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29 Cards in this Set
- Front
- Back
Mechanism of Phenobarbital
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Opens Cl channel and thus hyperpolarizes neuronal membranes
-May also decrease excitatory effects of glutamate -Abolishes seizures at subanesthetic doses |
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Indication of Phenobarbital
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Epilepsy Fool!!
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Advantages of Phenobarbital
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Least toxic, least expensive, and oldest anti-epileptic
-Very effective – broad spectrum |
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Disadvantages of Phenobarbital
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Sedation, dizziness, respiratory depression limit usefulness
-Drug interactions: P450 related |
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Mechanism of Phenytoin (Dilatin)
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Enhances Na channel inactivation
-Alters K and Ca channels and interacts with several NTs |
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Indications of Phenytoin (Dilatin)
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Epilepsy
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Advantages of Phenytoin (Dilatin)
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Very effective – broad spectrum
-Sedation less pronounced than with Phenobarbital |
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Disadvantages of Phenytoin (Dilatin)
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-Several side effects associated with chronic use (ataxia and slurred speech, diplopia, nystagmus, gingival hyperplasia, hirsutism, acne)
-Difficult to adjust dose (zero-order elimination) -Drug interactions: P450 |
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What is the mechanism for epilepsy
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excessive EEG discharges.
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What are seizures involving both hemispheres called?
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Generalized tonic-clonic or Grand Mal seizure
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What are absence (Petit Mal Seizures)
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Loss of consciousness with or without motor activity.
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Partial or focal seizures that involve one hemisphere are?
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simpe partial seizures.
they are confined muscular, sensory symptoms |
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What treats partial seizures which consciousness is only impaired?
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Lamotrigine (Lamictal)
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What treats febrile or abstinence seizures?
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Lamotrigine (Lamictal)
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What is the mechanism of Type I?
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prolong neuronal refractory period by acting on sodium channels
Block sustained, high freuqency repetitive firing (SRF) |
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What is the mechanism of Type II
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The activation of the exhisting inhibitory network (GABA is the major inhibitory NT).
Enhances GABA binding to its receptors and or CHLORIDE CHANNELS to HYPERPOLARIZE and inhibit neuronal function. Also can inhibit GABA reuptake or metabolism. |
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What is the mechanism for Type III
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Block T-calcium currents which are low threshold, transient calcium channels.
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Mechanism of Valproic Acid (Depakene)
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-Elevates GABA levels in CNS
-Enhances Na channel inactivation |
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Indications of Valproic Acid (Depakene)
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Fatty acid structure is unique
-Exhibits saturable protein binding and metabolism |
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Disadvantages of Valproic Acid (Depakene)
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-Hepatotoxicity, teratogencity, pancreatitis
-Side effects limit therapeutic use -Drug interactions: inhibits metabolism of several drugs |
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Mechanism of Lamotrigine (Lamictal)
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Enhances Na channel inactivation
-May alter Ca channels – may explain effectiveness against absence seizures |
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Indications of Lamotrigine (Lamictal)
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Used as adjunct or alone as alternative for both partial and generalized seizures
-Bipolar I disorder |
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Advantages of Lamotrigine (Lamictal)
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Epilepsy
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Disadvantages of Lamotrigine (Lamictal)
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Skin Rash
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Mechanism of Gabapentin (Neurontin)
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Structural analog of GABA (not a receptor agonist)
-May alter GABA release, uptake, or metabolism |
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Indication of Gabapentin (Neurontin)
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Older indications: postherpetic neuralgia, diabetic neuropathy, migraines
-Elimination affected by renal function |
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Advantages of Gabapentin (Neurontin)
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No significant drug interactions
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Disadvantages of Gabapentin (Neurontin)
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looks good
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Disadvantages of Zonisamide (Zonegran)
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Been known to develop kidney stones. Side effect is oligohydrosis and rashes. It inhibits sweating
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