamotrigine
carbamazepine
phenytoin/fosphenytoin
divalproex/VPA
topiramate
cenobamate

55
Q

calcium channel blockers list

A

ethosuximide (T-type)
topiramate (L-type)
gabapentinoids

56
Q

GABA-related list

A

benzodiazepine
barbiturates/primidone

57
Q

SV2A protein binding list

A

levetiracetam
brivaracetam

PathoPhysiology (29 decks)

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