Pathophysiology and Drug Therapy for Epilepsy Flashcards

1
Q

What is a seizure

A

a brief distinct event that is irregular that results from abnormal or synchronous discharge of cortical neurons

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2
Q

What happens on a cellular level during seizures

A

small group of abnormal neurons undergo prolonged depolarizations and recruit adjacent neurons into rapid firing

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3
Q

What are the 3 targets of antiepileptic drugs

A

voltage/ligand gated ion channels, GABA channels, glutamate channels

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4
Q

What is epilepsy

A

neurological condition characterized by 2 or more seizures unprovoked by an immediately identifiable cause separated by greater than 24 hours

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5
Q

T/F: Greater than 2/3 of people will never know why they have seizures

A

True

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6
Q

What are the previous ,but still useful, ways to divide seizure types

A

Partial (focal) and generalized

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7
Q

What is the factor that divides partial seizures into two categories, what are those categories

A

alteration of consciousness/responsivness, simple and complex

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8
Q

T/F: In simple partial seizures a patient will become unconscious or unresponsive, while complex this does not occur

A

False: Complex seizures causing unconsciousness or unresponsive behavior

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9
Q

What is aura

A

event/phenomenon that occurs right before a seizure happens to a patient

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10
Q

What is automatism, examples

A

A specific unconscious behavior that is associated with a seizure/ chewing, swallowing, lipsmacking, hand movements

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11
Q

What are the three most common first generation antiepileptic drugs

A

Carbamazepine, phenytoin, valporic acid

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12
Q

What are the six most common 2nd/3rd generation antiepileptic drugs

A

Lacosamide, lamotrigine, levetiracetam, oxacarbazepine, topiramate, vigabatrin

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13
Q

T/F: Patients are not started on seizure medication after the first unprovoked seizure true

A

True

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14
Q

When it is determined that someone needs medication for seizure control how much of the dose should be given at first

A

Start low, increase slowly

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15
Q

T/F: When dealing with seizures patients should be given dual or triple therapy

A

False: Restrict therapy to monotherapy whenever possible

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16
Q

What are factors that may precipitate a patient’s seizures

A

Alcohol, lack of sleep, stress, poor diet, fever, and flickering lights

17
Q

What drugs are first line for focal onset seizures and focal to bilateral seizures, 2nd line

A

carbamazepine, lamotrigine, levetiracetam, oxcarbazepine/ valproic acid, topiramate, lacosamide, phenytoin

18
Q

What are the six Antiepileptic drugs that can be used to treat generalized onset tonic-clonic seizures

A

carbamezepine, lamotrigine, topiramate, levetiracetam, phenytoin, valporic acid

19
Q

What are the three antiepileptic drugs that can be used to treat absence seizures

A

Valporic acid, lamotrigine, levetiracetam

20
Q

What four AEDs drugs can treat atypical absence and atonic seizures

A

Lamotrigein, valporic acid, topiramate, levetiracetam

21
Q

What two AEDs can treat myoclonic seizures

A

Valporic acid, levetiracetam

22
Q

What are common AED side effects

A

sedation, dizziness

23
Q

What AED shouldnt be used in patients who have anxiety due to a side effect

A

Levetiracetam

24
Q

What two AEDs have chronic side effects, what are those side effects

A
Carbamezepine (osteoporosis, leukopenia, hyponatremia)
Valporic acid (alopecia, weight gain, polycystic ovaries)
25
Q

What two AEDs are also indicated for migraines, depression, and bipolar disorder

A

Carbamezepine and Valporic acid

26
Q

What AED has no drug=drug interactions due to being metabolized mostly in the kidneys

A

Levetiracetam