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Pharmacology & Drugs > Neuro-Epileptic Drugs > Flashcards

Neuro-Epileptic Drugs Flashcards

1
Q

What is the definition of a seizure

A

Transient alteration of behavior due to disordered synchronous and rhythmic firing of brain neurons

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2
Q

What class of drug is Oxcarbazepine

A

Prolonged fast inactivation voltage gated sodium channel

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3
Q

What is the correlation between barbituates and needed levels of GABA

A

GABA independent

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4
Q

Which class is gabapentin

A

Alpha calcium channel

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5
Q

Which type of conditions can Calcium the T channels AEDs be used to treat

A

Petit mal aka absence seizures

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6
Q

What is the mechanism of Vigabatrin

A

Blocks metabolism of GABA-T

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7
Q

What is the general psychological risk associated with all AED

A

Depression and suicidal thoughts

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8
Q

What are the AED indications for primidone

A

Tonic/colon seizures

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9
Q

What are the sedating drugs given for treatment of nonconvulsive state epilepticus

A
  • Lorazepam
  • Diazepam
  • midazolam
  • Clonazepam
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10
Q

Which class is ethosuximide

A

T type Calcium Channel inhibitor

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11
Q

What drug class if Topiramate

A

AMPA receptor antagonist

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12
Q

What is the mechanism of action for Tiagabine

A

Blocks the reuptake of GABA via GAT1, leading to increased concentration in the cleft

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13
Q

What type of channel mediates the absence (petit mal) seizure

A

T type calcium channels

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14
Q

What are the AED indications for phenobarbital

A

Broad spectrum

-Epilepsy

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15
Q

What is the result of AED inducers taken with anticoagulants

A

Increase the clearance of warfarin, resulting in the increased risk for clots and thrombosis `

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16
Q

Which class is levitiracetams (and all -racetams)

A

Synaptic vesicles 2A proteins which loads Glutamate into vesicles

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17
Q

What are the AED indications for perampanel

A

Simple and complex seizures

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18
Q

What is the side effect of giving valproic acid or lamotrigine

A

-Inhibits conjugation of grubs by UGT, resulting in the accumulation of parent drug

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19
Q

What class of drug is lamotrigine

A

Prolonged fast inactivation voltage gated sodium channel

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20
Q

How do AMPA receptors function

A

Ligands bind to the AMPA receptor and allow depolarization

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21
Q

Which class is pregabalin

A

Alpha calcium channel

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22
Q

Which class is clonazepam

A

Benzodiazepine (aka post synaptic GABAreceptor)

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23
Q

What are the AED indications for lacosamide

A

Simple and complex seizures

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24
Q

What is the mechanism of valproic acid

A

Blocks metabolism of GABA via GABA-T

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25
Q

If a patients comes into the hospital with status epilepticus, what are the drugs given via the second IV

A

Fosphenyoin
Phenytoin
Valproic acid
Levetiracetam

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26
Q

What is the correlation between benzodiazapines and needed levels of GABA

A

Benzodiazepines are GABA dependent

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27
Q

What is the result of AED inducers taken with HIV medications

A

Increases the clearance and increased risk of HIV replication

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28
Q

What are the side effects of vigabatrin

A

Progressive, permanent, bilateral concentric vision loss

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29
Q

What are the AED indications for diazepam

A

Epilepsy

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30
Q

What is the mechanism of action for benzodiazepines

A

-Bind to an allosteric GABA receptor binding site that potentiates GABA binding and hyperpolarization

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31
Q

What is unique about carbamazepine and its metabolism

A

Induces CYP450, which subsequently increases its own metabolism, so there is a drop in efficacy of the drug, leading to recurrent seizures

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32
Q

What are the AED indications for valproic acid

A
  • Absence seizure
  • Broad spectrum seizure
  • Epilepsy
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33
Q

What are the AED indications for lamotrigine

A

Simple and complex Parital seizures

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34
Q

Which class is primidone

A

Barbituate (aka post synaptic GABAreceptor)

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35
Q

What drug class is perampanel

A

AMPA-receptor antagonist

36
Q

What are the three general classes of AED that inhibit the post synaptic GABA receptors

A
  • Barbituates
  • Benzodiazapines
  • Topiramate
37
Q

Which class of drug is Tiagabine

A

Presynaptic GAT-1 inhibitor

38
Q

What are the AED indications for Ethosuzimide

A

Absence seizures

39
Q

What class if felbamate

A

NMDA receptor antagonist

40
Q

What is the mechanism that some AED can cause osteoporosis

A

They induce CYP450, which causes vitamin D catabolism, resulting in lower circulating levels. This decreases absorption of Calcium in the intestine and subsequent increased PTH secretion and demineralization from bone

41
Q

What are the AED indications for lorazepam

A

Epilepsy

42
Q

What are the steps in the activation and depolarization of sodium voltage gated channels

A

1) Resting state (activation gate closed)
2) Open state (both open)
3) Fast-Inactivated (inactivation gate closed)
4) Inactivated closed (both gates closed)

43
Q

Which class of drug is lacosamide

A

Prolonged fast inactivation voltage gated sodium channel

44
Q

What class of drug is vigabatrin

A

Presynaptic GABA-T inhibitor

45
Q

What are the side effects of carbamazepine

A
  • Inducer of CYP-450
  • Leukopenia/neutropenia/thrombocytopenia
  • Osteoporosis
46
Q

How does the action of binding for the AED on voltage gated sodium channels effect when the AED can actually bind

A

AEDs can only bind to the pore when the activation gate is open, whcih is in the open state or the fast-Inactivated state

47
Q

What are the AED indications for clonazepam

A
  • Absence seizure

- Myoclonic seizure

48
Q

What class of drug is valproic acid

A

Presynaptic GABA-T inhibitor

49
Q

What is the effect of the the newer AEDs that are eliminated by the kidneys, rather than the liver

A

Patients with renal insufficiency must have their dose levels adjusted

50
Q

Which drug class is Lacosamine

A

Enhanced slow inactivation voltage gated sodium channel

51
Q

What class of drug is Carbamazepine

A

Prolonged fast inactivation voltage gated sodium channel

52
Q

What is the definition of epilepsy

A

Acquired or inherited malformation of neuronal ion channels or NT systems that disrupt the electrical activity of the brain

53
Q

Which class is phenobarbital

A

Barbituate (aka post synaptic GABAreceptor)

54
Q

Which class of drug is valproic acid

A

Prolonged fast inactivation voltage gated sodium channel

55
Q

What is the mechanism of an enhanced slow inactivation of sodium channels

A

Prolonged depolarized stimuli, the drug will reduce the amplitude and frequency of the sustained repetitive firing spikes

56
Q

What are the AED indications for levetiracetam

A

Epilepsy

57
Q

What are the AED indications for primidone

A

Simple and complex partial seizures

58
Q

If a patients comes into the hospital with status epilepticus, what is the first drug given if IV is not available

A

Midazolam

59
Q

What are the side effects associated with Phenytoin

A
  • Inducer of CYP450
  • gingival hyperplasia
  • hypothyroidism
  • CV risk
  • Hypocalcemia/Osteoporosis
60
Q

What are the nonsedating drugs given for treatment of nonconvulsive state epilepticus

A
  • Phenytoin
  • Fosphenytoin
  • Valproate
  • Levetiracetam
  • Lacosamide
61
Q

Which AED drugs are associated with osteoporosis during chronic use

A
  • Cabamazepine
  • Phenytoin
  • Phenobarbital
  • Valproic acid
62
Q

What are the AED indications for phenytoin

A

Tonic/clinic seizures

-Epilepsy

63
Q

What are the side effects of phenobarbital

A
  • Inducer of CYP450
  • CNS depression
  • Osteoporosis
64
Q

Which class of drug is topirimate

A

Prolonged fast inactivation voltage gated sodium channel

65
Q

What is the result of AED induces while taking OCs

A

Increases the clearance of the OC, resulting in increased risk of pregnancy

66
Q

What are the AED indications for topiramate

A

Broad spectrum

67
Q

Which class of drug is zonisamide

A

Prolonged fast inactivation voltage gated sodium channel

68
Q

What is a generalized seizure

A

Seizure that involves both hemispheres

69
Q

What is the binding site of AEDs with regards to those that bind to the voltage gated sodium channels

A

Binding site is in the interior of the sodium channel

70
Q

Which class of drug is phenytoin

A

Prolonged fast inactivation voltage gated sodium channel

71
Q

What allergic reaction is possible with the drug zonisamide

A

Allergic reaction to a sulfonamide

72
Q

Which class is diazepam

A

Benzodiazepine (aka post synaptic GABAreceptor)

73
Q

What are the AED indications for oxcarbazepine

A

Simple and complex partial seizures

74
Q

What is meant when they say that sodium voltage gated AED are use dependent

A

Because they bind to the inside of the pore, they can only bind when the pore is open. Therefore, the amount of binding is proportional to the frequency that the channel is open

75
Q

Which class of drug is Rufinamide

A

Prolonged fast inactivation voltage gated sodium channel

76
Q

Which class is lorazepam

A

Benzodiazepine (aka post synaptic GABAreceptor)

77
Q

What is a complex partial seizure

A

Starts in a localized cortical site and includes impairment of consciousness

78
Q

What is the mechanism of action for Barbiturates

A

Bind to an allosteric binding site on GABA receptor and increased Chloride channel opening

79
Q

Which class is Topiramate

A

GABA agonist

  • Sodium fast inactivator
  • AMPA receptor blocker
80
Q

What is a simple partial seizure

A

Starts in a localized cortical region and included the Preservation of consciousness

81
Q

What is the side effect of giving phenytoin, carbamazepine, or phenobarbital

A

Inducers of CYP 450

Induces conjugation of drugs by UGT, resulting in the reduction of the parent drug

82
Q

If a patients comes into the hospital with status epilepticus, what is the first drug given via IV

A

Lorazepam or diazepam

83
Q

Which class is clobazam

A

Benzodiazepine (aka post synaptic GABAreceptor)

84
Q

What are the characteristics of a sodium channel when it is in the inactivated state

A

Aka fast inactivated state

-Can not be deactivated directly or instantly because it is closed from the inside

85
Q

What are the AED indications for carbamazepine

A

Broad spectrum

86
Q

What are the kinetics associated with Phenyoin

A

Zero order

Pharmacology & Drugs (43 decks)

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