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Neuro Week 3 > Seizure Drugs > Flashcards

Seizure Drugs Flashcards

1
Q

seizures are due to increased or decreased circuit output in brain’?

A

increased

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2
Q

describe the character of the brain firing in seizures

A

disordered and synchronous

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3
Q

status epilepticus is what?

A

seizure longer than 5 mins or two within 5 mins

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4
Q

what are two types of seizures?

A

partial or generalized

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5
Q

what are two types of partial seizures?

A

simple and complex

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6
Q

do you lose consciousness in simple partial seizure?

A

no

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7
Q

do you lose consciousness in complex partial seizure?

A

yes

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8
Q

do you lose consciousness in generalized seizures?

A

yes..in all types

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9
Q

name the four ion changes that can lead to seizures

A

decreased Cl influx
decreased K+ efflux
increased Na or Ca influx

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10
Q

name the four seizure meds that are inhibitors of the voltage gated Na channels

A

carbamazepine
lamotrigine
phenytoin
valproate

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11
Q

how do Na channel blockers actual block the NA channels?

A

slow transition from inactivated to resting state…increase refractory period

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12
Q

what is common toxicity with phenytoin?

A

gingival hyperplasia

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13
Q

what is toxicity with carbamazepine?

A

water retention and hyponatremia

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14
Q

how does carbamazepine induce water retention and hyponatremia?

A

increased ADH

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15
Q

what are the two toxicities of valproate?

A

alopecia and weight gain

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16
Q

what is MoA of valproate?

A

voltage Na blocker

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17
Q

what is MoA of carbamazepine?

A

voltage Na blocker

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18
Q

what is MoA of phenytoin?

A

voltage Na blocker

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19
Q

what is MoA of lamotrigine?

A

voltage Na blocker

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20
Q

aside from voltage gated Na channel blockers what is another presynaptic mechanism to block excitatory pathway in seizures?

A

voltage gated caclium channel blockers

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21
Q

name the two voltage gated calcium channel blockers for seizures

A

gabapentin and pregabalin

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22
Q

what Nt tract do gabapentin and pregabalin work in?

A

glutamate

23
Q

what is MoA of gabapentin?

A

block Vg Ca channels in glutamate path

24
Q

what is MoA of pregabalin?

A

block Vg Ca channels in glutamate path

25
Q

what is the molecular target of levetiracetam?

A

SV2A

26
Q

what is SV2A important for?

A

vesicle fusion for Nt release of glutamate

27
Q

what drug targets the SV2A vesicle fusion protein?

A

levetiracetam

28
Q

what does levetiracetam prevent?

A

vesicle fusion and Nt release of glutamate

29
Q

how do topiramate and felbamate work to be anti seizure?

A

block ligand gated Na channels in post synaptic neuron in glutamate tracts

30
Q

name the two drugs that block glutamate post synaptic ligand gated Na channels

A

topiramate and felbamate

31
Q

what is the target of topiramate?

A

AMPA

32
Q

what is the target of felbamate?

A

NMDA

33
Q

what are two severe tox of felbamate?

A

aplastic anemia and acute liver failure

34
Q

what are two tox of topiramate?

A

weight loss and renal calculi

35
Q

what is MoA of ethosuximide?

A

slows Ca2+ induced depol in post synaptic neuron in Glutamate tract

36
Q

what is drug that inhibits Ca2+ entry into post synaptic neuron in glutamate tract?

A

ethosiximide

37
Q

what is MoA of tiagabine?

A

reuptake inhib of GABA

38
Q

what Nt path does tiagabine work in?

A

GABA

39
Q

what drug inhibits uptake of GABA?

A

tiagabine

40
Q

what is MoA of vigabatrin and valproate in GABA pathway?

A

they inhibit breakdown of GABA in pre synaptic neuron

41
Q

what two drugs inhibit breakdown of GABA in pre synaptic neuron?

A

vigabatrin and valproate

42
Q

what is side effect of vigabatrin?

A

progressive permanent blindnes

43
Q

what is class of drugs that positively modulates GABA receptors on post synaptic neurons and is used to treat seizures?

A

Benzos

44
Q

what is main benzo ued for anti seizure med?

A

clonazepam

45
Q

aside from benzos what other class of meds can positively modulate GABA receptor in seizure treatment?

A

phenobarbitol

46
Q

what drug for anti seizure inhibits CYP2C9?

A

valproate

47
Q

inhibiting CYP2C9 leads to increase in conc of what drugs?

A

lot of other anti seizures…carbamazepine, phenytoin, topiramate, felbamate, lamotrigine

48
Q

what two anti seizure drugs induce CYP3A4

A

phenytoin and carbamazepine

49
Q

how is phenytoin cleared at high dose?

A

zero order…saturated…constant mg/hour, T1/2 not constant

50
Q

how is phenytoin cleared at low conc?

A

1st order, T1/2 constant

51
Q

what two seizure drugs lead to ineffective OCP use?

A

phenytoin and carbamazepine

52
Q

how do phenytoin and carbamazepine lead to ineffective OCP?

A

induce CYP3A4 which leads to quick breakdown of ethinyl estradiol making OCP ineffective

53
Q

name the four seizure meds that are teratogenic

A

phenytoin
carbamazepine
topiramate
valproate

54
Q

name the two seizure drugs that decreae folate in women of child bearinf age

A

carbamazepine and phenytoin

Neuro Week 3 (13 decks)

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