Pharm- Treatment of Epilepsy

Question 1

What are the Mechanisms of actions of Antiepileptic drugs?

Answer 1

1. Reducing electrical excitability of cell membranes through use- dependent block of Na channels.
2. Enhancing GABA mediated synaptic inhibition.
3. Inhibiting Ca 2+ channels.

Question 2

What are examples of Sodium channel blockers ( Anti-epileptic drugs) ?

Answer 2

Please- Phenytoin
Tell - Topiramate
Laurie - Lamotrigine
Zendaya - Zonisamide
Feels for - Felbamate
Vanilla - Valproic acid
Capuccino - Carbamazepine

Question 3

What is a seizure?

Answer 3

A seizure reflects an imbalance between excitatory and inhibitory activity in the brain, with an increment of excitation over inhibition.

Question 4

What are the two ways in which AED’s enhance GABA mediated inhibition?

Answer 4

1. By enhanced postsynaptic action of GABA.
2. By inhibiting GABA transaminase [responsible for inactivating GABA].

Question 5

Which drug inhibits the enzyme GABA transaminase ( which is responsible for inactivating GABA)?

Answer 5

Vigabatrin

Question 6

Fill in the blanks. “ __________ functions as the “ pacemakers” of normal rhythmic brain activity .

Answer 6

Calcium channels

Question 7

Which drug owes its antiepileptic effect mainly to inhibition of P/Q type Ca channel ?

Answer 7

Gabapentin

Question 8

Which drug inhibits GABA uptake therefore
Increase in extracellular concentration of GABA and enhances action of GABA as inhibitory neurotransmitter?

Answer 8

Tiagabine

Question 9

Which drug causes the Inhibition of T type Ca 2+ channels?

Answer 9

Ethosuximide

Question 10

What is the first line agent of Absence seizures ?

Answer 10

Ethosuximide

Question 11

What is the MOA of Phenobarbital?

Answer 11

Potentiates GABA- ergic neuronal transmission by ↑ duration of Cl – channel openings → membrane hyperpolarization & ↓ excitability

Question 12

What is the MOA of Topiramate?

Answer 12

• Blockade of AMPA/ kainate subtype of glutamate receptors.
• Blockade of voltage- sensitive Na + channels

Question 13

What is the clinical use of Lamotrigine?

Answer 13

Used to treat partial, generalized tonic- clonic, absence seizures; bipolar affective disorder

Question 14

What is the MOA of Lamotrigine?

Answer 14

Blockade voltage –dependent Na + channels

Question 15

What are the adverse effects of Lamotrigine?

Answer 15

Dizziness, blurred vision, rarely – toxic epidermal necrolysis, Stevens –Johnson syndrome

Question 16

Which drugs are used for Tonic-Clonic seizures?

Answer 16

Phenytoin
Carbamazepine
Valproate
Primidone
Vigabatrin
Lamotrigine
Phenobarbital

Question 17

Which drugs are used for Partial ( focal ) Seizures?

Answer 17

Carbamazepine
Phenytoin
Valproic acid
Primidone
Phenobarbital
Lamotrigine
Zonisamide

Question 18

Which drugs are used for the treatment for Absence seizures?

Answer 18

Ethosuximide +
Valproic acid
Lamotrigine

Question 19

Which drugs are used for Myoclonic seizures?

Answer 19

Valproate
Diazepam, Clonazepam
Zonisamide
Ethosuximide

Question 20

Which anti-epileptic drug can be used for treatment of Anxiety disorders?

Answer 20

Gabapentin

Question 21

Which anti-epileptic drug can be used for treatment Arrythmias?

Answer 21

Phenytoin

Question 22

Which Anti-epilipetic drugs can be used to treat Bipolar affective disorder?

Answer 22

Carbamazepine
Valproate
Lamotrigine
Topiramate

Question 23

Which AED’s should be avoided in young women?

Answer 23

Valpotrate
Phenytoin