Mod6- Antiseizure Drugs Flashcards
What are the drugs for the Tonic-clonic and partial seizures?
- Carbamazepine
- Lamotrigine
- Phenytoin
- Valproic Acid
Absence Seizure
- Clonazepam
- Ethosuximide
- Valproic Acid
Myoclonic Seizures
Clonazepam
Lamotrigine
Valproic Acid
What are your Back-up and Adjuntive Drugs?
- Falbamate
- Gabapentin
- Lamotrigine
- Levetiracetam
- Phenobarbital
- Tiagabine
- Topiramide
- Vigabatrin
- Zonisamide
Finite episodes of brain dysfunction resulting from abnormal discharge of cerebral neurons
Seizures
What are your classification of seizure based on characteristics?
- –simple or complex
- –partial, generalized or partial with secondary generalization
What are your Partial seizures?
- Simple partial seizures
- Comlex partial seizures
- Partial seizures secondary generalized
What are your generalized seizures?
- Generalized tonic-clonic (grand mal ) seizures
- Absence ( petit ,al) seizures
- Tonic seizures
- Atonic seizures
- Clonic and myoclonic seizures
- infantile spasms
” Diba ang INFANTS kelangan ng G-A-T-A-S ( make C an S)
What is simple partial seizures?
–Consciousness is preserved
–Diverse manifestations determined by the region of cortex activated by the seizure
What is COMPLEX PARTIAL SEIZURES?
- Impaired consciousness lasting 30 seconds to 2 minutes,
- Often associated with purposeless movements such as lip smacking or hand wringing
What is GENERALIZED TONIC-CLONIC SEIZURES (GRAND MAL)?
- –Loss of consciousness and sustained contractions (tonic) of muscles throughout the body
- followed by periods of muscle contraction
- alternating with periods of relaxation (clonic), typically lasting 1 to 2 minutes.
What is ABSENCE SEIZURES (PETIT MAL)?
–Impaired consciousness (often abrupt onset and brief)
–Automatisms, loss of postural tone, or enuresis (refers to a repeated inability to control urination)
–Begin in childhood and usually cease by age 20 yrs
What is Myoclonic Seizure?
Sudden, brief, shocklikecontractions of musculature (myo-clonicjerks) which may be restricted to part of one extremity or may be generalized
What is STATUS EPILEPTICUS?
–Series of seizures (usually tonic-clonic) without recovery of consciousness between attacks
–Life-threatening emergency
What are the similar drugs of Phenytoin?
FOSYPHENYTOIN,
MEPHENYTOIN,
ETHOTOIN
Phenytoin is what class of drug?
Anticonvulsantdrug (hydantoin)
What is the MOA of Phenytoin?
It alters Na+, K+, and Ca2+ conductance, membrane potentials, and the concentrations of amino acids and the neurotransmitters nor-epinephrine, acetylcholine, and γ-aminobutyricacid (GABA).
What is the clinical use of Phenytoin?
- Generalized tonic-clonicseizures (DOC),
- Partial seizures (DOC),
- Status epilepticus,
- Arrhythmias(Group 1B action)
What are the toxicities of Phenytoin?
- Nystagmus,
- Diplopia,
- ataxia,
- Sedation,
- Gingival Hyperplasia,
- Hirsutism,
- Anemias,
- Peripheral neuropathy,
- Osteoporosis,
- Teratogen(fetal hydantoinsyndrome)
Phenytoin is a potent inducer of ______________
CYP450
What kinetic order does Phenytoin follows?
Follows zero-order kinetics at high doses
Is phenytoin Extensively protein bound?
YES
DESCRIBE FETAL HYDANTOIN SYNDROME
- Upturned nose
- Mild midfacialhypoplasia
- Long upper lip with thin vermilion border
- Lower distal digital hypoplasia
Carbamazepine belongs to what class of drug?
Anticonvulsantdrug (tricyclic)
What is the MOA of Carbamazepine?
**Blocks voltage-gated Na+channels **by slowing the rate of recovery of voltage-activated Na+ channels.
What is the clinical use of Phenobarbital?
- Generalized tonic-clonicseizures
- , Partial seizures,
- Status epilepticus,
- Insomnia,
- Hyperbilirubinemia
What are you Phenobarbital toxicities?
- Extension of CNS depressant actions,
- Tolerance,
- Dependence liability (greaterthanbenzodiazepines),
- Acuteintermittent porphyria
Phenobarbital is a potent inducer of?
CYP450
What is the preferred antiseizure drug in children and pregnant women?
PHENOBARBITAL
What are the similar drugs of ETHUSUXIMIDE?
SimilarDrugs
PHENSUXIMIDE
, METHSUXIMIDE
Ethosuximide belongs to what class of drug?
Drug Class
Anticonvulsantdrug
(cyclic ureide)
WHat is the MOA of Ethosuximide?
Decreases low threshold Ca2+currents (T-type) in thalamus
What is the clinical use of Ethosuximide?
***Absence seizures (DOC)
What are the toxicities of Ethosuximide?
- Gastrointestinal distress, ****
- Lethargy,
- Headache,
- Behavioral changes
Diazepam of belongs to what class of drug?
Anticonvulsantdrug (benzodiazepine)
What is the MOA of DIAZEPAM?
Binds GABAA receptor subunits to increase frequencyof chloride channel opening; membrane hyperpolarization
What are the clinical use of DIAZEPAM?
Status epilepticus***
What are the toxicities of Diazepam?
- Anterogradeamnesia,**********
- Decreased psychomotor skills,
- Unwanted daytime sedation, *************
Respiratory depression, - Tolerance,
- Dependence liability
Clonazepam belong to what class of drugs?
Anticonvulsantdrug (benzodiazepine)
What is the MOA of Clonazepam?
- Binds GABAAreceptor subunits to increase frequencyof chloride channel opening; membrane hyperpolarization
- Same with diazepam
What are the clinical use of Clonazepam?
Absence seizures,
Myoclonicseizures,
Infantile spasms
What are the toxicities of clonazepam?
Anterogradeamnesia, Decreased psychomotor skills, Unwanted daytime sedation, Respiratory depression, Tolerance, Dependence liability
Same with DIAZEPAM
What are the similar drugs of GABAPENTIN?
PREGABALIN
” remember gamit to ni tita raffy”
GABAPENTIN belongs to what class of drug?
Anticonvulsantdrug (GABA derivative)
What is the MOA of GABAPENTIN?
Blocks Ca2+channels on N-type channels (main)
.Increases GABA release.
Decrease in synaptic release of glutamate
What are the Clinical use of GABAPENTIN?
- Partial seizures (adjunct),
- Neuropathicpain(postherpeticneuralgia), *** Remember Tita RAffy
- Migraine ***
What are the toxicities of Gabapentin?
- Dizziness,
- Sedation,
- Ataxia,
- Nystagmus,
- Tremor (all are most common adverse effects)
**Lamotrigine **belongs to what class of drugs?
Anticonvulsantdrug (phenyltriazine)
What is the MOA of Lamotrigine?
Blocks Na+and Ca2+channels, Decreases synaptic release of glutamate
What is the clinical use of Lamotrigine?
- Generalized tonic-clonicseizures,
- Partial seizures,
- Myoclonicseizures,
- Absence seizures,
- Bipolar disorder
What are the toxicities of Lamotrigine?
- Dizziness,
- Ataxia,
- Nausea,
- Rash,
- Stevens-Johnson syndromev***
To what class of drug does LEVETIRACETAM belongs?
Anticonvulsantdrug (piracetam)
What is the MOA of LEVETIRACETAM?
Selectivelybinds synaptic vesicular protein SV2AModifies synaptic release of glutamate and GABA.
What is the clinical use of LEvetiracetam?
- Generalized tonic-clonicseizures,
- Partial seizures,
- Juvenilemyoclonicepilepsy
What are the toxicities of Levetiracetam?
- Dizziness,
- Sedation,
- Weakness,
- Irritability,
- Hallucinations,
- Psychosis
TOPIRAMTE belongs to what class of drugs?
Anticonvulsantdrug (substituedmonosaccharide)
What is the MOA of TOPIRAMTE?
Multiple actions on synaptic function, probably via actions on phosphorylation(Na, Ca, GABA, AMPA-glutamate, carbonic anhydrase)
What are the clinical use of TOPIRAMATE?
- Generalized tonic-clonicseizures,
- Absence seizures,
- Partial seizures,
- Lennox-Gastautsyndrome,
- West syndrome,
- Migraine
What are the toxicities of TOPIRAMATE?
- Drowsiness,
- Dizziness, Ataxia,
- Psychomotor slowing, ***
- Memory impairment,***
- Paresthesias,
- Weight loss,***
- Acute myopia, ***
- Glaucoma,***
- Urolithiasis***
BIPOLAR AFFECTIVE DISORDERS
- valproicacid (first-line for mania),
- carbamazepine,
- lamotrigine
What is the DOC for TRIGEMINAL NEURALGIA
carbamazepine(DOC),
What are the drugs use for Trigeminal Neuralgia?
carbamazepine(DOC), oxcarbazepine
NEUROPATHIC PAIN (POSTHERPETIC NEURALGIA)
–gabapentin, pregabalin
MIGRAINE
–gabapentin, phenytoin, topiramate
___________ refers to a disorder of brain function characterized by the periodic and unpredictable occurrence of seizures
Epilepsy
__________________is the most widely e!ectivemode for the treatment of patients with epilepsy
Medication or vagalnerve stimulator therapy
