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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