Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Neuro- Epilepsy/Seizures > Flashcards

Neuro- Epilepsy/Seizures Flashcards

1
Q

what seizure involves only one portion of one hemisphere and can be sensory OR motor in nature that has no impairment in consciousness

A

simple partial… now called focal seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what seizure involves only one portion of one hemisphere and can be sensory OR motor in nature WITH impaired consciousness

A

Complex partial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

MC generalized seizure?

A

Grand Mal (tonic-clonic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Alternating muscle contractions and relaxations + LOC

A

Grand Mal (tonic-clonic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Brief impairment of consciousness, may present in kids aged 3-5YO
*patient stares into space
*has rapid eye blinking
NO postictal phase

A

absence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List the generalized seizures

*which has no postictal phase

A
  1. grand mal tonic clonic
  2. absence–no PI phase
  3. Myoclonic
  4. Atonic
  5. Clonic
  6. Tonic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Muscle contractions confined to one part of the body

A

myoclonic seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Sudden loss of muscle tone or “drop attacks”

A

atonic seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Short episodes of muscle contractions, may resemble myoclonic, but with consciousness more impaired

A

Clonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Increased tone in extension muscles —-lasts less than 60 seconds

A

Tonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

General MOA of anti-seizure medications (3)

A
  1. Blocks voltage gated NA or CA channels
  2. Enhances GABAergic impulses
  3. Interferes with excitatory glutamate transmission
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define anticonvulsant

-produces_____?

A

helps terminates convulsive seizures

-produces significant degree of SEDATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define anti-epileptic

-decreases____?

A

used PROPHYLACTICALLY to reduce or prevent epileptic seizures
-decreases excitability of brain cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

T/F: Antiseixure medications suppress seizures but do not cure or prevent epilepsy

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

define drug characteristics to include when picking AED

A
  • cost

- drug interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

choice of AED tx is based on:

A
  1. classification of seizures
  2. PT specific variables (age, comorbidites, lifestlye, personal preference)
  3. characteristics of drug
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q 
FOCAL epilepsy (simple, complex) : general drug NON ELDERLY PT regime 
1st 
2nd
3rd
4th
A

1st: Lamotrigine, Levetiracetam or Topiramate
2nd: Carbamazepine or Lacosamide or Pregabalin or Zonisamide
3rd: Divalproex, Gabapentin, Oxcarbazepine, Phenytoin
4th: vagal stimulator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q 
FOCAL epilepsy (simple, complex) : general drug FOR ELDERLY PT regime 
1st 
2nd
3rd
4th
A

1st: Lamotrigine
2nd: Gabapentin
3rd: Carbamazepine
4th: vagal stimulator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

TX regime for absence seizure:
1st
2nd
3rd

A

1st: Ethosuximide
2nd: Valporic acid (depakote)
3rd: Lamotrigine (Lamictal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

TX regime for SE:
1st
2nd
3rd

A

1st: IV BENZOS—- Lorazepam** or Diazepam
2nd: IV Phenytoin or Fosphenytoin IM
3rd: IV Phenobarbital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Epileptic Tonic-Clonic seizure in PEDS PT… what is a good 1st line

A

Lamotrigine? or Topiramate?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

1st line tx for myoclonus

A

Valporic acid *****

clonazepam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

1st line tx for febrile seizure

A

Phenobarbital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

MOA for benzodiazepines

A

Increase inhibitory effects of GABA—they bind to GABA receptors and therefore reduce firing rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

when are benzos usually used in tx of seizures

A

emergent setting or acute tx due to tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

List the intermediate acting benzos

A

Lorazepam—ativan (first line in SE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

List the long acting benzos

A

diazepam (valium) and clonazepam (klonopin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Do benzos cause sedation?

A

YES!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

reversal agent for benzo OD

A

Flumazenil reveres the sedation property in OD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

SE of class of anti-seizure meds

A 
N/V
sedation 
ataxia 
Rash 
***HYPONATREMIA **** 
wt gain or loss 
teratogenetic 
osteoporosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

which drugs can worsen absence seizure?

A

Gabapentin

Carbamazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

MOA for cabamazepine

A
  • Prolongs inactivation of NA+ channels (blocks NA)
  • decreases the neuronal influx of sodium ions
  • prevents high freq and repetitive firing of neurons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Phenytoin side effects

A 
P: P-450 drug interactions 
H:  Hirstuism (excess facial hair growht in women)
E: enlarged gums--gingival hyperplasia  
N: nystagmus 
Y: yellow discoloration of skin 
T: teratogenic 
O: osteomalacia 
I: interfere with folate/B12 absorption 
N: Neuropathies--vertigo and ataxia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Carbamazepine side effects

*mnemonic

A

H–hyponatremia** (esp eldery) and hepatotixc
E–eosinophillia
A—agranulocytosis, ataxia, aplastic anemia
D—Diplopia, dizziness
S—SJS, Splenomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

SE for Valproate (valproic acid)

A 
V----vomiting 
A--alopecia
L---liver toxicity 
P---Pancreatitis/Pancytopenia 
R---retention of fats (wt gain) 
O----oedema (periphereal) 
A---Anorexia
T---Tremor 
E---Enzyme inhibitor---P450 drug interactions
36
Q

Indications for Carbamazepine

A

partial–simple and complex
gen tonic-clonic

mania
Bipolar disorder (2nd line)
Trigeminal neuralgia ** (frist line)

37
Q

What is the tx for trigeminal neuralgia 1st line

A

Carbamazepine

38
Q

Can you prescribe carbamazepine in pregnancy?

A

no

39
Q

which AED drugs cause hyponetremia

A

Carbamazepine (esp in eldery)

40
Q

Phenobarbital drug clas?

A

barbituate and hypnotic

41
Q

T/F: all barbituates are anticonvulsants and have epilpetic properties

A

FALSE

*****yes true that all barbituates are anticonvulsants but not ALL are antiepilpetic *only a few are

42
Q

MOA phenobarb

A

increases inhibitory effect of GABA

Decrs release of glutamate

43
Q

Indications for phenobarb

A

FIRST LINE TX IN FEBRILE SZ

  • status ep after phenytoin administration
  • partial (simplex and complex)
  • gen TC
44
Q

SE for phenobarb

A 
Depression******
osteoporosis ***** 
irritability ****** 
sedation 
hypnosis
45
Q

which drug is part of Hydantoins?

A

Phenytoin

46
Q

what is an advantage to using phenytoin as an AED?

A

little sedation!!!

no CNS depression

47
Q

MOA for phenytoin

A

Prolongs inactivation pd of NA channels

48
Q

indicatoins for phenytoin

A

IV in acute situations—-second line SE ***

-focal and generalized sz

49
Q

routes of adminstration for Phenytoin

A

IV**

DO NOT GIVE IM

50
Q

Do you need to monitor drug levels for phenytoin

A

yes

51
Q

SE of phenytoin

A 
Gingival hyperplasia 
rash--erythema multiforme and SJS 
hirtuism 
dizziness
ataxia 
diplopia 
postural imbalance 
teratogenic
52
Q

Phenytoin and Fosphenytoin–which cann be admin IM?

A

Fosphenytoin only

**second line too for SE if cant get IV

53
Q

Valproic Acid MOA

A
  • blocks NA
  • Enhances GABA + NMDA
  • Blocks CA

***provides broad spectrum of anti-seizure activity

54
Q

INDS for Valproic acid

A

Bipolar

  • absence sz
  • gen TC sz
  • partial sz
  • *first line for myoclonic
55
Q

valproic acid is 1st line tx in what sz

A

myoclonus

56
Q

SE for valproic acid

A

**pancreatitis
**hepatotoxicity
n/v/d
tremor
teratogenic

57
Q

which AED can cause pancreatitis?

A

Valproic acid

58
Q

which AEDs are teratogenic

A

phenytoin
valproic acid
carbamazepine

59
Q

Lamotrigine MOA

A

Inactivates NA and CA

60
Q

INDS for lamotrigine

A

wide variety of seizures

Bipolar

61
Q

SE lamotrigine

A 
dizzines
ataxia 
sleepiness 
allergic rash 
HA 
visual disutrbances
rare cases SJS
62
Q

What do we do if we add Divalpproex to our tx with Lamotrigine

A

We must reduce the dose of Lamotrigine

63
Q

what can occur if you titrate Lamotrigine too fast?

A

Rash can develop—-can progress to LT anaphylaxsis

64
Q

Levetiracetam (keppra) used when??

A

as adjunct therapy in tx of:

  • partial
  • myoclonic
  • generalized TC

kids and adults

65
Q

SE of Levetriacetam

A 
Sleepiness
dizziness
HA
tiredness 
nervousnss
mood alteration
66
Q

what is a good adjunct tx to add for partial, myoclonic or gen TC seizures?

A

Levetriacetam

67
Q

Topiramate INDS

A

TC and partial SZs

*prevention of migraines

68
Q

Which AED mediaction can also help in TX of mirgraines?

A

Topiramate

69
Q

SE of Topiramate

A 
sleepiness
dizziness
tiredness
mental confuseion 
RENAL STONES***
70
Q

which drug can cause renal stones

A

Topiramate

Zonisamide

71
Q

Zonisamide IND

A

Gen TC and partial

myclonus

72
Q

SE for Zonisamide

A

minor cns disturbances
sleepiness
rashes
renal stones

73
Q

Felbamate MOA

A

broad spectrum

  • na block
  • CA block
  • glutamate block
  • enhance GABA
74
Q

SE for Felbamate

A
  • **aplastic anemia

* **liver failure

75
Q

IND for Felbamate

A

Refractory epilepsies

76
Q

which drug can cause aplastic anemia

A

Felbamate

77
Q

Gabapentin MOA

A

ANALOG OF GABA
blocks CA
decreases glutamate

78
Q

Gabapentin SE

A

FEW*
-HA
dizziness
tiredness
adjust dose for PT with renal dx…

79
Q

What is a good AED for elderly

A

gabapentin

80
Q

INDS for gabapentin

A

focal sz

post-herpectic neuralgia for PAIN

81
Q

what drug do we give for fibromyalgia

A

Pregabalin

82
Q

Lacosamdie IND

A

*add on tx with other drugs (adjunct) for partial seizures in PT >17 YO

83
Q

MOA for Lacosamide

A

blocks NA

84
Q

what is a good adjunct tx for partial seizures in PT 17+

A

Lacosamide

85
Q

SE for Lacosamide

A

blury vision
dizzines
ataxia
electrical issues with heart can occur too

Pharmacology (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions