Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BRS YR2 > Pharmacology of Epilepsy > Flashcards

Pharmacology of Epilepsy Flashcards

1
Q

What is the primary mechanism of action of Lamotrigine?

A
  • Blocks VGSCs, preventing sodium influx
  • Prevents depolarisation of glutamatergic neurons
  • reduced glutamate excitotoxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the drug target of Lamotrigine?

A

Voltage Gated Sodium Channels (VGSCs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the main side effects of Lamotrigine?

A 
Common:
- rash
- drowsiness
Rare:
- Steven-Johnson's Syndrome
- Suicidal thoughts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can be done to prevent the frequency and severity of allergic skin reactions when taking Lamotrigine?

A

introducing it gradually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the primary mechanism of action of Sodium Valproate?

A
  • Inhibition of GABA transaminase, preventing the breakdown of GABA
  • Increasing GABA concentration directly in the synapse, pre-synaptically
  • Prolongs GABA in the synapse due to the extra-neuronal metabolism and removal being slowed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the drug target of Sodium Valproate?

A

GABA transaminase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the side effects of Sodium Valproate?

A 
MANY
Common:
- stomach pain
- diarrhoea
- drowsiness
- weight gain
- hair loss
SERIOUS:
- hepatotoxicity
- teratogenicity
- pancreatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why should a broad CYP enzyme inhibitor be prescribed in conjunction with Sodium Valproate?

A

Increases the serum concentration of many co-administered drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the primary mechanism of action of Diazepam?

A
  • Increased Cl- influx to GABA binding to the GABA-A receptor
  • hyperpolarisation of excitatory neurons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the drug target of Diazepam?

A

Benzodiazepine site on the GABA-A receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the side effects of Diazepam?

A 
common:
- drowsiness
- respiratory depression (IV or high dose)
SERIOUS:
- hemolytic anaemia
- jaundice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why is Diazepam not used for the long term suppression of seizures?

A
  • tolerance development

- Addictive, dependence likely (Schedule 4 controlled drug)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the primary mechanism of action of Levetiracetam?

A
  • Inhibition of the synaptic vesicle protein SV2A
  • prevents vesicle exocytosis
  • reduces glutamate secretion
  • reduces glutamate excitotoxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the drug target of Levetiracetam?

A

Synaptic Vesicle Protein, SV2A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the common side effects of Levetiracetam?

A
  • dizziness
  • somnolence
  • fatigue
  • headache
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is Levetiracetam favorable?

A
  • no effect on the cytochrome P450 enzyme system

- unlikely to have drug-drug interactions

17
Q

What is important to note when prescribing therapeutic drugs for seizures?

A
  • must tell pateint, they CANNOT drive

- they MUST tell the DVLA

18
Q

Why does Lamotrigine cause drowsiness?

A
  • acts on all presynaptic glutamate receptors
  • non-specific
  • slows down the whole brain
  • depressant effect on the brain
19
Q

When can Sodium Valproate be prescribed to those of child-bearing age?

A

ONLY when prescribed by a neurologist

20
Q

Why can’t those of child-bearing age take Sodium Valproate?

A

teratogenic (reproductive toxicity)

21
Q

What is the treatment of epilepsy dependent on?

A
  • type of seizure

- the individual patient

22
Q

What on an ECG can indicate an increased risk of seizure recurrance?

A

interictal epileptiform discharge (IED)

23
Q

What are the main aims of antiepileptic drug (AED) therapy?

A
  • eliminate seizures (or reduce frequency)
  • avoid the adverse effects of LT treatment
  • aid patients to maintain/restore a normal lifestyle
24
Q

What must be done when Anti-Epileptic drug therapy is started?

A

must document advice to tell the DVLA that they cannot drive.

25
Q

What is the first line and adjunctive treatment for those with absence seizures? (NOT CHILDBEARING)

A 
First line:
- ethosuximide
- sodium valproate
Adjunctive treatment:
combine 2 of:
- ethosuximide
- sodium valproate
- lamotrigine
26
Q

What is the first line and adjunctive treatment for those with absence seizures? (CHILDBEARING)

A 
First line:
- ethosuximide
Adjunctive treatment
combine:
- ethosuximide
- lamotrigine
27
Q

What is the first line and adjunctive treatment for those with focal seizures? (NOT CHILDBEARING)

A 
First line:
- carbamazepine
- lamotrigine
Adjunctive treatment
-any
28
Q

What is the first line and adjunctive treatment for those with focal seizures? (CHILDBEARING)

A 
First line: 
- carbamazepine 
- levetiracetam
Adjunctive treatment
- any
(NO SODIUM VALPROATE)
29
Q

What is the first line and adjunctive treatment for those with generalised tonic-clonic seizures? (NOT CHILDBEARING)

A 
First line:
-sodium valproate
Adjunctive treatment:
combine 2 of:
- sodium valproate
- levetiracetam
- topirimate
30
Q

What is the first line and adjunctive treatment for those with generalised tonic-clonic seizures? (CHILDBEARING)

A 
First line:
- Lamotrigine 
- Carbamazepine
Adjunctive treatment:
combine:
- levetiracetam 
- topirimate
31
Q

What is the first line and adjunctive treatment for those with myoclonic seizures? (NOT CHILDBEARING)

A 
First line:
- sodium valproate
Adjunctive treatment:
- clobazam
- lamotrigine
- levetiracetam 
- topirimate
32
Q

What is the first line and adjunctive treatment for those with myoclonic seizures? (CHILDBEARING)

A 
First line:
- levetiracetam 
- topiramate
Adjunctive treatment:
- clobazam 
- lamotrigine
- levetiracetam 
- topirimate
33
Q

What is the first line and adjunctive treatment for those with tonic or atonic seizures? (NOT CHILDBEARING)

A

First line:
- sodium valproate
Adjunctive treatment:
- lamotrigine

34
Q

What is the first line and adjunctive treatment for those with tonic or atonic seizures? (CHILDBEARING)

A 
First line:
- sodium valproate
(WITH PREGNANCY PREVENTION PLAN)
Adjunctive treatment:
- lamotrigine
35
Q

What is the effect of sodium valproate with in utero exposure?

A
  • neural tube defects
  • decreased IQ
  • autism
36
Q

What is the impact of the combined oral contraceptive on lamotrigine blood levels?

A
  • co-administration leads to low lamotrigine blood levels
  • lamotrigine has no effect on blood ethinyl estradiol levels
  • reduced seizure control
  • NO contraceptive failure
37
Q

Why does the combined oral contraceptive have an effect on lamotrigine levels?

A

may:

  • reduce absorption
  • enhance metabolism
  • may enhance excretion
38
Q

How do you combat the effect of COC pill on lamotrigine?

A
  • change AED or contraception
    OR
  • increase the dosage of lamotrigine
39
Q

What do drug-drug interactions tend to involve?

A
  • changes to liver metabolism

- AED commonly effect other drugs

BRS YR2 (70 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions