Seizure Pharm

Question 1

Identify basic seizure types and choose appropriate pharmacological treatments

Answer 1

partial seizures have localized onset, use valproate, carbamazepine, phenytoin,

generalized seizures have no localized onset, includes grand mal (clonic tonic) and petit mal (absence)

Question 2

Choose the lab tests required with use of antiseizure drugs

Question 3

Summarize the antiseizure drugs that exert effects on hepatic enzymes and recognize the
antiseizure drugs associated with extensive/few drug interactions.

Question 4

Understand the basic principles associated with the clinical management of epilepsy

Answer 4

it’s about balancing risk of seizures with side effects, which are often sedation, dizziness, ataxia, depression, weight change, vomiting, behavioral and psychiatric changes

antiseizures reduce the effectiveness of oral contraceptives

valproate is teratogenic

Question 5

what’s the mechanism of most antiseizures?

Answer 5

decrease glutamate, increase GABA, block ion channels

Question 6

drug for absence?

Answer 6

ethosuxamide

Question 7

phenytoin

Answer 7

inhibits na channels, nonlinear relationship between dose and plasma concentration because of saturatable hepatic enzyme effect, many adverse effects

Question 8

carbamazepine

Answer 8

inhibit na channels, induces own metabolism, diplopia and osteoporosis common, rare but fatal stevens johnson syndrome,

partial seizures

Question 9

gabapentin

Answer 9

primarily for partial seizures, decrease ca influx,

Question 10

valproate

Answer 10

induces gaba and blocks na and ca channels, liver function tests required (alanine transaminase, etc), inhibits hepatic enzymes, teratogen

Question 11

which drugs induce hepatic enzymes?

Answer 11

phenobarbitol, phenytoin, carbamazepine

Question 12

what’s used for acute treatment of status ellepticus?

Answer 12

iv lorazepam