Antiseizure

Front 1

Seizure MOA

Back 1

underactivity of GABA or over activity of glutamate transmission

Front 2

Kindling

Back 2

hyperexcitable state, caused by periodic brief low intensity elecrical stimulation of amygdala or other limbic structures. Caused by inhibiting NMDA

Front 3

Partial seizure MOA, what stops them?

Back 3

neurons fire at high frequency, reducing ability of Na+ channels to recover from inactivation

Front 4

Absence seizure MOA?

Back 4

3Hz spike and wave discharge from thalamus. T current voltage gated Ca2+ channels.

Front 5

Drugs that prolong Na+ channel inactivation?

Back 5

phenytoin, carbamazepine, lamotrigine, valproic acid

Front 6

Drugs that block T type Ca2+ current in thalamus?

Back 6

ethosuximide, valproic acid

Front 7

Drugs that enhance gaba? How?

Back 7

phenobarbital and bezodiazepines. Open Cl- channels, hyperpolarize.

Front 8

Drugs that induce cytochrome p450?

Back 8

phenytoin, carbamazepine, phenobarbital

Front 9

Phenytoin/ fosphenytoin MOA, uses?

Back 9

block sustained high frequency repetitive firing of neurons by prolonging inactivation of the Na+ channel. Partial seizures and generalized tonic clonic seizures, NOT ABSENCE!

Front 10

Phenytoin kinetics?

Back 10

Dose dependent, small first order, large zero order. Phenytoin oral, fophenytoin IV. Small therapeutic range. Highly protein bound.

Front 11

Drugs that displace phenytoin from protein?

Back 11

phenylbutazone, sulfonamides

Front 12

Phenytoin prevents metabolism of?

Back 12

warfarin

Front 13

phenytoin increases metabloism of?

Back 13

oral contraceptives

Front 14

Phenytoins metabolism is increasedby?

Back 14

carbamazepine

Front 15

Phenytoin side effects?

Back 15

gingival hyperplasia, hirsuitism, abnormal VitD metabolism, Ca2+ absorption inhibition, rash, teratogen

Front 16

Carbamazepine MOA?

Back 16

blocks Na+ channels and decreases NT release

Front 17

Carbamazepine differs from phenytoin how?

Back 17

mood stabilizing, used for bipolar

Front 18

Carbamazepine DOC for? other uses?

Back 18

Partial seizures, also generalized tonic clonic seizures and trigeminal neuralgia.

Front 19

Carbamazepine kinetics?

Back 19

induces cyp3a4, metabolzes oral contraceptives. Induces own metabolism. Therapeutic range 6-12 microgram

Front 20

Carbamazepine increases metabolism of?

Back 20

phenytoin, primidone, ethosuximide, valproic acid, clonazepam, haloperidol, oral cont.

Front 21

Inhibit carbamazepine metabolism?

Back 21

cimetidine, fluoxetine

Front 22

Carbamazepine toxicity?

Back 22

GI upset, blood dyscrasia, stevens johnsons

Front 23

Steven johnsons allele?

Back 23

HLA B1502

Front 24

Phenobarbital, MOA and uses?

Back 24

prolongs chloride channel opening, hyperpolarization. Partial and generalized tonic clonic seizures

Front 25

Metabolized to phenobarbital?

Back 25

primidone

Front 26

Vigabatrin?

Back 26

irreversible inhibitor of gaba transaminase, causes visual effects.

Front 27

Lamotrigine, MOA and uses?

Back 27

inactivates voltage dependent Na+ channels. Partial seizures, absence seizures. Bipolar disorder.

Front 28

Lamotrigine toxicity?

Back 28

nausea, somnolence, rash. Preg Cat C.

Front 29

GABA pentin MOA and uses?

Back 29

GABA analog, NOT AGONIST.
Partial, generalized tonic clonic seizures. Neuropathic pain, bipolar, antianxiety.

Front 30

GABA pentin kinetics?

Back 30

short T 1/2. Wide dose range. Kidney excretion w/ linear kinetics. Preg CAT C.

Front 31

Topiramate MOA?

Back 31

blocks voltage gated Na+ channels, enhaces GABAa currents, limits glutamate receptor activation. INHIBITS spread of seizure.

Front 32

Topiramate uses?

Back 32

partial and generalized tonic clonic seizures. Migraine propylaxis. West's syndrome and lennox getaut.

Front 33

Topiramate SE?

Back 33

decreases effectvieness of birthcontrol. pre cat C. dizziness, sedation, nervousness, confusion.

Front 34

Tiagabine MOA and uses?

Back 34

inhibits GABA uptake, partial seizures. Preg CatC

Front 35

Absence seizure DOC, drugs MOA?

Back 35

ethouximide, reduces low threshold Ca2+ current in thalamus.

Front 36

Ethosuximide clearance decreased by?

Back 36

valproic acid

Front 37

Ethosuximide SE?

Back 37

gastric pain, preg cat C

Front 38

DOC for absence seizures w/ generalized tonic clonic seizures?
MOA

Back 38

valproic acid, blocks high frequency repetitive firing

Front 39

Valproic acid uses?

Back 39

absence, generalized tc, myoclonic, bipolar, migraines.

Front 40

Valproic acid interactions?

Back 40

inhibits own metabolism. Inhibits metabolism of phenytoin, carbamazepine, and phenobarbital which causes coma.

Front 41

Valproic acid toxicity?

Back 41

Hepatotoxicity

Front 42

Clonazepam used for?

Back 42

absence seizures

Front 43

Diazepam/lorazepam used for?

Back 43

status epilepticus (IV)

Front 44

Drugs that cause steven johnsons?

Back 44

Phenytoin, Ethosuximide, Tiagabine

Carbamazepine, Oxcarbazepine, Phenobarbital, primodine

Valproic acid, lamotrigine

Front 45

At physiologic pH, local anesthetics exist in what form?

Back 45

ionized

Front 46

factors that decrease effectiveness of local anesthetics?

Back 46

inflammation with acidification

Front 47

Epinephrine anesthetic MOA?

Back 47

decreases substance P via alpha 2

Front 48

Amide anesthetics?

Back 48

bupivacaine, lidocaine, prilocaine

Front 49

Ester anesthetics?

Back 49

benzocaine, cocaine, procaine

Front 50

Amide distribution, metabolism?

Back 50

Wide distribution. liver cp450

Front 51

Ester distribution, metabolism?

Back 51

rapid via pseudocholinesterase

Front 52

Carbonation

Back 52

saturation with CO2, decreases pH to increase cellular concentration.

Front 53

Side effects not seen with cocaine?

Back 53

negative inotropy, vasodilation/hypotension

Front 54

bupivacaine SE?

Back 54

broadens QRS

Front 55

Prilocaine SE?

Back 55

metabolite causes methemoglobinemia, Tx with methylene blue

Front 56

ester/PABA SE?

Back 56

allergic reaction

Front 57

Lidocaine duration of action, uses?

Back 57

intermediate, infiltration blocks and epidurals

Front 58

Mepivicaine?

Back 58

intermediate duration longer than lidocaine. Causes less drowsiness and sedation.

Front 59

Bupivacaine duration uses?

Back 59

LONG, infiltration blocks and epidural anesthesia

Front 60

Ropivicaine?

Back 60

S isomer of bupivicaine. Less lipid soluble, cleared via liver and less likely to cause adverse effects.

Front 61

TCA MOA and uses?

Back 61

inhibit NE and 5HT reuptake. chronic pain and fibromyalgia

Front 62

Duloxetine MOA and uses?

Back 62

TCA, diabetic peripheral neuropathy and fibromyalgia

Front 63

Used for neuropathic pain?

Back 63

Gabapentin and pregabalin

Front 64

Used for fibromyalgia and shingles pain?

Back 64

pregabalin

Front 65

Used for trigeminal neuralgia pain?

Back 65

carbamazepine

Front 66

Muscle relaxant most likely to be abused?

Back 66

carisoprodil

Front 67

Muscle relaxant used for fibromyalgia?

Back 67

cyclobenzaprine

Front 68

Topical NSAID?

Back 68

diclofenac

Front 69

Lidocaine patches?

Back 69

local analgesia, especialy for post herpetic neuralgia