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Boards Prep > Pharmacology of Anti-Seizure Drugs > Flashcards

Pharmacology of Anti-Seizure Drugs Flashcards

1
Q

What drugs are used as rescue drugs for status epilepticus and may be administered nasally?

A

Diazepam, Lorazepam, Clonazepam

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2
Q

This drug is second-line for status elepticus.

A

Fosphenytoin

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3
Q

What ASMs are broad spectrum enzyme inducers?

A

Phenytoin, Carbamazepine, Phenobarbital

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4
Q

True/False. There is no drug to treat epilepsy.

A

True. Current drugs treat active seizures and manage symptoms, but cannot cure epilepsy.

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5
Q

What ASM blocks NMDA receptors?

A

Felbamate

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6
Q

What ASM is associated with anger and irritability?

A

Levetiracetam

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7
Q

What is the MOA of Tiagabine?

A

Inhibits pre-synaptic GABA uptake

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8
Q

What ASM is associated with weight loss?

A

Topiramate

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9
Q

This drug may be used to treat focal seizures in children and adults, but is not a first line option.

A

Phenytoin

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10
Q

Diplopia and ataxia are ADRs most commonly associated with what ASM?

A

Carbamazepine

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11
Q

What ASM has zero-order kinetics?

A

Phenytoin

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12
Q

ASMs that target Na+ channels should be closely monitored in what patient population?

A

Patients over 60yo or with cardiac issues

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13
Q

Topiramate is used for the treatment of what seizure types?

A

Monotherapy for focal and generalized seizures and migranes

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14
Q

What ASMs act by inhibiting Na+ channels?

A

Phenytoin, Carbamazepine, Lamotrigine, Topiramate, VPA

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15
Q

What is the MOA of Valproate/Valproic Acid?

A

Blocks Na+ channels and increases K+ permeability

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16
Q

What is the first line therapy for absence epilepsy in adults?

A

Ethosuximide

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17
Q

What is the use for Tiagabine?

A

Adjunct therapy for focal seizures

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18
Q

What ASM may exacerbate myoclonic and abscene seizures, if prescribed?

A

Carbamazepine

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19
Q

Infantile spasms and tuberous sclerosis can be treated with what ASM?

A

Vigabatrin

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20
Q

What Na+ channel-targeting ASMs are broad spectrum?

A

Lamotrigine, Valproate, Topiramate,

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21
Q

What is the MOA of Carbamazepine?

A

Binds to inactivated Na+ channels

22
Q

Benzodiazepines & barbituates both bind the GABAa receptor to enhance Cl- channel function. How do their MOAs differ?

A

Benzodiazepines increase the duration of channel opening. Barbituates increase the frequency of channel opening. Both cause hyperpolariztion.

23
Q

These ASMs are good for adjunct therapy, but are not used first line for any epilepsy.

A

Gabapentin, Pregabalin

24
Q

What ASM is a first-line therapy for seizures in neonates?

A

Phenobarbital

25
Q

Vigabtrin is associated with what irreversible ADR?

A

Vision deficits and retinopathy

26
Q

What ASM is associated with weight loss?

A

Ethosuximide & Topiramate

27
Q

How is Levetircetam used in adults?

A

Adjunct therapy for focal seizures

28
Q

What is the MOA of Levetircetam?

A

Binds the synaptic vesicle to modify neurotransmitter release

29
Q

What ASMs are associated with behavioral changes?

A

Levetircetam, Perampanel

30
Q

What ADRs are most associated with Valproate/Valproic Acid?

A

GI disturbances

31
Q

What ASM can be added as an adjunct therapy to treat generalized tonic-clonic seizures in children?

A

Levetircetam

32
Q

What serious ADRs are associated with phenytoin?

A

SJS/TEN, gingival hyperplasia

33
Q

What is the MOA of Lamotrigine?

A

Bind inactivated Na+ channels

34
Q

What rare ADR is unique to Lamotrigine?

A

Hemophagocytic Lymphohistiocytosis (HLH)

35
Q

What ASM is contraindicated during pregnancy?

A

Valproate/Valproic Acid

36
Q

What is the MOA of gabapentin & pregabalin?

A

Bind Ca2+ channels to decrease Ca2+ influx and thus glutamate release

37
Q

What ASM irreversible inhibits the GABA aminotransferase to prevent degradation of GABA?

A

Vigabatrin

38
Q

Dependence and tolerance are commonly associated with what class of ASMs?

A

Benzodiazepines (Diazepam, Lorazepam, Clonazepam)

39
Q

How do ASMs inhibit Na+ channels?

A

They bind to Na+ channels in the inactivated state to extend the refractory period

40
Q

When is the MOA of Phenytoin and Fosphenytoin?

A

Bind inactivated Na+ channels

41
Q

Juvenile Myoclonic Epilepsy is effectively treated with this ASM.

A

Valproate/Valproic Acid

42
Q

What is the most common drug to treat focal seizures?

A

Carbamazepine

43
Q

What is the first line therapy for absence epilepsy in children?

A

Ethosuximide

44
Q

What is the MOA of Carbamazepine?

A

Bind inactivated Na+ channels

45
Q

In utero cardiac malformations are associated with which ASM?

A

Phenobarbital

46
Q

How does Fosphenytoin differ from Phenytoin?

A

Fosphenytoin is a phenytoin derivate that may be administered via IM or IV

47
Q

Most ASMs are broad inducers of enzymes. What ASM is a broad INHIBITOR?

A

Valproate/Valproic Acid

48
Q

What ASM acts on Ca2+ channels on thalamic neurons?

A

Ethosuximide

49
Q

Cannabidol has been approved for treatment of what seizure disorders?

A

Lennox-Gastaut Syndrome, Dravet Syndrome, Tuberous Sclerosis

50
Q

What serious ADRs are associated with Felbamate?

A

Liver failure, aplastic anemia

51
Q

Cognitive slowing is associated with what ASM?

A

Topiramate

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