Unit 4: PPT Cards Flashcards
What is epilepsy?
Epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures due to abnormal electrical activity in the brain.
Differentiate between primary and secondary epilepsy
Primary (Idiopathic) Epilepsy: No identifiable cause, often starts in childhood.
* Secondary Epilepsy: Caused by trauma, infection, stroke, tumors, or brain injury
What are the major types of seizures?
- Partial Seizures (Petit Mal): Affect one area; can be simple (no loss of consciousness) or complex (impaired awareness).
- Generalized Seizures (Grand Mal): Affect both hemispheres, including tonic-clonic, absence, tonic, clonic seizures.
- Status Epilepticus: Continuous seizures lasting >5 minutes, a medical emergency.
What is the goal of antiepileptic therapy?
To prevent seizures while minimizing side effects and toxicity.
Name first-line drugs for acute seizures.
Benzodiazepines (e.g., Lorazepam, Diazepam).
What are the commonly used maintenance antiepileptic drugs?
- Phenytoin (Dilantin): Risk of gingival hypertrophy, highly protein-bound, given slow IV infusion.
- Carbamazepine (Tegretol): Liver enzyme inducer, risk of Stevens-Johnson Syndrome.
- Valproic Acid (Depakote): Blocks sodium channels, teratogenic.
- Phenobarbital: Barbiturate, increases GABA.
What is a major risk with antiepileptic drugs?
Narrow therapeutic range – requires regular monitoring to avoid toxicity.
What causes Parkinson’s Disease?
Loss of dopamine-producing neurons, leading to an imbalance between dopamine (inhibitory) and acetylcholine (excitatory).
What are the hallmark symptoms of Parkinson’s?
TRAP:
* Tremor
* Rigidity
* Akinesia (bradykinesia)
* Postural instability
What is the “on-off phenomenon” in Parkinson’s treatment?
Fluctuation between mobility (“on”) and freezing (“off”) due to variable levodopa effectiveness.
Parkinson’s Disease Medications:
Levodopa-Carbidopa (Sinemet): Levodopa converts to dopamine,
while Carbidopa prevents breakdown before crossing the blood-brain barrier.
What are other drug classes used for Parkinson’s?
- MAO-B Inhibitors: Selegiline, Rasagiline (increase dopamine levels).
- Dopamine Agonists: Bromocriptine, Pramipexole.
- COMT Inhibitors: Entacapone (prolongs levodopa effect).
- Anticholinergics: Benztropine (Cogentin) (reduces tremors and rigidity).
What foods should patients on MAOIs avoid?
Tyramine-rich foods (e.g., aged cheese, red wine, fermented meats) to prevent hypertensive crisis.
Q: What are the three major types of mental health disorders?
- Anxiety disorders
- Affective (Mood) disorders
- Psychotic disorders
What is the biochemical imbalance theory?
Mental disorders arise due to imbalances in neurotransmitters such as dopamine, serotonin, norepinephrine.
Name first-line anxiolytic drugs.
Benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam).
What is the antidote for benzodiazepine overdose?
A: Flumazenil (Anexate).
Antidepressants:
What are the four major classes of antidepressants?
- SSRIs: Fluoxetine (Prozac), Sertraline (Zoloft), Escitalopram (Cipralex)
- SNRIs: Venlafaxine (Effexor)
- TCAs: Amitriptyline (Elavil)
- MAOIs: Phenelzine (Nardil), Tranylcypromine (Parnate)
What are SSRI’s?
Class of anti depressions to treat depression and other mental health conditions
SSRIs increase serotonin levels in the brain.
What is SNRI?
a class of antidepressants that help treat depression, anxiety, and chronic pain.
They work by increasing the levels of serotonin and norepinephrine in the brain.
What is TCA?
Tricyclic antidepressants (TCAs) are a class of medications used to treat depression and other conditions.
They are also known as first-generation antidepressant
What is serotonin syndrome?
Excess serotonin leading to hyperthermia, tremors, diaphoresis, confusion.
Why should patients on TCAs be given only small doses at a time?
High risk of overdose, leading to seizures and dysrhythmias.
What is the hallmark symptom of psychotic disorders?
Loss of contact with reality (e.g., hallucinations, delusions).
Name two major classes of antipsychotics.
- Typical (First-Gen): Haloperidol (high risk of extrapyramidal side effects).
- Atypical (Second-Gen): Clozapine, Risperidone (lower risk of EPS, but risk of weight gain, diabetes).
What must be monitored in patients taking lithium?
Serum levels (0.6–1.2 mmol/L) to prevent toxicity.
What is a critical instruction for patients on antiepileptic drugs?
Never stop abruptly to avoid rebound seizures.
What should patients on Levodopa avoid in their diet?
High-protein meals, as they interfere with drug absorption.
Name the major types of seizures.
- Partial Seizures (Petit Mal): Begin in one area of the brain.
o Simple Partial: No loss of consciousness.
o Complex Partial: Impaired awareness, automatisms (lip-smacking, hand-rubbing). - Generalized Seizures (Grand Mal): Affect both hemispheres.
o Tonic-Clonic (Grand Mal): Stiffening (tonic) → Jerking (clonic).
o Absence Seizures (Petit Mal): Brief staring spells. - Status Epilepticus: Continuous seizures lasting >5 minutes → Medical emergency.
What is the goal of AED therapy?
Control seizures while minimizing side effects and toxicity.
Name some common maintenance AEDs
- Phenytoin (Dilantin): Highly protein-bound, slow IV infusion, side effect: gingival hypertrophy.
- Carbamazepine (Tegretol): Liver enzyme inducer, risk of Stevens-Johnson Syndrome.
- Valproic Acid (Depakote): Used for resistant seizures, teratogenic.
- Phenobarbital: Barbiturate, increases GABA activity.
What are some newer AEDs?
- Gabapentin (Neurontin): Used for partial seizures, mimics GABA.
- Lamotrigine (Lamictal): Blocks sodium channels, risk of Stevens-Johnson Syndrome.
- Topiramate (Topamax): Enhances GABA, used as adjunct therapy.
Why must AED levels be regularly monitored?
Most have a narrow therapeutic range, meaning small changes can cause toxicity or ineffective treatment.
What is the “wearing-off” phenomenon in Parkinson’s treatment?
Levodopa loses effectiveness over time, requiring higher doses or additional medications.
What is the first-line treatment for Parkinson’s?
Levodopa-Carbidopa (Sinemet) – Levodopa converts to dopamine,
while Carbidopa prevents breakdown before reaching the brain.
Name dopamine-modulating drugs used in Parkinson’s.
- MAO-B Inhibitors (Selegiline, Rasagiline): Inhibit dopamine breakdown.
- Dopamine Agonists (Bromocriptine, Pramipexole): Mimic dopamine action.
- COMT Inhibitors (Entacapone): Prolong levodopa effects.
What drug class is used to reduce tremors and rigidity in Parkinson’s?
Anticholinergics (e.g., Benztropine (Cogentin)).
Which Parkinson’s drug should not be taken with high-protein meals?
Levodopa-Carbidopa, as protein interferes with absorption.
What are the three major mental health disorders?
- Anxiety Disorders
- Affective (Mood) Disorders
- Psychotic Disorders
What is the biochemical imbalance theory?
Mental illnesses are due to abnormal levels of neurotransmitters like dopamine, serotonin, norepinephrine.
What drug is the first-line treatment for anxiety?
Benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam).
Name the four major classes of antidepressants.
- SSRIs (Selective Serotonin Reuptake Inhibitors)
- SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
- TCAs (Tricyclic Antidepressants)
- MAOIs (Monoamine Oxidase Inhibitors)
Name common SSRIs.
Fluoxetine (Prozac), Sertraline (Zoloft), Escitalopram (Cipralex).
What is serotonin syndrome?
Excess serotonin leading to hyperthermia, tremors, diaphoresis, and confusion.
Why should patients on TCAs be given small doses?
High overdose risk → seizures & dysrhythmias.
What foods should be avoided with MAOIs?
Tyramine-rich foods (e.g., aged cheese, wine) due to risk of hypertensive crisis.
Antipsychotics:
What is the hallmark symptom of psychosis?
Loss of contact with reality (hallucinations, delusions).
Antipsychotics-
Differentiate typical vs. atypical antipsychotics.
- Typical (1st-gen): Haloperidol (high risk of EPS).
- Atypical (2nd-gen): Clozapine, Risperidone (lower EPS risk, but metabolic effects).
What must be monitored for patients taking lithium?
Serum levels (0.6–1.2 mmol/L) to prevent toxicity.
What is critical for AED therapy?
Never stop abruptly to avoid rebound seizures.
