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29 Cards in this Set

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