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CNS > Pharma-Antiepileptic Drugs > Flashcards

Pharma-Antiepileptic Drugs Flashcards

0
Q

1) Clozapine
2) Olanzapine
3) Risperidone
4) Ziprasidone
5) Amisulpride

A

Atypical antipsychotics (Second generation)

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1
Q

1) Chlorpromazine

2) Haloperidol

A

Typical antipsychotics (First generation)

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2
Q

MOA of typical antipsychotics

A

Block D2 receptors in brain’s dopamine pathways

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3
Q

MOA of atypical antipsychotics

A

Block D2 receptors in brain’s dopamine pathways with additional to serotonin receptors

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4
Q

Seizures?

A

Abnormal excessive neuroactivity in the brain

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5
Q

Convulsions?

A

1) Contraction and relaxation of skeletal muscle (Repeated and rapid)
2) Due to head injury, drug overdose or toxins

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6
Q

Epilepsy?

A

Seizures with or without convulsions with no immediate underlying cause

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7
Q

Classifications of seizures

A

1) Partial “focal” seizures
2) Generalised seizures
3) Status epilepticus

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8
Q

Aim of treatment of anti-epileptic drugs

A

1) Drugs/pharmacological

2) Vagus nerve stimulation

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9
Q

MOA of anti-epileptic drugs

A

1) Inhibit voltage-gated sodium channels
2) Reduce GABA-ergic transmission
3) Calcium channel inhibitors

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10
Q

1) Phenytoin
2) Carbamazepine
3) Lamotrigine
4) Valproic acid

A

Inhibit voltage-gated sodium channels

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11
Q

1) Ethosuximide

2) Lamotrigine

A

Ca2+ channel inhibitors

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12
Q

1) Benzodiazepines
2) Phenobarbital
3) Valproic acid
4) Galbapentin, Pregabalin
5) Felbamate

A

Reduce GABA-ergic transmission

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13
Q

1) Grand mal, Complex Partial
2) Not indicated for absence seizures
3) Antiarrythmic drug (Digoxin toxicity)
4) Enhance inactive form of Na2+ channels

A

Phenytoin (Dilantin)

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14
Q

1) Nystagmus, double vision, tremor, ataxia, sedation (CNS-related)
2) Megaloblastic anemia due to low folate production
3) Teratogenic
4) Drug-induced lupus
5) Gingival hyperplasia
6) Induction of liver enzymes
7) Interacts with Warfarin and Trimethoprim

A

Side effects of phenytoin

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15
Q

Fosphenytoin?

A

Prodrug of phenytoin

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16
Q

1) Grand mal, Complex Partial
2) Not indicated for absence seizures
3) Trigeminal neuralgia; neuropathic pain
4) Long half life (~30 hours)

A

Carbamazepine (Tegretol)

17
Q

1) Aplastic anemia
2) Teratogenic: Spina Bifida
3) Drowsiness, dizziness, headache, nausea (CNS)
4) Enhance liver enzymes

A

Side effects of carbamazepine

18
Q

Oxycarbazepine

A

Prodrug of carbamazepine

19
Q

Drug of choice for absence seizures

A

Ethosuximide

20
Q

1) CNS-related side effects

2) GI-related side effects

A

Ethosuximide

21
Q

1) Absence seizures
2) Tonic-clonic (Grand mal)
3) Status epilepticus

A

Valproic acid

22
Q

Mood stabiliser for bipolar mania?

A

Valproic acid

23
Q

1) CNS-related
2) Diarrhea, liver toxicity (GI-related)
3) Hyperandrogenism (Female)
4) Low liver enzyme production
5) Blood protein-bound
6) Teratogenic

A

Side effects of valproic acid

24
Q

Drug of choice for status epilepticus

A

Benzodiazepines, Phenobarbital

25
Q

MOA of Phenobarbital and Benzodiazepines

A

Potentiate GABA function

26
Q

1) Diazepam

2) Lorazepam

A

Benzodiazepines, Phenobarbital

27
Q

Special precaution for Benzodiazepines and Phenobarbital

A

Low therapeutic index

28
Q

Side effect of Benzodiazepines and Phenobarbital

A

Sedation

29
Q

1) Partial, Generalised, Atypical Absence seizures
2) Metabolised in liver
3) Indication for bipolar and neuropathic pain

A

Lamotrigine

30
Q

Side effect of lamotrigine

A

Severe skin reaction (serious side effect)

31
Q

Lamotrigine + Phenytoin?

A

Increase lamotrigine dose

32
Q

Lamotrigine + Valproate

A

Reduce lamotrigine dose

33
Q

1) Euphoria

2) Sedation

A

Side effects of Gabapentin, Pregabalin

34
Q

1) Fatal
2) Aplastic anemia
3) Hepatic failure

A

Side effects of felbamate

35
Q

1) Used for refractory epilepsies

2) Multiple mechanisms (Na+, Ca2+, GABA, NMDA)

A

Felbamate

36
Q

1) Dizziness

2) Somnolence

A

Side effects of Levetiracetam (Keppra)

37
Q

1) Partial seizures
2) Adjunct for Generalised epilepsy
3) Unknown MOA

A

Levetiracetam (Keppra)

38
Q

TT of status epilepticus

A

1) IV Diazepam or lorazepam
2) IV Phenytoin or Fosphenytoin
3) IV Phenobarbitone

39
Q

TT of severe refractory epilepsy

A

1) GA
2) Artificial respiration
3) Neuromuscular blocker

40
Q

1) Monotherapy
2) Lowest possible dose
3) Lamotrigine, oxcarbazepine, gabapentin are indicated
4) Valproate, phenobarbital, others are contraindicated

A

Pregnancy

41
Q

No or minimal effect to hepatic enzymes

A

1) Topiramate

2) Oxcarbazepine

CNS (6 decks)

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