Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Unit 3 Anticonvulsant Drugs > Flashcards

Unit 3 Anticonvulsant Drugs Flashcards

1
Q

Seizures

A

Sudden, transient episodes of brain dysfunction

Altered behavior due to abnormally excessive, synchronous, & rhythmic firing of hyper-excitable neurons in brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Convulsions

A

Activation of motor neurons leading to involuntary contractions of skeletal muscle
Characteristic of seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of seizures

A

CNS injury
Congenital abnormalities in brain
Genetic factors
Infections, hypoglycemia, hypoxia, toxic and metabolic disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Epilepsy

A

Chronic neurological disorder characterized by recurrent sizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Primary (idiopathic) epilepsy

A

Unknown origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Secondary epilepsy

A

identifiable cause (trauma, tumor, infection, etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Most common partial seizure

A

Complex partial (temporal lobe)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Most common generalized seizure

A

Tonic-clonic (grand mal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Simple Partial seizure

A

least complicated/severe
Minimal spread
No loss of consciousness, limited motor or sensory (one limb or muscle group)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Complex Partial seizure

A

Starts in a small brain area (temporal or frontal lobe) & quickly spreads to other areas (limbic system)
Altered consciousness with potential automatisms (don’t realize they are doing something)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Partial becoming generalized seizure

A

partial seizures that spread throughout brain & progress to generalized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Absence (petit mal) seizure

A

Generalized
Sudden onset & abrupt cessation (10-45 sec)
Brief loss of consciousness
Typical in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tonic-Clonic (grand mal) seizure

A

Generalized
Tonic spasms & major convulsions of entire body (bilateral)
Loss of consciousness
4 stages: Aura - sense of impending seizure
Tonic phase - muscle tensing & rigidity of all extremities, tremor
Clonic phase - convulsions due to rapid & repeating muscle contractions & relaxing Stuporous state & sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Atonic seizure

A

Generalized
Common in children
Loss in muscle tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Status Epilepticus

A

Continuous or very rapid recurring seizures

Medical emergency requires immediate therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Epilepsy treatment options

A

Antiepileptic medications, surgery, vagus nerve stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Antiepileptic medication goal

A 
Restore normal patterns of electrical activity
Inhibit seizures (& try to prevent from recurring), partially effective as prophylaxis, not a cure for seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Partial seizure with or without secondarily generalized anticonvulsant drugs

A

Carbamazepine (CBZ), Phenytoin (PHT), Valproate (VPA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Drugs used for tonic clonic seizure (grand mal), tonic seizures, atonic seizures

A

Carbamazepine, Phenytoin, Valproate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Drugs used for Absence seizures (petit mal)

A

Ethosuzimide (ETH), Valproate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Drugs used for myoclonic seizures

A

Clonazepam, valproate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Drugs used for Status Epilepticus

A

Diazepam, Larazepam, Phenytoin, Fosphenytoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Anticonvulsant drugs can inhibit firing by

A
  1. Decrease excitatory effects of glutamate & repetitive firing of neurons (block VG Na channels, etc.)
  2. Increase inhibitory effects of GABA
  3. Alter neuronal activation by altering movement of ions across neuronal membrane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Presynaptic targets diminishing glutamate release

A

Inactivation of VG Na channels, Inactivation of VG Ca channels, increase of K channel opening, SV2A synaptic vesicle proteins, CRMP-2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Postsynaptic targets diminishing glutamate release

A

Blockade of AMPA receptors, blockade of NMDA receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Anti-seizure agents bind to Na channel in what state?

A

Inactive state

Prevent conversion back to resting state to prolong inactivation & decrease firing

27
Q

Targets increasing effects of GABA

A

Inhibition of GABA transporters (block GABA reputake), inhibition of GABA-transaminase (block GABA metabolism), Potentiates activation of GABAa receptors, GABAb receptors, Synaptic vesicular proteins

28
Q

Anticonvulsant side effects

A

Sedation, diplopia, nystagmus, ataxia, GI upset
Abrupt withdrawal has potential for seizures, decrease efficacy of oral contraceptives, teratogenic, phenobarbital considered safest during pregnancy

29
Q

Reduced activity of Ca channels in anticonvulsant agents

A

Reduce Ca influx - decreased transmitter release & prevent excitability
Effective against absence seizures (petiti mal) because of reduced pacemaker current

30
Q

Phenytoin

A

Original drug - Hydantoins
Absorption varies, poorly soluble in aqueous
Metabolized in liver, dose-dependent (zero-order) elimination (can saturate enzyme system)

31
Q

Fosphenytoin

A

Hydantoin

Newer, more soluble prodrug of phenytoin used for parenteral routes (IV & IM)

32
Q

Phenytoin MOA

A

Block & prolong inactivated state VG Na channel -> decreases synaptic release of glutamate & block high-frequency neuron firing
Enhance release of GABA
Prevent seizure propagation

33
Q

Phenytoin Clinical uses

A

Generalized tonic-clonic seizures (grand mal), Partial seizures, Status epilepticus

34
Q

Phenytoin side effects

A

Sedation, ataxia, nystagmus, diplopia, cardiac dysrhythmias, hirsutism, gingival hyperplasia, osteomalacia, megaloblastic anemia, fetal hydantoin syndrome (cleft palate & lip, teratogenic)

35
Q

Carbamazepine

A

Tricyclic compound
MOA: same as phenytoin, inhibition of VG Na channels
Well absorbed, hepatic metabolism (P450s)

36
Q

Oxacarbazepine

A

Newer, similar to carbamazepine

Shorter half-life, but active metabolite has long duration & fewer drug interactions

37
Q

Carbamazepine clinical uses

A

General clonic-tonic seizures, partial seizures, trigeminal neuralgia (drug of choice), bipolar disorder

38
Q

Carbamazepine side effects & toxicity

A

CNS depression, osteomalacia, aplastic anemia, megaloblastic anemia
SIADH (syndrome of inappropriate ADH secretion; fluid retention & hyponatremia), Teratogenic (spina bifida & cleft lip/palate)

39
Q

Carbamazepine drug itneractions

A

Phenytoin, valprate, phenobarbital

40
Q

Phenobarbital

A

Barbiturate

MOA: enhances phasic GABAa receptor responses (increase opening time of Cl channel)

41
Q

Phenobarbital clinical uses

A

Tonic-clonic, partial, myoclonic, generalized, neonatal (common drug of choice), & status epilepticus

42
Q

Primidone

A

Metabolized by liver to phenobarbital & phenyl ethyl malonic acid

43
Q

Ethosuximide

A

MOA: block presynaptic T-type Ca channel

Metabolized by liver

44
Q

Ethosuximide clinical use

A

Absence seizures (petit mal) Drug of choice

45
Q

Valproic acid

A

Least sedating
MOA: similar to phenytoin, inhibit presynaptic T-type Ca channels (block neuronal firing), inhibition of GABA transaminase

46
Q

Valproic acid clinical uses

A

Partial seizures, tonic-clonic, absence seizure (drug of choice), bipolar disorder

47
Q

Valproic acid adverse effects

A

Hepatotoxic syndrome, Teratogenic risk, GI upset, thrombocytopenia, pancreatitis, alopecia

48
Q

Diazepam

A

Benzodiazepines
Used for status epilepticus (initial stop, not long term treatment) & seizure clusters
MOA: potentiate GABAa responses by increasing frequency of channel opening
Has sedative effects & can develop tolerance

49
Q

Lorazepam

A

Benzodiazepines

Similar to diazepam but has longer duration of action - can be used to prevent status epilepticus

50
Q

Gabapentin

A

Newer agent, amino acid, analog of GABA
Minimal hepatic metabolism (short 1/2 life)
MOA: block presynaptic VG Ca channels

51
Q

Gabapentin clinical uses

A

Tonic-clonic, partial, generalized, Neuropathic pain (fibromyalgia, etc.)

52
Q

Pregabalin

A

similar to gabapentin, GABA analog

53
Q

Lamotrigine

A

Similar to carbamazepine

MOA: block presynaptic VG Na & Ca channels

54
Q

Lamotrigine clinical uses

A

partial seizures, generalized seizures, tonic-clonic, absence

55
Q

Lamotrigine adverse effects

A

Rash (especially if used with valproate), headache, ataxia, Stevens-Johnson syndrome

56
Q

Felbamate (other agent)

A

Block Na channels & glutamate receptors
Used in seizure states (often as adjunct)
Cause aplastic anemia, hepatic failure

57
Q

Topiramate (other agent)

A

Can cause sedation, confusion, parasthesias, anorexia

Interacts with zonisamide

58
Q

Tiagabine (other agent)

A

Specifically designed as an inhibitor of GABA uptake
Partial seizures
Can cause sedation, dizziness, headache, tremor

59
Q

Goal of muscle relaxants

A

Normalize muscle excitability without causing profound decreased muscle function

60
Q

muscle spasticity

A

exaggerated muscle stretch reflex that occurs following injury to CNS

61
Q

muscle spasm

A

increase in muscle tension seed after musculoskeletal injuries & inflammation (local, not CNS)

62
Q

Diazepam

A

Increases central inhibitory actions of GABA on alpha motor neurons in spinal cord (increase frequency of chloride ion influx)
Treat muscle spasms (exertion, MS, cerebral palsy, injury)
Limitations - CNS depression

63
Q

Baclofen

A

GABAb receptor agonist - increased K conductance, hyperpolarization, reduction in Ca influx, reduction in excitatory transmitter release
Reduces muscle spasticity with MS, spinal & brain injury
As effective as diazepam, but causes less sedation

Pharmacology (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions