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Pharm > Seizures (Exam 3) > Flashcards

Seizures (Exam 3) Flashcards

Exam 3

1
Q

Causes of seizures (6)

A

infection, neoplasm, head injury, heredity, toxic effects, metabolic disorders

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2
Q

prior treatments for seizures (traditional)

A

trephining, cupping, herbal remedies, animal extracts

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3
Q

what is the primary mechanism of anti seizure meds

A

target voltage gated ion channels

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4
Q

Do we see an increase or decrease in AP firing with anti seizure meds?

A

decrease

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5
Q

typical MOA of anti seizures (3)

A

modification of ion conductance, enhancing inhibition, inhibiting excitation

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5
Q

5 neurotransmitter/ion targets

A

GABA, Glutamate, na, Ca, K

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6
Q

Focal aware =

A

simple partial

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7
Q

focal impaired

A

complex partial

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8
Q

focal to bilateral tonic-clonic

A

starts in one area and spreads to area of brain, partial seizure

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9
Q

myoclonic means?

A

muscle twitching rather than muscle rigidity

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10
Q

atonic/tonic =

A

drop attack

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11
Q

infantile spasms =

A

west’s syndrome

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12
Q

does an eeg show normal discharge with simple focal seizures?

A

yes

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12
Q

post ictal =

A

post seizure

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13
Q

does simple focal affect consciousness

A

no

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14
Q

do complex focal affect consciousness?

A

yes

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15
Q

can you lose consciousness with complex focal?

A

yes

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16
Q

what are automatisms?

A

lip smakcing, swallowing, fumbling, scratching, walking about

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17
Q

what do focal seizures secondarily generalized begin as?

A

simple or complex then spread

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18
Q

can animals detect aura?

A

yes

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19
Q

where of generalized seizures begin?

A

over the entire surface of brain

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20
Q

what do we see with generalized seizures (3)

A

aura, tonic-clinic and post-ictal

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21
Q

another name for absence seizure?

A

petite mal

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22
Q

do we stare into space w absence seizure?

A

yes

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23
Q

atonic seizures

A

sudden lose of muscle tone, falls without warning

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23
Q

tonic seizures

A

sudden muscle contraction and stiffen, falling

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23
Q

clonic and myoclonic sezires

A

body jerks like being shocked

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24
Q

infantile spasms

A

affects childs head, torso and limbs

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25
Q

when do infantile seizures start?

A

before 6 months

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26
Q

Phenytoin has what of the total MOA for anti seizure MOAs

A

all of them

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27
Q

what ions do phenytoin affect>

A

sodium, potassium, calcium

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28
Q

is fosphenytoin the prodrug for phenytoin

A

yes

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29
Q

what is the prodrug for phenytoin?

A

fosphenytoin

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30
Q

what seizures does phenytoin target?

A

partial and tonic-clonic

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31
Q

Where does phenytoin accumulate?

A

ER of brain, liver, muscle, and fat

32
Q

where is phenytoin metabolized?

A

liver

33
Q

what toxicities do we see with phenytoin? (9)

A

dose related, nystagmus, loss of extraocular movement, diplopia, ataxia, sedation, gingival hyperplasia, hirsuitism, coarse facial hair

34
Q

is phenytoin highly protein bound?

A

yes

35
Q

is carbamazepine a TCA or SSRI?

A

TCA

36
Q

is the MOA of carba similar or different to phenytoin?

A

similar

37
Q

carbamazepine is the drug of choice for what seizure?

A

focal seizures

38
Q

at therapeutic concentrations, does carbamazepine block or excite sodium channels

A

block

39
Q

can we use carbamazepine with phenytoin?

A

yes

40
Q

which antiseizure med is beneficial with trigeminal neuralgia?

A

carbamzaepine

41
Q

can we use carbamazepine with bipolar disorder?

A

yes

42
Q

How much of carbamazepine is bound to plasma porteins?

A

70%

43
Q

what drugs does carbamazepine interact with? (5)

A

phenytoin, phenobarbital, ethosuxemdie, valproic acid clonazepam

44
Q

What type of seizure is lacosamide used for?

A

focal seizures

44
Q

does lacosamide block or excite sodium channels?

A

block

45
Q

what toxicity do we see with lacosamide? (4)

A

dizziness, nausea, HA, diplopia

46
Q

what is the oldest anti seizure?

A

phenobarbital

46
Q

what is the antiseizure used primarily for infants?

A

phenobarbital

47
Q

does phenobarbital treat tonic-clonic

A

yes

47
Q

what seizure is phenobarbital used to treat?

A

focal seizures & tonic clonic

48
Q

what seizure is phenobarbital not useful in?

A

absence, infantile spasms, atonic

49
Q

can phenobarbital worsen seizures its not useful for?

A

yes

50
Q

what toxicities is phenobarbital associated with?

A

sedation, overdose, slurred speech, confusion, resp, depression, coma

51
Q

Drugs used for generalized seizures and arent used in tonic clonic include?

A

Valproic acid and ethosuximide

52
Q

ethosuximide is used for what seizures?

A

absence

53
Q

what is the MOA of ethosuximide>

A

inhibition of calcium channels

54
Q

toxicity associated with ethosuximide (2)

A

gastric issues, lethargy

55
Q

Valproic acid is also known as

A

depakote

55
Q

does valproic acid increase GABA?

A

yes

56
Q

what is valproic acid used to treat? (5)

A

absence seizures, some myoclonic seizures, generalized tonic-clonic, bipolar, migraine

57
Q

Toxicity associated with valproic acid?

A

GI issues

58
Q

What does valproic acid do to phenytoin on proteins?

A

displaces phenytoin

59
Q

What is the MOA of benzos?

A

depresses all levels of CNS, increases GABA

59
Q

does valproic acid inhibit metabolism of phenobarbital, phenytoin, carbamazepine?

A

yes

60
Q

What benzos are used to manage epilepsy? (4)

A

diazepam, lorazepam, clonazepam, cloarazepate

61
Q

Is diazepam effective in stopping continuous seizure activity?

A

yes

62
Q

what type of seizure is clonazepam used to treat>

A

absence seizures and some myoclonic

62
Q

What drugs do we give to treat infantile spasms?

A

prednisone and vigabatrin (GABA analog)

63
Q

is lorazepam more effective than diazepam for treating status epilecticus?

A

yes

64
Q

what is the most common form of status epilepticus?

A

generalized tonic-clonic

65
Q

what craniotomy can we do to treat status epilepticus?

A

the epileptic foci

66
Q

Phenytoin treats what?

A

tonic-clonic and all focal

67
Q

carbamazepines treats what?

A

tonic-clonic, focal (DOC), TGN, bipolar

68
Q

phenobarbital treats what?

A

tonic-clonic, focal-declining, DOC for infants

69
Q

lamotrigine treats what?

A

focal

70
Q

GABA analogs treat what>

A

adjunct, neuralgia, infantile spasms

71
Q

ethosuxamide

A

absence

71
Q

valproic acid treats what?

A

absence, tonic-clonic, clonic, bipolar, migraine

72
Q

benzos treat what

A

status epilepticus, absence

73
Q

Generalized tonic clonic means what?

A

grand mal

74
Q

generalized absence means what?

A

petite mal

75
Q
A

Pharm (11 decks)

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