Unit 4: Epilepsy and Anti-Seizure Agents Flashcards

1
Q

L1: Mechanism of Action? BZDs

A

Facilitates GABA transmission

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2
Q

L1: Mechanism of Action? Phenobarbital

A

Enhance GABA, inhibit glutamate

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3
Q

L2: Clinical Uses? Diazepam

A

Status epilepticus

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4
Q

L2: Clinical Uses? Ethosuximide

A

Absence Seizures

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5
Q

L2: Clinical Uses? Levetiracetam

A

Tonic-Clonic Seizures

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6
Q

L2: Clinical Uses? Phenobarbital

A

Adjunctive Agent

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7
Q

L2: Mechanism of Action? Carbamazepine

A

Blocks Na channels

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8
Q

L2: Mechanism of Action? Clonazepam

A

Inhibition of T-type Ca channels (BZD)

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9
Q

L2: Mechanism of Action? Ethosuximide

A

Inhibition of T-type Ca channels

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10
Q

L2: Mechanism of Action? Levetiracetam

A

Unknown/Ca channels

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11
Q

L2: Mechanism of Action? Phenytoin

A

Blocks Na channels

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12
Q

L2: Name 2 agents used in absence seizures

A

Ethosuximide, Valproate

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13
Q

L2: Name three non-medical treatments for epilepsy.

A

Ketogenic diet, surgery, vagal nerve stimulation

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14
Q

L2: What is the diagnosis? Generalized seizures and cognitive dysfunction with typical onset in early childhood; slow spike and wave EEG pattern, caused by infections, malformations or tuberous sclerosis

A

Lennox Gastaut Syndrome

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15
Q

L2: Which epilepsy treatment? Kidney stones, QT prolongation, bruising, pancreatitis, immunosuppression

A

Ketogenic diet

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16
Q

L2: Which epilepsy treatment? Temporary hoarseness, cough, shortness of breath

A

Vagal nerve stimulation

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17
Q

L2: Which pharmacologic agent? Diplopia, ataxia, n/v, Stevens Johnson sydnrome, rarely: blood dyscrasias or hepatotoxicity

A

Carbamazepine

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18
Q

L2: Which pharmacologic agent? Nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, rash

A

Phenytoin

19
Q

L2: Which pharmacologic agent? Somnolence and development of tolerance

A

Diazepam

20
Q

L2: Which type of seizure? Associated with fever, focal, longer than 15 minutes, recurs in less than 24 hours

A

Febrile complex

21
Q

L2: Which type of seizure? Associated with fever, generalized, less than 15 minutes without recurrence within 24 hours

A

Febrile simple

22
Q

L2: Which type of seizure? Involves simple behavrios such as chewing or picking at clothing

A

Partial complex

23
Q

L2: Which type of seizure? Period of altered mental status unaccompanied by major motor manifestations

A

Partial complex, Absence

24
Q

L2: Which type of seizure? Recurrent major motor seizures without regained consciousness between episodes

A

Status epilepticus

25
Q

L2: Which type of seizure? Slower frequency EEG pattern than absence seizures

A

Partial simple and Partial complex

26
Q

L3: Clinical Uses? Carbamazepine

A

Partial Seizures, Tonic-Clonic Seizures, Trigeminal neuralgia

27
Q

L3: Clinical Uses? Lamotrigine

A

Partial or Generalized seizures, mania, migraine

28
Q

L3: Clinical Uses? Valproate/Divalproex

A

Tonic-Clonic Seizures, Absence seizures

29
Q

L3: Mechanism of Action? Absence Seizures

A

Inappropriate activation of T-type Ca channels

30
Q

L3: Mechanism of Action? Gabapentin

A

GABA analog that decreases glutamate via VSSC action

31
Q

L3: Mechanism of Action? Lamotrigine

A

Unclear/suppression of repetitive APs, inhbition of excitatory NTs, VSCC modulation

32
Q

L3: Mechanism of Action? Tonic-Clonic Seziures

A

Loss of GABA tone (possible increased glutamate or Na channel excitation)

33
Q

L3: Mechanism of Action? Valproate/Divalproex

A

Unclear/ potentiation of GABA, limits T-type Ca channels

34
Q

L3: Name 3 agents used in status epilepticus as first-line treatment

A

Diazepam, Lorazepam, Midazolam

35
Q

L3: Which 2 anti-seizure agents should be avoided in pregnant patients?

A

Valproate/Divalproex, Phenobarbital

36
Q

L3: Which pharmacologic agent? Dizziness, ataxia, diplopia, skin rash, nausea, milder than phenytoin

A

Lamotrigine

37
Q

L3: Which pharmacologic agent? Fatigue, somnolence, asthenia, dizziness

A

Levetiracetam

38
Q

L3: Which pharmacologic agent? n/v, headache/dizziness, rarely: bone marrow suppresion, tongue pain, gum hypertrophy

A

Ethosuximide

39
Q

L3: Which pharmacologic agent? n/v, weight gain, easy bruising, hepatotoxicity especially in patients

A

Valproate/Divalproex

40
Q

L3: Which pharmacologic agent? Sedation and possible behavioral problems

A

Clonazepam

41
Q

L4: Name 4 broad-spectrum anti-seizure agents

A

Phenobarbital, Diazepam, Valproate, Divalproex

42
Q

L4: Name 5 agents used in Tonic-clonic (Grand mal) seizures

A

Valproate, Lamotrigine, Levetiracetam, Phenytoin, Carbamazepine

43
Q

L4: Which 3 anti-seizure agents induce the CYP450 system?

A

Phenobarbital, Phenytoin, Carbamazepine