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Pharmacology SNQ > Miscellaneous Ant-epileptics > Flashcards

Miscellaneous Ant-epileptics Flashcards

1
Q

What are the medicines that inhibit voltage gated Na+ channels ?

A

(CVPLT )
carbamazepine, valproic acid, phenytoin, lamotrigine, and topiramate,lacosamide,fosphenytoin.

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2
Q

What is the specific actions of Lamotrigine ?

A

selectively binds and inhibits voltage-gated sodium channels, stabilizing presynaptic neuronal membranes and inhibiting presynaptic glutamate and aspartate release.

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3
Q

What is the specific actions of Topiramate ?

A

*It inhibits Voltage gated Na+ and Voltage gated Ca2+ channels.
*It reduces membrane depolarization via AMPA/Kainate receptors and enhances GABA-A receptor activity, strengthening inhibitory effects.
*Topiramate inhibits the release of CGRP and glutamate from trigeminal neurovascular nerve endings, effectively disrupting cortical spreading depression in migraine.

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4
Q

What is the specific actions of Valproic acid ?

A

*It inhibits voltage gated Na+ and break down of GABA by inhibiting the enzyme GABA transamenase causing enhanced GABArgic transmission.
* It also enhances the Expression of the enzyme glutamic acid decarboxylase which converts glutamate to GABA.
* It effectively inhibits T-type calcium channels, which have been implicated in absence seizures and thalamocortical oscillations. It also enhances L-type calcium channels, which are involved in neuronal plasticity and neuroprotection. It also affect N-type calcium channels associated with neuropathic pain and migraine.

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5
Q

What are the commonly used medications for the treatment of GTCS ?

A
  • Carbamazepine
  • Phenytoin and Fosphenytoin
  • Lamotrigine and Topiramate
  • Valproic acid.
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6
Q

What are the Na+ blockers used for the Tx of absence seizures ?

A

Lamotrigine and Valproic acid.

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7
Q

What are the Na+ channel blockers of choice for the prophylaxis of status epilepticus ?

A

Phenytoin and Fosphenytoin.

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8
Q

What are the Na+ channel blockers used as mood stabilisers for bipolar disorder ?

A

Carbamazepine, Valproic acid, and lamotrigine.

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9
Q

Which is the Na+ channel blocker used as teh first line Tx of trigeminal neuralgia ?

A

Carbamazepine

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10
Q

What are the Na+ channel blockers used as prophylaxis for migraines and cluster headaches ?

A

Valproic acid and topiramate

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11
Q

What are the side effects of carbamazepine ?

A
  • Diplopia and ataxia
  • Agranulocytosis
  • Liver toxicity
  • SIADH
  • Steven Johnson’s syndrome
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12
Q

What are the teratogenic effects of carbamazepine ?

A

Cleft palate and neural tube defects such as spina bifida.

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13
Q

What are the medications whose effects are reduced by the carbamazepine mediated induction of CYP450?

A

Benzodiapeines, Phenytoin, Quinidine, and Warfarin.

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14
Q

What are the common side effects of Lamotrigine ?

A

Bullered vision, Nausea, and vomiting.

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15
Q

What is the higher dose dependent side effect of lamotrigine ?

A

SJS

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16
Q

What are the main side effects of phenytoin ?

A

Nystagmus, diplopia, ataxia, hirsutism, and gingival hyperplasia.

17
Q

How does phenytoin cause megaloblastic anaemia ?

A

By inhibiting folate absorption from the small intestine.

18
Q

What are the rare side effects of Phenytoin ?

A

SJS and SLE like syndrome.

19
Q

What are the teratogenic effects of phenytoin ?

A

IUGR, intellectual disability, cleft palate, and congenital heart defects.

20
Q

What are the common side effects of valproic acid ?

A

GI symptoms, tremor, alopecia, weight gain, and thrombocytopenia.

21
Q

What are the side effects of topiramate ?

A

Sedation, kidney stones, weight loss, and visual disturbances and glaucoma.

22
Q

What are the calcium channel blockers used in neurologic diseases?

A

Ethosuximide, Gabapentin and levitracetam.

23
Q

What is the drug of choice for absence seizures ?

A

Ethosuximide

24
Q

What are the indications for calcium channel blocker Gabapentin?

A

Partial seizures, neuropathic pain, peripheral neuropathy, fibromyalgia and as a prophylaxis for migraine.

25
Q

What is the MOA of Levitracetam ?

A

Its exact mechanism of anti-epileptic effect is unknown. However, it prevents calcium-dependent vesicular neurotransmitter release by selectively inhibiting synaptic vesicle protein 2A (SV2A).

26
Q

What are the side effects of Ethosuximide ?

A

Itching, fatigue, GI symptoms, headache, and SJS.

27
Q

What are the side effects of gabapentin ?

A

Sedation and ataxia.

28
Q

What are the side effects of Levitracetam ?

A

Fatigue, sedation, headache, and changes in personality.

29
Q

What is the MOA of Vigabatrin ?

A

It enhances GABArgic transmission by inhibiting the enzyme GABA transamenase.

30
Q

What is the MOA of Tiagabine ?

A

It inhibits the GABA reuptake of GABA from the synapse leading to enhanced gabargic transmission.

31
Q

What is the indication for Vigabatrin and Tiagabine ?

A

It is used to treat partial seizures.

32
Q

What is the serious side effect of vigabatrin ?

A

Permanent bilateral visual loss.

Pharmacology SNQ (16 decks)

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