MIDTERMS: Anti-Seizures Flashcards
What is the primary goal of antiseizure medications in the treatment of epilepsy?
a) To increase neuronal excitation
b) To suppress the excitability of neurons that initiate seizures
c) To promote the release of monoamines
d) To inhibit GABA receptors
b) To suppress the excitability of neurons that initiate seizures
Which class of anti-epileptic drugs is commonly used for the treatment of absence (petit mal) seizures?
a) Benzodiazepines
b) Hydantoins
c) Succinimides
d) Valproates
c) Succinimides
Which anti-epileptic drug is known for causing gingival hyperplasia as an adverse effect?
a) Valproic acid
b) Phenytoin
c) Diazepam
d) Ethosuximide
b) Phenytoin
True or False: Benzodiazepines are primarily used for the long-term management of epilepsy.
False
Explanation: Benzodiazepines are typically used as adjunct therapy or for acute management, such as status epilepticus, rather than long-term management.
Which of the following drugs is classified as a hydantoin?
a) Diazepam
b) Phenytoin
c) Carbamazepine
d) Ethosuximide
b) Phenytoin
Valproic acid is used off-label for all of the following conditions EXCEPT:
a) Bipolar disorder
b) Migraine headaches
c) Trigeminal neuralgia
d) Fibromyalgia
c) Trigeminal neuralgia
True or False: Barbiturates can enhance the inhibitory effects of GABA by increasing the duration of chloride channel opening.
True
True or False: Valproic acid has a wide therapeutic window and is considered non-toxic.
False
Explanation: Valproic acid has a narrow therapeutic window and can be very toxic if not monitored properly.
__________ are anti-epileptic drugs that stabilize neuronal membranes by decreasing sodium entry into neurons.
Hydantoins
__________ is an anti-epileptic drug used specifically for absence seizures by decreasing calcium influx in thalamic neurons.
Ethosuximide
True or False: Phenytoin is effective in treating absence seizures.
False
Explanation: Phenytoin is primarily used for partial and generalized tonic-clonic seizures, not absence seizures.
Describe the mechanism of action of benzodiazepines in the treatment of epilepsy.
Benzodiazepines enhance the effects of GABA at the GABA
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A
receptor, increasing the frequency of chloride channel opening. This leads to hyperpolarization of neurons, thereby reducing neuronal excitability and preventing seizures.
One of the common adverse effects of benzodiazepines is __________, which refers to a lack of muscle coordination.
Ataxia
Match the anti-epileptic drug to its corresponding class:
Drug Class
a) Diazepam 1. Hydantoins
b) Phenytoin 2. Succinimides
c) Ethosuximide 3. Benzodiazepines
d) Carbamazepine 4. Iminostilbenes
e) Valproic acid 5. Valproates
a) Diazepam → 3. Benzodiazepines
b) Phenytoin → 1. Hydantoins
c) Ethosuximide → 2. Succinimides
d) Carbamazepine → 4. Iminostilbenes
e) Valproic acid → 5. Valproates
True or False: Succinimides decrease calcium influx in thalamic neurons to exert their anticonvulsant effect.
True
A patient being treated for absence seizures with Ethosuximide develops severe GI distress and a skin rash. What should be the immediate course of action?
The immediate course of action should be to discontinue Ethosuximide and consult a healthcare provider. The patient may need to switch to an alternative anti-epileptic medication and manage the adverse effects accordingly.
________ is a benzodiazepine derivative used as an antagonist to reverse the effects of benzodiazepine overdose.
Flumazenil
The drug __________ is used off-label for bipolar disorder and migraine headaches and works by increasing GABA levels.
Valproic acid
List three common adverse side effects of hydantoin anti-epileptic drugs like Phenytoin.
Gastric irritation
Gingival hyperplasia
Hirsutism
A 30-year-old patient with a history of epilepsy is experiencing frequent partial seizures despite being on Phenytoin. The patient also reports developing gum overgrowth. Which anti-epileptic drug should be considered as an alternative?
Carbamazepine or Oxcarbazepine (Iminostilbenes) could be considered as alternatives to Phenytoin to manage partial seizures and avoid gingival hyperplasia.
Explain why valproic acid requires careful monitoring during treatment.
Valproic acid has a very narrow therapeutic window, making it highly toxic if levels become too high. Adverse effects such as GI distress, temporary hair loss, weight changes, and impaired platelet function necessitate close monitoring of drug levels and patient symptoms.
What are the primary uses of succinimide anti-epileptic drugs?
Succinimides, such as Ethosuximide, are primarily used for the treatment of absence (petit mal) seizures.
Barbiturates enhance the inhibitory effects of GABA by increasing the __________ of chloride channels.
Duration
Why are succinimides like Ethosuximide not effective for generalized tonic-clonic seizures?
Succinimides specifically target absence seizures by decreasing calcium influx in thalamic neurons. They do not effectively stabilize neuronal membranes involved in generalized tonic-clonic seizures, making them ineffective for that seizure type.
