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
Vigabtrin is associated with what irreversible ADR?
Vision deficits and retinopathy
26
What ASM is associated with weight loss?
Ethosuximide & Topiramate
27
How is Levetircetam used in adults?
Adjunct therapy for focal seizures
28
What is the MOA of Levetircetam?
Binds the synaptic vesicle to modify neurotransmitter release
29
What ASMs are associated with behavioral changes?
Levetircetam, Perampanel
30
What ADRs are most associated with Valproate/Valproic Acid?
GI disturbances
31
What ASM can be added as an adjunct therapy to treat generalized tonic-clonic seizures in children?
Levetircetam
32
What serious ADRs are associated with phenytoin?
SJS/TEN, gingival hyperplasia
33
What is the MOA of Lamotrigine?
Bind inactivated Na+ channels
34
What rare ADR is unique to Lamotrigine?
Hemophagocytic Lymphohistiocytosis (HLH)
35
What ASM is contraindicated during pregnancy?
Valproate/Valproic Acid
36
What is the MOA of gabapentin & pregabalin?
Bind Ca2+ channels to decrease Ca2+ influx and thus glutamate release
37
What ASM irreversible inhibits the GABA aminotransferase to prevent degradation of GABA?
Vigabatrin
38
Dependence and tolerance are commonly associated with what class of ASMs?
Benzodiazepines (Diazepam, Lorazepam, Clonazepam)
39
How do ASMs inhibit Na+ channels?
They bind to Na+ channels in the inactivated state to extend the refractory period
40
When is the MOA of Phenytoin and Fosphenytoin?
Bind inactivated Na+ channels
41
Juvenile Myoclonic Epilepsy is effectively treated with this ASM.
Valproate/Valproic Acid
42
What is the most common drug to treat focal seizures?
Carbamazepine
43
What is the first line therapy for absence epilepsy in children?
Ethosuximide
44
What is the MOA of Carbamazepine?
Bind inactivated Na+ channels
45
In utero cardiac malformations are associated with which ASM?
Phenobarbital
46
How does Fosphenytoin differ from Phenytoin?
Fosphenytoin is a phenytoin derivate that may be administered via IM or IV
47
Most ASMs are broad inducers of enzymes. What ASM is a broad INHIBITOR?
Valproate/Valproic Acid
48
What ASM acts on Ca2+ channels on thalamic neurons?
Ethosuximide
49
Cannabidol has been approved for treatment of what seizure disorders?
Lennox-Gastaut Syndrome, Dravet Syndrome, Tuberous Sclerosis
50
What serious ADRs are associated with Felbamate?
Liver failure, aplastic anemia
51
Cognitive slowing is associated with what ASM?
Topiramate