Seizure drugs Flashcards
Describe molecular targets of anticonvulsant drugs.
Enhance GABA mediated neuronal inhibition
Antagonism of excitatory transmitters
Reduction of calcium influx
decrease sodium influx, prolong inactivation of NA channels
Know drugs used to treat focal seizures and generalized tonic- clonic seizures and their mechanisms of action.
Phenytoin, fosphenytoin - (stabilize inactive form of NA channel)
Carbamazepine and oxcarbazepine - bind and stabalize he inactive state of NA channel
Lacosamide - Enahcnes inactivation of voltage gated NA channels
Phenobarbital and Primidone - increase duration of Cl channel opening even
Diazepam and clonazepam - increase frequency of cl channel opening events
Gabepentin and pregabalin - increases GABA release
Vigabatrin and tiagabine - irreversible inhibitors of GABA transaminase
Felbamate - NMDA receptor antagonist
Topiramate - AMPA and kainate receptor antagonist
Know drugs used to treat absence seizures and their mechanisms of action.
Succinimides
Clonazepam
Lamotrigine
valproate
Levetiracetam
Describe interactions between anti-convulsant drugs.
Describe toxic side-effects of anti-convulsant drugs
Understand how the non-linear pharmacokinetics of phenytoin affect the drug’s plasma levels and how the drug is administered
Be able to identify the chemical structures of phenytoin, phenobarbital, ethosuximide, and valproate
GO TO NOTES
Molecular targets at the excitatory synapse: presynaptic targets
Na channels
Ca channels
Molecular targets at the excitatory synapse: post-synaptic
NMDA receptors
AMPA receptors
Molecular targets at the inhibitory targets: presynaptic targets
GABA transporter (GAT-1)
GABA transaminase (GABA-T)
Molecular targets at the inhibitory targets: post-synaptic targets
GABA-a receptor
GABA-b receptor
Phenytoin MOA, SE
Binds and stabalizes the inactive state of the NA channel this blocking the influx of NA
increases the duration that the NA channel is inactive
SE: arrythmia, visual, GI symptoms
