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46 Cards in this Set

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Antiseizure drugs are used for what type of pt's
Those with febrile seizures or seizures due to acute illness (meningitis)
Define epilepsy
Means "to seize upon". Applied to those with chronic seizures
What 4 things are abnormal in seizures?
Sensory, motor (convulsions), autonomic, and psychic activity
Under partial seizures, describe the fx's of a simple partial seizure?
No loss of consciousness, focal motor, sensory, or speech disturbances
Describe a complex partial seizure?
Has impaired consciousness, dreamy disaffected state, with or w/o automatisms
Generalized seizures involve both ____?
State the difference b/t a grandmal and petit mal seizure?
GM/tonic clonic: sensory aura, gen. convulsions of musculature, LOC
PM/absence seizures: LOC (30sec), immobility, vacant look, children 4-12yrs
What is a third type of gen. seizure? Describe it?
myoclonic? Myoclonic jerks, loss of muscle tone, falling
What could be the etiology of various seizures?
idiopathic, brain injury, congenital malformation, w/drawal from antidepressants, neoplasia, genetics, hyperthermia (kids), kindling from prior shock
An antiseizure drug should perform at least one of the following things?
Enhance GABAergic xmission(inhibitory)diminute glutamatergic xmission(excitatory), or modify ionic conduction
What is a neurons RMP? What is the fxn of depolarization and hyperpolarization?
-70mV. 1) Na+ enters cell, and moves potential to a pos. value 2) K+ leaves the cell, or Cl- enters moving the potential to a neg value where the cell has less potential to fire.
Generalized seizures involve both ____?
State the difference b/t a grandmal and petit mal seizure?
GM/tonic clonic: sensory aura, gen. convulsions of musculature, LOC
PM/absence seizures: LOC (30sec), immobility, vacant look, children 4-12yrs
Glutamate binding induces what process?
Depolarization by opening Na+ channels.
How does the binding of GABA to the GABA,A receptor affect the cell?
Opens a Cl- channel, hyperpolarization.
How do Na+ channels close after depolarization?
The spontaneously inactivate
What drug may control Ca+ currents in absence seizures? In what way?
Ethosuximide. By the reduction of currents.
What 3 changes may initiate neuron excitability?
Abnormal ionic channels, receptors, or the extracellular environment.
Name the drugs and their categories which slow Na+ channel recovery from inactivation?
Phenytoin (Hydantoin), Carbamazepine (Iminostilbenes), Valproic acid (Carboxylic acids), Lamotrigine, & Topiramate
These drugs may allow more Cl- ions to enter a neuron, and block glutamate receptors?
Phenobarbitol, Primodone (barbituates)
Diazepam, Clonazepam (benzodiazepines)
What two anticonvulsants is primodone metabolized to?
Phenobarbitol, & Phenylethylmalonamide
What neurons are thought to be resposible for absence seizures?
Thalamic neurons.
These drugs reduce the current through Ca+ channels in thalamic neurons?
Ethosuximide (Succinimides)
Valproic Acid (Carboxylic acids
These drugs reduce the current through Ca+ channels in thalamic neurons?
Ethosuximide (Succinimides)
Valproic Acid (Carboxylic acids
These drugs inhibit the metabolism of "GABA"
Vigabatrin, Gabapentin, & Tiagabine
What is the MOA of Vigabatrin?
Irreversible inhibitor of GABA-transaminase
What is the MOA of Gabapentin?
Promotes nonvesicular release of GABA or inhibits its uptake
What is the MOA of Tiagabine?
Inhibits GABA uptake
O.k. Smarty pants! Name the drugs that work at the GABA receptor, transporter, nonvesicular release, transaminase inhibitor
1) Benzodiazepines, Barbituates 2) Tiagabine, Gabapentin, Vigaba"trin"
The new drug Zonisamide has what actions? What is its side effect?
Blocks Na+ channels, reduces Ca+ channel activity, inc. GABA release, blocks K+/glutamate-mediated excitation.
Weight loss
This drug has similar actions to Zonisamide but may treat bipolar disorder and EtOH consumption?
Topiramate
These 2 drugs "C"an "G"o and treat simple partial seizures
Carbamezepine, and Gabapentin
This drug may treat complex partial and all types of generalized seizures
Valproic acid
What 2 drugs may aggravate absence seizures? ("Ph"ina "C"an't)
Carbamezapine, and Phenytoin
These repeated seizures are lifethreatening and require heart, lung, and metabolic management. What are they and what is used to treat them?
Status Epilepticus. Diazepam, Phenytoin, and Phenobarbital if no success.
What are some of the many side effects of antiseizure drugs?
(NoVie HAS A RAW Rash)
N/V, rash, nystagmus, disturbed vision, ataxia, sedation, aplastic anemia, hepatoxicity, resp. depression w/ overdose, w/drawal effects
Why is the dosing of phenytoin so important?
As the dosage increases, the hydroxylation system becomes saturated so that more doses produce large increases in plasma concentration.
What drugs may positively effect the metabolism of phenytoin?
carbamezepine, and phenobarbitol
These drugs may negatively effect the metabolism of carbamezepine?
Erythromycin, Isoniazid, and Propoxyphene
These are some side effects of phenytoin?
N/V, CNS depression, confusion, inhibition of ADH, gingival hyperplasia, hirsutism, megaloblastic anemia
Phenytoin may also have this effect?
Antiarrhythmic
What are the risks for expectant mothers taking phenytoin?
"Fetal hydantoin syndrome" - cleft lip, cleft palate, congenital heart disease, growth and mental deficiency
What drug has been implicated to cause spina bifida?
Valproate
These 3 antiseizure drugs may treat mania?
carbamazepine, gabapentin, valproate
These 2 drugs may act as mood stabilizers?
Topiramate and carbamazepine
This drugs may tx Parkinson's disease
Gabapentin
These 2 drugs may treat migraines?
Valproate, and Zonisamide
These two drugs may treat neuropathic pain?
Gabapentin, and Zonisamide