Seizure Disorders Flashcards
1
Q
- no loss of consciousness, localized to specific area of brain
- cortical focal
- increasing electrical activity at a focus followed by synchronization of surrounding neurons, abnormal firing can spread to adjacent neurons
A
partial seizures
2
Q
focal seizure activity in one hemisphere spreads throughout brain, involves LOC
A
tonic clonic (grand mal) seizure
3
Q
- brief interruptions of consciousness manifested as motionless starting
- common in school aged children
- abnormal synchronization of thalamocortical and cortical cells, activation of T-type calcium channels that are normally active during sleep
A
absence (petit mal) seizures
4
Q
greater than 5 minutes without regaining consciousness
A
status epilepticus
5
Q
prolonged activation of ____ channels reduced the ability of neurons to fire at high frequencies
A
sodium
6
Q
inhibition of _______ channels tend to be efficacious for absence seizures
A
T-type calcium channels
7
Q
- enhance GABAergic activity
- DOC for status epilepticus
- good for infantile myoclonic, tonic clonic, absence seizrues but onlly for 2-3 weeks due to tolerance
- adverse: sedation
A
diazepam, clonazepam
8
Q
- increase chloride ion channel flux by increasing channel open time, decrease glutamatergic neurotransmission
- DOC for tonic clonic
- very sedating
- Stevens Johnson, abrupt withdrawal –> status epilepticus, induces microsomal enzymes, possible teratogen
A
phenobarbital (barbiturate)
9
Q
- converted to phenobarbital and PEMA, parent and products are active as anticonvulsant
- drowsiness, ataxia, n/v, rash, diplopia, blood dyscrasias
- effective in patients not responding to phenytoin or phenobarbital
- give in combo with phenytoin but never phenobarbital
A
primidone
10
Q
- prolong inactivation of sodium channels and decrease glutamate release
- DOC for tonic clonic and partial
- less sedating than barbiturates
- drug interactions: induce P450s, vit D deficiency, highly protein bound
- saturation, small dose increases can result in toxicity
- adverse: dipolopia, ataxia, n/v/rash, hyperplasia of gums, hirsutism, teratogenic
A
phenytoin (hydantoin)
11
Q
- broad spectrum, increases inactivation of Na channels, inhibits T type calcium channels, enhances GABA, modifies AA metabolism
- DOC for tonic clonic
- hepatotoxicity, esp in children <2yo
- sedation uncommon, IV prep for status epilepticus
- **P450 inhibitor
A
valproic acid
12
Q
- increase inactivation of sodium channels, decreases release of glutamate
- safe, nontoxic, non sedating
- induces microsomal enzymes, blood dyscrasias
A
carbamazepine
13
Q
- increases inactivation of sodium channels, may inhibit T type calcium channels and decrease glutamate release
- effective in partial and absence seizures
- GI, nausea, sedation, diplopia, rashes
- valproic acid increases half life
- add on, approved as monotherapy
A
lamotrigine
14
Q
- increases inactivation of sodium channels, enhances GABA and decreases glutamate activity
- effective for partial and generalized tonic clonic, perhaps absence
- sedation, mental dulling, abnormal vision, parasthesia, decreased serum bicarb
- decrease efficacy of oral contraceptives
- add on, monotherapy
A
topiramate
15
Q
- add on for partial seizure
- modifies synaptic release of GABA by binding to synaptic vesicular protein SV2A
- agitation, drowsiness, asthenia, muscle weakness, dizziness
A
levetiracetam
