Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
36 Cards in this Set
- Front
- Back
|
Seizure
|
Finite episode of brain dysfxn from abnormal synchronous neuronal discharge
|
|
|
Epilepsy
|
Chronic disorder w/recurrent seizures
|
|
|
Symptomatic epilepsy
|
Associated w/infection, head injury, tumor, toxicity, metabolic disorder, develpmental abnormalities, or CV dz
|
|
|
Idiopathic epilepsy
|
Not associated w/underlying disorder
|
|
|
Types of Partial Seizures
|
Simple
Complex Partial secondarily generalized |
|
|
Types of Generalized Seizures
|
Tonic-clonic (grand mal)
Absence (petit mal) Myoclonic |
|
|
Characteristics of Simple partial seizures
|
PRESERVATION OF CONSCIOUSNESS
sensory auras or limited unilateral motor convulsions 20-60s |
|
|
Characteristics of Complex partial seizures
|
Impaired consciousness, automatisms common, post-ictal confusion and/or lethargy. 30s-2min
|
|
|
Characteristics of Partial seizure secondarily generalized
|
Onset progressing to generalized tonic-clonic 1-2 min
|
|
|
What is the most common refractor seizure type in adults
|
Complex partial
|
|
|
Tonic-clonic
|
Loss of consciousness, major convulsions, tonic spasm followed by clonic jerking, prolonged post-ictal stupor
1-2 min |
|
|
Absence Seizures
|
Abrupt interruption of consciousness--staring and cessation of ongoing activities, symmetrical jerking
< 30s |
|
|
What about absence seizures make it distinguishable from complex partial seizures
|
LACK of post-ictal abnormalities
|
|
|
Myoclonic
|
Brief, shock-like contraction of muscle
~1 sec |
|
|
Drugs of choice to treat partial seizures
(There are 3) |
CARBAMAZEPINE
Phenytoin Valproate |
|
|
Drugs used as front line monotherapy in partial seizures
(there are 7) |
Carbamazepine (car-ba-mah'-ze-pine)
Phenytoin Oxcarbazepine (ox-car-bAy'-ze-pine) Lamotrigine (la-mO'-tri-jeen') Valproate Topiramate (tOh-peer'-a-mate) Gabapentin (gaba-pen'-tin) |
|
|
Drugs used as adjunct therapy for partial seizures
(there are 6) |
Levetiracetam (lev e tear AH seh tam)
(Topiramate) (Gabapentin) Zonisamide (zoe-nih'-sa-mide) Tiagabine (tie-AY'-ga-bine) Vigabatrin *()= off-label use |
|
|
Drugs used in refractory cases of partial seizures
|
Felbamate (fel-BAH'-mate)
Vigabatrin |
|
|
Drugs of choice for Tonic-clonic seizures?
|
VALPROATE
Phenytoin Carbamazepine |
|
|
Tonic-clonic Front line therapy
|
Valproate
(Lamotrigine) |
|
|
Tonic-clonic adjunct therapy
|
Topiramate
|
|
|
Other drugs for tonic-clonic seizures
(there are 4) |
(Zonisamide)
(Oxcarbazepine) Phenobarbital Primidone |
|
|
Front line monotherapy and drugs of choice for Absence seizures
|
Ethosuximide
Valproate Lamotrigine (not drug of choice) |
|
|
Drug of choice and front line therapy for myoclonic
|
Valproate
|
|
|
Off-label drugs used for Myoclonic
|
Lamotrigine
Topiramate Zonisamide |
|
|
Seizure model for generalized tonic-clonic
|
Maximal electroshock (MES)
|
|
|
Model for Complex partial
|
Kindling
|
|
|
Model for Absence
|
Pentylenetetrazol (PTZ)
Genetic models |
|
|
Antiseizure drugs decrease SPREAD of seizure and INCREASE seizure threshold by
|
Decreasing excitation
Enhancing inhibition Modifying neuronal excitability by altering ion channel activity |
|
|
Drugs that decrease excitation by acting on presynaptic glutamate
|
Phenobarbital
Lamotrigine |
|
|
Drugs that decrease excitation by acting on AMPA/KA postsynaptic receptors
|
Topiramate
|
|
|
Drug that decreases excitation by acting on postsynaptic NMDA receptors
|
Felbamate
|
|
|
Drugs that enhance inhibition
(name 8) |
Valproate
Vigabatrin Tiagabine Phenobarbital Levetiracetam Topiramate Felbamate Gabapentin |
|
|
Drugs that alter activity of ion channels
(name 10) |
Carbamazepine
Oxcarbazepine Phenytoin Valproate Lamotrigine Topiramate Zonisamide Primidone Levetiracetam Ethosuximide |
|
|
Drugs that decrease excitation
(name 4) |
Phenobarbital
Topiramate Lamotrigine Felbamate |
|
|
Drugs that alter ion channels by acting on K+ channels. On Ca channels?
|
K+: Oxcarbazepine, Levetiracetam
Ca2+ (N-type): Levetiracetam and Oxcarbazepine Ca2+ (T-type): Ethosuximide, Valproate, Zonisamide |
