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Neuro Midterm > Pharmacology - Epilepsy > Flashcards

Pharmacology - Epilepsy Flashcards

1
Q

true or false

seizures are generally self-limiting

A

true

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2
Q

focal seizures are also known as ___ seizures

A

partial

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3
Q

some neonates are not treated with antiepileptics but with….

A

steroids

for isoniazid seizures use pyridoxial

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4
Q

***perampanel MOA

A

specific AMPA receptor antagonist

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5
Q

name 6 drugs that block voltage gated sodium channel

A

phenytoin
fospheyntoin
carbamazepine
oxcarbazepine
eslicarbazepine
zonisamide

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6
Q

name a drug that blocks voltage gated sodium channels AND enhances GABA release

A

cenobamate

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7
Q

what drug inhibits GABA transaminase with little - no metabolism?

A

vigabatrin

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8
Q

what drug inhibits GAT-1

A

tigabine

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9
Q

3 MOA of valproate (depakote)

A
  1. inhibits GABA transaminase
  2. blocks voltage gated sodium channels
  3. downregulates NMDA receptors
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10
Q

name 3 benzodiazepines

A

diazepam
lorazepam
clonazepam

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11
Q

**name 2 drugs that interact with SV2A proteins and what this does

A

inhibits repetitive burst firing of neurons

leviteracetam, brivaracetam

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12
Q

** AE of levitiracetam and briviracetam, particularly in kids

A

increased aggression

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13
Q

*MOA retigabine

A

neuronal KCNQ/Kv7 potassium channel opener

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14
Q

ethosuximide MOA

A

blocks T-type calcium channels

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15
Q

MOA of gabapentin and pregabalin

A

inhibits the alpha, delta subunits of voltage gated calcium channels

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16
Q

true or false

both gabapentin and pregabalin undergo little-no metabolism

A

true

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17
Q

**MOA phenytoin

A

blocks voltage gated sodium channels

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18
Q

*phenytoin dosing concern

A

dose correct WEEKLY

does not have a stable half life and follows non linear kinetics. also highly protein bound

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19
Q

true or false

fosphenytoin has much better kinetics than phenytoin

A

true, but also is a lot more money

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20
Q

what kind of seizures can phenytoin be used in

A

all except absence

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21
Q

**phenytoin inhibits both the ___ and ____ of seizures

A

spread and initiation

(inhibition of spread is greater)

if action potential DOES occur, prevents the spread

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22
Q

*AE of phenytoin

A

osteoporosis/osteomalacia (rickets)

wide array of blood disorders - have to look at CBC

SJS

encephalopathy (ataxia, slurred speech) - it’s a cerebellar toxin!

DISLE (drug induced lupus)

can lead to dysarrhtyhmias and SA/AV blocks (bc class IB antiarrhythmic)

lethargy

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23
Q

phenytoin DDI concerns

A

CYP2C9, 2C29

highly protein bound

24
Q

1st AE that tends to show up in a person with phenytoin toxicity

A

horizontal gaze nystagmus

25
Q

as phenytoin concentration gets above ______, toxicities begin

what to look for 1st

A

20mg/L

nystagmus

30-40 = ataxia
40-50 = lethargy

26
Q

most antiepileptics ___ the CNS

what effect can this have in kids

A

depress the CNS

drugs like phenytoin can impair learning and memory in kids

27
Q

*dihydroergotamine

28
Q

**MOA carbamazepine

A

blocks sodium channels AND calcium channels

29
Q

the MODERN antiepileptics mainly block what

A

calcium channels

30
Q

common AE of carbamazepine

A

hyponatremia

31
Q

true or false

eslicarbazepine is a prodrug

32
Q

AE cenobamate (XCOPRI)

A

DRESS

drug induced eosinophilic syndrome

33
Q

**lamotrigine MOAs

A

-blocks sodium channels

-suppresses release of glutamate and aspartate (excitatory amino acids)

34
Q

lamotrigine concern

A

SJS if you rapidly dose escalate

35
Q

*4 antiepileptics metabolized by CYP3A4

A

carbamazepine
zonisimide
ethosuximide
perampenal

36
Q

**MOA valproate

A

-blocks GABA transaminase

-weak block on sodium channels

also downregulates NMDA receptors

37
Q

*AE valproate

is it teratogenic?

A

weight gain/loss, increased or decreased appetite, mood swings

YES teratogenic

38
Q

vigabatrin MOA

A

inhibits GABA transminase

39
Q

what enzyme metabolizes phenobarbital

40
Q

tiagabine MOA

A

inhibits GABA reuptake - does not inhibit GABA transaminase

41
Q

**ethosuximide MOA

A

inhibits voltage gated calcium channels

42
Q

ethosuximide may worsen what kind of seizures

A

tonic-clonic

43
Q

phenobarbital is an enzyme inducer or inhibitor

44
Q

*MOA gabapentin

A

multi moa, but MAIN is blocking voltage gated calcium channels

but also elevates GABA and blocks sodium channel (possible select all that apply and the answer is all of the above)

45
Q

advantage of pregabalin over gabapentin in diabetics

A

pregabalin works better for them for peripheral neuropathy

46
Q

***MOA lacosamide

A

enhances the slow inactivation of voltage gated sodium channels without affecting the fast inactivation of sodium channels

47
Q

*lacosamide modulates ____. this preventws what

A

modulates CRMP-2 (collapsin response mediator protein-2

prevents abnormal neuronal connections in the brain

48
Q

*lacosamide only affects which nerons and how is this beneficial

A

neurons that are depolarized or active for long periods of time

this is good bc we want to target these neurons for epilepsy

49
Q

*MOA topiramate

A

blocks sodium channels
downregulates AMPA/kainate receptors (so suppresses glutamate activity)

50
Q

*felbamate MOA

A

blocks sodium channels

upregulates GABA receptors

downregulates NMDA receptors (inhibits glutamate effects)

51
Q

**MOA keppra

A

reduces/inhibits neurotransmitter release by binding SV2A

also inhibits presynaptic calcium channels

52
Q

2 MOA briviracetam

A

-blocks SV2A
-inhibits sodium channels

53
Q

AMPA is a ___ receptor subtype

54
Q

BBW perampenal

A

aggression and unusual hostility

55
Q

*AMPA receptor antagonist

A

perampenal

56
Q

*tiagabine inhibits ____

A

GAT-1 transporter

Neuro Midterm (20 decks)

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