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