Mehl. Epilepsy/hypnotic drugs Flashcards
M. USMLE doesn’t care about MOAs for these. They care about side-effects mostly, as per my observation.
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M. Valproic acid. Moa?
Blocks sodium channels and incr. GABA
M. Blocks sodium channels and incr. GABA?
Valproic acid.
M. Used as an alternative to lithium in Tx of bipolar disorder.???
Valproic acid
M. Used as an alternative to lithium in Tx of….??
Valproic acid
in Tx of bipolar disorder
M. Valproic acid. Adverse?
Causes neural tube defects in pregnancy due to interference with folate metabolism.
M. Causes neural tube defects in pregnancy due to interference with folate metabolism.? 3 drugs
Valproic acid
Carbamazepine
Phenytoin
M. Carbamazepine, Moa?
Blocks sodium channels.
M. Blocks sodium channels. drugs? 2
Carbamazepine
Phenytoin
M. What drug is generic anti-epileptic; also used as prophylaxis for trigeminal neuralgia.??
Carbamazepine.
M. Carbamazepine prophylaxis for what?
also used as prophylaxis for trigeminal neuralgia.
M. Carbamazepine adverse in pregnancy?
Causes neural tube defects in pregnancy due to interference with folate metabolism.
M. Carbamazepine adverse in non-pregnant?
Can cause aplastic anemia and SIADH.
M. Phenytoin Moa?
Blocks sodium channels.
M. Phenytoin. Generic anti-epileptic.
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M. Phenytoin. adverse in pregnancy?
Causes neural tube defects in pregnancy due to interference with folate metabolism
M. Phenytoin. what syndrome in pregnant can cause?
Can cause fetal hydrantoin syndrome (finger nail hypoplasia + abnormal facies).
M. Phenytoin. when used for status epilepticus?
when BZD fails.
Its second step drug.
M. Ethosuximide Moa?
Blocks thalamic calcium channels. Only anti-epileptic USMLE might ask MOA.
M. Blocks thalamic calcium channels. Only anti-epileptic USMLE might ask MOA. Drug?
Ethosuximide
M. Ethosuximide for what seizures Tx?
Used for absence seizures.
M. BZD - Diazepam, lorazepam, midazolam, chlordiazepoxide, etc.
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M. BZD moa?
Bind to GABA-A receptor, which incr. frequency of Cl- channel opening, thereby allowing Cl- to flow into the neuron, hyperpolarizing it and inhibiting it (i.e., decr. firing).
M. Bind to GABA-A receptor, which incr. frequency of Cl- channel opening, thereby allowing Cl- to flow into the neuron, hyperpolarizing it and inhibiting it (i.e., decr. firing). Drugs?
BZD
M. BZD. sleep etc uses? 3
Hypnotic (induces sleep);
anxiolytic (reduces anxiety);
anti-convulsant.
M. first line status epilepticus drug?
BZD
M. BZD. Clonazepam used for …..?
insomnia/anxiety (shows up on NBME).
M. Tx of stimulant intoxication (i.e., cocaine, amphetamine, PCP).??
BZD
M. Tx for specific phobia (e.g., fear of flying).???
BZD
M. Tx for alcohol withdrawal (delirium tremens / alcoholic hallucinosis).
BZD
M. Tx social phobia 2nd-line if patient has asthma, since we don’t give propranolol in this setting (asked on NBME).???
BZD
M. BZD.
USMLE wants you to know that alcohol also binds to and activates GABA-A receptor, but at a different location from benzos. There’s an NBME Q where you have to select the illustration of an alcohol molecule and benzo binding to the same receptor, but at different sites.
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M. BZD what adverse?
Can cause respiratory depression.
M. BZD overdose Tx? antidote
Treat overdose with flumazenil (antagonist of benzo receptor).
M. Barbiturates. Phenobarbital, thiopental, etc.
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M. Barbiturates. Moa?
Bind to GABA-A receptor; incr. duration of chloride channel opening, making them more efficacious (and dangerous) than benzos.
M. Bind to GABA-A receptor; incr. duration of chloride channel opening, making them more efficacious (and dangerous) than benzos. drug?
Barbiturates.
M. Barbiturates. used in what specific case?
Used for general anesthesia.
M. Barbiturates. as third line Tx in what case?
Used for unremitting status epilepticus if benzos and phenytoin fail.
3rd step in status epilepticus
M. Non-benzo hypnotics. drugs? 2
Zolpidem, zaleplon
M. Non-benzo hypnotics. Zolpidem, zaleplon. Moa?
Activate GABA-A receptor, but bind to a different subunit from benzos.
M. Non-benzo hypnotics. Zolpidem, zaleplon. adverse?
Can cause addiction similar to benzos
M. Magnesium Tx and prevention for what?
Used for Tx and prevention of eclamptic seizures in pregnancy.
M. Magnesium for prevention in babies?
Given to pregnant women giving birth <32 weeks’ gestation for neuroprotection for the fetus.
M. Magnesium in what cardiac cases? 2
Used for torsades arrhythmia and digoxin toxicity.
M. Lamotrigine Moa?
Blocks sodium channels.
General anti-epileptic.
M. Lamotrigine adverse?
Can cause Stevens-Johnson syndrome.
