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IP3 > Test 1: Epilepsy and Alzheimer's > Flashcards

Test 1: Epilepsy and Alzheimer's Flashcards

1
Q

Type of Partial seizures

A

simple

complex

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2
Q

partial simple seizures characteristics

A

aura
consciousness not impaired
memory intact

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3
Q

partial complex seizures characteristics

A

consciousness impaired
memory impaired
automatism

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4
Q

Type of generalized seizures

A 
absence
atonic
tonic
myoclonic
tonic clonic
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5
Q

absence seizure characteristics

A

brief 2-5 seconds
onset 4-14 years
mild atonia
automatisms

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6
Q

atonic seizure characteristics

A

brief <15 seconds

sudden loss of muscle tone

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7
Q

tonic seizure characteristics

A

brief <20 seconds

sudden loss of muscle tone, dropping things

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8
Q

myoclonic seizure characteristics

A

brief

bilateral jerk of neck, shoulders, legs

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9
Q

tonic clonic seizure characteristics

A

loss of consciousness
tongue biting
incontinence

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10
Q

treatment of status epilepticus

A

IV benzo
(Fos)phenytoin
phenobarbital

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11
Q

3 ways to decrease excitatory stimulus in seizures

A

reduce sustained AP
reduce excitatory NT release
inhibit excitatory receptors

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12
Q

target to reduce sustained AP generation

A

Na channels

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13
Q

target to reduce excitatory NT release

A

synaptic vesicles
Ca channels
-T-type channels
-alpha2delta1 channels

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14
Q

target to inhibit excitatory receptors

A

glutamate receptor

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15
Q

how to increase inhibitory stimulus in seizures

A

enhance inhibitory neurotransmission via GABA

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16
Q

3 targets of AED on GABA to increase inhibitory stimulus

A

positive allosteric modulation
GABA reuptake inhibiton
inhibit metabolism

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17
Q

MOA of Na channel inhibiton

A

bind to and stabilize Na channels that are inactivated

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18
Q

AED that target synaptic vesicles

A

Levetiracetam

Brivaracetam

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19
Q

MOA of Keppra and Briviacet

A

bind with high affinity to a specific synaptic vesicle protein (SV2A) to inhibit release of neurotransmitter release

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20
Q

AED that target Ca channel

A

Gabapentin

Pregabalin

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21
Q

MOA of Gabapentin, Pregabalin

A

do not work on GABAr

bind w/ high affinity to alpha2-delta site of voltage-gated Ca channel to reduce release of glutamate and NE

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22
Q

AED that targets glutamate receptors

A

Perampanel

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23
Q

MOA of perampanel

A

noncompetitive AMPA receptor antagonist

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24
Q

AED that targets GABA transporter

A

Tiagabine

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25
Q

MOA of Tiagabine

A

inhibits GABA transporter to decrease GABA reuptake into neurons and glial cells=increase inhibitory transmission

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26
Q

AED that targets GABA transaminase

A

Vigabatrin

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27
Q

MOA of Vigabatrin

A

inhibit GABA transaminase (inativates GABA) to raise CNS GABA levels

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28
Q

AED that targets GABA-A receptors

A

Benzodiazepines

Barbiturates

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29
Q

MOA of Benzos

A

allosterically facilitates activation of the GABA-A receptor

30
Q

AED for absence seizures

A

Ethosuximide

Valproic acid

31
Q

MOA of Ethosuximide and Valproic Acid

A

inhibit T-type Ca channels

32
Q

result of enzyme induction

A

increased metabolism, decreased serum concentration and effects

33
Q

result of enzyme inhibition

A

reduced metabolism and accumulation of the affected drugs

34
Q

4 major inducers

A

carbamazepine
phenytoin
phenobarbital
primidone

35
Q

valproate inhibits….

A 
lamtrogine
phenobarb
carbamazepine
amitriptyline
nortriptyline
cisplatin
etoposide
36
Q

Carbamazepine induces…

A 
Warfarin
Psychotropic drugs
DHP
simvastatin
BC
37
Q

BC induced by….

A

OXC if dose >1200mg/day
TPM if dose >200mg/day
perampanel

38
Q

estrogen induces…

A

Lamotrigine

39
Q

Warfarin effects w/…..
adding inducer
withdrawing inducer

A

increased coagulation risk

increased bleeding risk

40
Q

Which AED can be affected by antacids

A

Gabapentin

41
Q

K channel stabilizer

A

Ezogabine

Flupirtine

42
Q

AED treat complex partial

A 
ethotoin
phenytoin
phenacemide
carbamazepine
lacosamide
OXC
Gabapentin
Perampanel
Felbamate
Phenobarbital
Primidone
Vigabatrin
Tiagabine
Valproate
Lamictal
Zonisamide
Topiramate
Clonazepam
43
Q

AED treat Tonic-clonic

A 
Ethotoin
Phenytoin
Carbamazepine
OXC
Leve
Perampanel
Felbamate
Phenobarbital
primidone
valproate
lamotrigine
clonazepam
44
Q

AED treat status epilepticus

A

Fosphenytoin

Trimethadione

45
Q

absence seizure treated by which class of AED

A

T-type Ca channel inhibitors

46
Q

AED that cause kidney stones

A

Zonisamide

Topiramate

47
Q

AED that cause gingival hyperplaisa

A

phenytoin

48
Q

AED that cause weight loss

A

zonisamide

topiramate

49
Q

AED that cause weight gain

A

Pregabalin

valproate

50
Q

AED that causes osteomalacia

A

phenytoin
carbamazepine
phenobarbital

51
Q

AED that cause hyponatremia

A

carbamazepine

OXC

52
Q

3 types of dementia

A

lewy body dementia
frontotemporal dementia
reversible cause

53
Q

4 reversible causes of dementia

A

normal pressure hydrocephalus
thyroid dysfunction
vitamin b12 deficiency
depression

54
Q

DSM-5 Criteria

A
  1. evidence of significant conitive decline in 1+ domain
  2. deficits interfere with ADL
  3. deficit do not occur only in context of delirium
  4. deficits not better explained by another mental disorder
55
Q

MMSE score 0

A

positive for cognitive impaire

56
Q

MMSE score 1-2

A

if abnormal CDT then positive for impairment

if normal CDT then negative for impairment

57
Q

MMSE score 3

A

negative screen for dementia

58
Q

Mild Alzheimer’s

A

MMSE 24-20
forgetfulness
mild anxiety

59
Q

Moderate Alzheimer’s

A 
MMSE 10-19
concentration decline
complex skills decline
withdrawal
delusions
anxiety
60
Q

Severe Alzheimer’s

A 
MMSE <10
unable to recall people or places
needs help with ADLs
dysphobia
apathy
61
Q

Profound Alzheimer’s

A

MMSE 0

62
Q

tx for anxiety in AD

A

trazodone
buspirone
SSRI

63
Q

tx for depression in AD

A

trazodone

SSRI

64
Q

tx for general agitation in AD

A

redirecting activity

safety proofing

65
Q

tx for psychotic behaviors in AD

A

atypical antipsychotics

66
Q

tx for Aggressive behavior in AD

A

divalproex/carbamazepine in combo w/atypical antipsychotics

dextromethoropharn-quinidine

67
Q

4 antipsychotics for AD

A

aripiprazole
olanzapine
quetiapine
risperidone

68
Q

Donepezil dose

A

6 weeks of 5mg/day then 10mg/day

69
Q

Rivastigimine dose

A

1.5 mg BID increase by 1.5mg BID q 2 weeks up to 6mg BID

70
Q

Galantamine dose

A

4mg BID after 4 weeks increase to 8mg BID then again to 12mg BID

71
Q

Memantine dose

A

initial 5mg qd increase dose at minimum 1 week intervals in 5mg increments to 10mg/day as 5mg and 10mg in separate doses

IP3 (7 decks)

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