Seizures + drugs

Question 1

absence seizure

Answer 1

• petit mal seizure
• sudden interruptions in consciousness
• blank stare + rapid blinking and lip smacking
• result from abnormal synchronization of thalamocortical and cortical cells
• EEG similar to the patterns generated during slow-wave (stage 3) sleep
• Ethosuximide ( T-type Ca-channel blocker) = first-line therapy

Question 2

Drugs That Enhance Sodium Channel-Mediated Inhibition

Answer 2

• for the treatment of focal and secondary generalized seizures.
• phenytoin , carbamazepine , lamotrigine , lacosamide , and valproic acid
• Prevention of repetitive firing within a potential seizure focus.

Question 3

Phenytoin

Answer 3

• Acts directly on the Na+ channel to slow the rate of channel recovery from the inactivated state to the closed state.
• use-dependent manner
• For focal seizures and tonic–clonic seizures
• Adverse effects: including ataxia, nystagmus, incoordination, confusion, gingival hyperplasia, megaloblastic anemia, hirsutism, facial coarsening, and a systemic skin rash.
• Inducers:

Question 4

Carbamazepine

Answer 4

• Better choice for patients prone to DDI than phenytoin, due to shorter half life

Question 5

Drugs that act on T-type calcium channel

Answer 5

• used to treat absence seizures .
• Zonisamide
• Ethosuximide

Question 6

Drugs that act on HVA

Answer 6

• Lamotrigine
• Gabapentin
• Pregabalin
• Keppra
• Topiramate
• Felbamate
• Phenobarbital

Question 7

Drugs That Enhance GABA-Mediated Inhibition

Answer 7

• Benzodiazepines (Diazepam, Lorazepam, Midazolam, Clonazepam)
• Barbiturates (Phenobarbital)
• Vigabatrin

Question 8

Drugs That Inhibit Glutamate Receptors

Answer 8

• Felbamate
• Rufinamide