Neuro 4: Anticonvulsant Drugs

Front 1

What is the basic mechanism of anti-convulsants?

Back 1

> refractory period and dercreasing repetitive firing; altering synaptic transmission; reduction of excitatory NT

Front 2

What two NT do anti-conv focus on?

Back 2

increase GABA (inhibitory) and reduce Glutamate (excitatory)

Front 3

What are the drugs of choice for a generalized tonic/clonic or partial seizure?

Back 3

Phentoin and Carbamazepine and Valproic acid

Front 4

What is the drug of choice for a generalized absence seizure?

Back 4

Ethosuximide

Front 5

What is the drug of choice for a myoclonic seizure?

Back 5

Valporic Acid

Front 6

What are the drugs of choice for status epilepticus?

Back 6

Diazepam and Lorazepam (IV) followed by Fosphenytoin (IV)

Front 7

What is used for stabilization in status epilepticus?

Back 7

Phenytoin

Front 8

What age group is Phenytoin most used in?

Back 8

Children

Front 9

What was the original advance of pheytoin?

Back 9

Less sedation

Front 10

What are 2 cosmetic effects of Phenytoin?

Back 10

Gingival hyperplasia and hirsutism

Front 11

What may occur in the fetus if phenytoin is invloved?

Back 11

Cleft palate

Front 12

Increases in phenytoin should be in what increments?

Back 12

25-30

Front 13

What may Phenytoin also be used for?

Back 13

Cardiac dysrhythmias and neuropathic pain

Front 14

What drug would stimulate the metabolsim of phenytoin?

Back 14

Carbamzepine (Plasma concentration of phenytoin is decreased by drugs that stimulate hepatic metabolism)

Front 15

What drug can produce a blood dyscrasia?

Back 15

Phenytoin

Front 16

Besides tx a generalized T/C or partial seizure, what else is Carbamezepine used to tx?

Back 16

Neuropathic pain and manic disorder

Front 17

What is a common side effect of carbamazepine? (besides the general GI and vision effects)

Back 17

Erythematous skin rash

Front 18

What drug may cause aplastic anemia and or argranulocytosis --> ulcerative lesions of mucous membranes?

Back 18

Carbamazepine

Front 19

What do you NOT use Carbamazepine with?

Back 19

MAO inhibitors (because it resembles a trcyclic antidepressant(

Front 20

What effect does Carbamazepine have on other drugs?

Back 20

IT < the levels of other anti-convulsants and even itself via enzyme induction

Front 21

What is a side effect of Phenobarb?

Back 21

Sedation

Front 22

What drug may cause a megaloblastic anemia?

Back 22

Phenobarb

Front 23

Phenobarb may lower levels of which drug?

Back 23

Carbamazepine

Front 24

What drug may inhibit phenobarb metabolism?

Back 24

Valproic acid

Front 25

What does Primidone eventually convert into?

Back 25

Phenobarbitol

Front 26

What drug may produce anorexia as a side effect?

Back 26

Ethosuximide

Front 27

What are there very few interactions with Ethosuximide?

Back 27

The drug is not protein bound

Front 28

What effect does Valproic acid have on Ethosuximide?

Back 28

< ethosuximide's metabolism, so > plasma concentration

Front 29

Why may your choose Valproic acid over Ethosuximide to treat Absence seizures?

Back 29

Its usefulness in generalized tonic-clonic seizures as well

Front 30

Why is Ethosuxamide usually the primary choice to treat ONLY a pure absence seizure? (Rather than valproic acid?)

Back 30

VA can have sudden liver failure

Front 31

What four drugs does Valproic acid increase by inhibiting their metabolism?

Back 31

Phenobarbital, Phenytoin, and Carbamazine and Ethosuxamide

Front 32

What drug inhibits platelet aggregation?

Back 32

Valproic acid

Front 33

Use in Valproic acid is contraindicated in patients already on what meds?

Back 33

Anticoagulants (It inhibits platelet aggregation)

Front 34

What drug may produce weight gain?

Back 34

Valproic acid

Front 35

For what other problems does Valproic acid have established efficacy?

Back 35

Mania, migraine

Front 36

What drugs would you use for febrile seizures in children?

Back 36

Diazepam or Lorazepam

Front 37

What drug is now available in a rectal suppository?

Back 37

Diazepam

Front 38

What is the drug of choice when tx neuropathic pain?

Back 38

Gabapentin

Front 39

What else may Gabapentin be used to tx?

Back 39

Mania and movement disorders (Parkinson's)

Front 40

Through what mechanism does Tiagabine act?

Back 40

Blocks the GABA uptake transporter

Front 41

What drug may produce a life threatening dermatitis in pediatric patients?

Back 41

Lamotrigine

Front 42

What other possible efficacies may Lamotrigine produce?

Back 42

Mania and migraine tx

Front 43

What drug has been associated with spina bifida?

Back 43

Valproic acid