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28 Cards in this Set
- Front
- Back
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Epilepsy
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-starts in the gray matter
- excessive/hyper sync activit of neurons in the CC |
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Causes - drug causing
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Lower seizure threshold
Theophylline, Tricyclic anti-depressants, some phenothiazines hyperglyecima |
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Atonic seizures
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loss of muscle - fall abruptly
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Absense - petit mal
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VALPROATE & ETHOSUXIMIDE
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Tonic-clonic , rigid flex then extension - then clonic jerking
cry from larynx |
CARBAMAZEPINE
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myoclonic - no LOC, muscle jerkin
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a
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TOnic - lack clonic
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ka
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Partial seizures - one hemisphere..some underlying brain leison
COMPLEX - LOC- temperoal lobe assoc with schizo simple - No LOC, epileptic aura.. |
Partial - CARBAMAZEPINE
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status epilepticus - seizures after another w/o consc btw
hours-days....maybe due to rapid withdrawl of anticonvulsants |
ka
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febrile seizures..3mo-5 yrs
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ka
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Lennox syndrome - 2-6yrs old
freq and diff seizure types..hard to treat |
ka
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Carbamazepine
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Tonic-clonic & partial
-Cp450 inducer - looks like Imipramide (ADepressent, Adverse - Ataxia-diploipa, ST MEMORY LOSS cardiac problems...hypoNa and hyperVolum Drug interactions increase metabolism (oral contraceptvives!) |
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Valproate
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partial & generalized seizures
DOC - TONIC CLONIC highly protein bound MOA: - potent GABA, Na/Ca blocker Adverse: Fine tremors - use B2 blcokers wtgain, LIVER DAMAGE (avoid children under 3, avoid with salicylates..displace) P450 inhib, Neural tube defects |
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Phenytoin
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Generalized & partial
MOA: blocks Na/Ca - stops spread of activity Adverse: encephalopahty, fetal hydantion syndrome Gingival hyperplasia Folic A def Cp450 inducer (enhaces valproate) - ccan be displaced by albumin by valproate |
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Ehosuximide
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= valporate for absense seizures
MOA : ca blocker in thalamus not enz inducer |
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Phenobarbital & Primidone
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chronic epilepsy, used when others fail..Partial & general seiz
MOA: GABA receptor, keeps Cl open longer - osteomalacia Potent Cp450 inducer Pheobarb - reduce bilirubin in neonates (otheruse) |
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Primidone
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PROdrug
more effective then pheno - Partial and tC seiz metabolites affective anti-convuls PHENOBARB & Phenylethylmalonamide |
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Benzodiazepines
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Diazepam/clonazepam (can cause behv problems)
- termination of status epli, febrile seizueres partial and generaliz zeiries ppl develeop tolerace...increase DOSE - no Cp450 |
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Gabapentin
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analog of GABA...and enhances relesae of GABA
short 1/2 - Partial, TC, neuro pain not an inducer -sleepy and fatigue |
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Topiramate
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partial seizures
incrase GABA blocks relse of EAA (glutamate) |
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Lamotrigine
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blocks Na/inhibs glutamate release
t1/2 30 hours partial and genearl |
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Vigabatrin
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gaba analog
partial & focal seizure |
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Levetriacetam
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epi and toourettes
binds to SV2A, impedes nerve conduction |
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Felbamate
Tiagabine Zonisamide Pregabalin |
partial - aplastiic anemia/liver
GABA reuptake inhib partial & lennox gest partial, GAD, neuropain |
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Mood stablizeres
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valporate, gabapenin, carbamazepine
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AED
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remove stimulus,
multi drug should be AVOIDED seizure due to alcohol - treat withdrawl |
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AED - fetus
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Valproate - NTD
phenytoin - Fetal hydantion syndrome if past first trimester - no pt switching drugs Phenytoin, Phenobarb and Primidone - KIDS VIT K dept clotting factors def. - all excreted in breast milk |
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AED - fractures
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p450 induction, vit d metabolized....impaired Ca+ absorp...bone cells affected
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