Parker Pharm Ii: Packet 2 - Aed

Front 1

In which type of seizure is conciseness preserved and motors signs and sensory signs are directly related to seizure origin, and last 20-60 sec?

Back 1

Simple partial seizure

Front 2

What type of seizure become bilateral, ususally arises from the temporal lobe, has purposeless movements of lip smacking/hand wringing, and consciousness may be impaired for 30 secs to 2 mins.

Back 2

Complex partial seizures

Front 3

Which type of seizure involves loss of consciusness, sustained contractions (tonic) followed by relaxations (clonic) of muscles throughout the body (1-2 mins), and evolve to a tonic-clonic seizure?

Back 3

Partial seizures evolving to generalized seizure

Front 4

What majority of generalized seizures are due to?

Back 4

genetic defects

- most commonly: juvenile myoclonic epilepsy

Front 5

What type of seizure involves loss of consciousness, brief stare, eye flickering, and generally no motion (lasting >30 secs)?

Back 5

Absence seizures: Petit Mal

Front 6

Which type of seizure involves brief (1 sec) shock-like contractions of muscles either restricted or generalized location?

Back 6

Myoclonic

Front 7

Which type of seizure involves sudden onset, loss of consciousness; sustained contractions (tonic) followed by rapid contractions and relaxation (clonic) of muscles throughout the body (lasting 1-2 min)

Back 7

tonic-clonic: Grand Mal

Front 8

What type of seizure involves sudden loss of muscle tone?

Back 8

Atonic

Front 9

Drugs used to treat partial and generalized tonic-clonic seizures reduce neuronal activity by what mechanism?

Back 9

Reduce neuronal activity by either prolonging Na+ channel inactivation or enhancing GABA activity.

Front 10

Drugs used to treat myoclonic and absence seizures target what mechanism?

Back 10

Target T-type calcium channels.

- T-type calcium channels target the thalamo-cortical pacemaker activity which underlies this type of seizure.

Front 11

What are the conventional agents used for simple partial and complex partial seizures?

Back 11

- Carbamazepine (Tegretol)

- Phenytoin (Dilantin)

- Valproate (Dapakote)

Front 12

What are the conventional agents used for evolving seizures?

Back 12

- Carbamazepine (Tegretol)

- Phenytoin (Dilantin)

- Valproate (Dapakote)

- Primidone (mysoline) *

- Phenobarbital (Luminal) *

* additional drugs to the conventional ones used for partial simple and partial complex

Front 13

What are the newer agents used for partial simple, partial complex, and evolving seizures?

Back 13

Gabapentin (Neurotonin)

Lamotrigine (Lamictal)

Levetriacetam (Keppra)

Tiagabine (Gabitril)

Topiramate (Topamax)

Zonisamide (Zonegran)

Front 14

What are the conventional agents used for simple partial and complex partial seizures?

Back 14

- Carbamazepine (Tegretol)

- Phenytoin (Dilantin)

- Valproate (Dapakote)

Front 15

What are the conventional agents used for evolving seizures?

Back 15

- Carbamazepine (Tegretol)

- Phenytoin (Dilantin)

- Valproate (Dapakote)

- Primidone (mysoline) *

- Phenobarbital (Luminal) *

* additional drugs to the conventional ones used for partial simple and partial complex

Front 16

What conventional agents are used for for absence seizures?

Back 16

Ethosuximide (Zarontin)

Valproate (Depakote)

Clonazepam (Klonopin)

Front 17

What conventional agent is used for Myotonic seizures?

Back 17

Valproate (Depakote)

Front 18

What are the newer agents used for partial simple, partial complex, and evolving seizures?

Back 18

Gabapentin (Neurotonin)

Lamotrigine (Lamictal)

Levetriacetam (Keppra)

Tiagabine (Gabitril)

Topiramate (Topamax)

Zonisamide (Zonegran)

Front 19

What conventional agents are used for for absence seizures?

Back 19

Ethosuximide (Zarontin)

Valproate (Depakote)

Clonazepam (Klonopin)

Front 20

What conventional agent is used for Myotonic seizures?

Back 20

Valproate (Depakote)

Front 21

What conventional drugs are used for tonic-clonic seizures?

Back 21

- Carbamazepine (Tegretol)

- Phenobarbital (Luminal)

- Phenytoin (Dilantin)

- Primidone (Mysoline)

- Valproate (Depakote)

Front 22

What newer agents are used for Absence seizures?

Back 22

Lamotrigine (Lamictal)

Front 23

Which newer agents are used for Tonic-Clonic seizures?

Back 23

Lamotrigine (Lamictal)

Topiramate (Topamax)

Front 24

What drug is a more soluble prodrug that is converted to phenytoin (Dilantin) in the body?

Back 24

Fosphenytoin (Cerebyx) -

Front 25

What is the effect of giving Phenytoin with Valproate?

Back 25

Valproate can displace Phenytoin from serum proteins, resulting in marked increase in phenytoin concentrations.

Front 26

What is the difference between elimination of phenytoin at high concentrations and low concentrations?

Back 26

@ low concentrations - phenytoin metabolism follows 1st order kinetics

@ higher concentrations - maximum capacity of liver to metabolize phenytoin is reached causing elimiantion to follow zero order kinetics (an equal amount of drug is eliminated per unit of time since the enzymes are saturated)

Front 27

What is the effect of giving Warfarin and Phenytoin together?

Back 27

Phenytoin can displace Warfarin from albumin binding sites resulting in increase warfarin concentrations. Also, they are both metabolized by CYP2C9 so they can decrease metabolism of each other.

Front 28

What are the uses for Phenytoin (Dilantin)?

Back 28

-Generalized Tonic-Clonic seizures

- Partial (Simple and Complex) Seizures.

Front 29

Phenytoin (Dilantin) can induce metabolism of what drugs?

Back 29

Oral Contaceptives

Front 30

What drugs can inhibit Phenytoin (Dilantin) metabolism?

Back 30

Isoniazid

Front 31

What drugs can induce Phenytoin (Dilantin) metabolism?

Back 31

phenobarbital and carbamazepine

Front 32

What are the most common side effects of Phenytoin (Dilantin) that require dose reduction?

Back 32

Diplopia and Ataxia

- not Nystagmus and loss of smooth extra-ocular pursuit movements (occur at low doses)

Front 33

What AED is also used to treat bipolar disorder?

Back 33

CarbaMAZepine

Front 34

Carbamazepine (Tegretol) should be not be given with what type of drug due to its structural relationship to TCA imipramine?

Back 34

MOA inhibitors - can precipitate hypertensive crisis

Front 35

What is the MOA of Vigabatrin (Sabril)?

Back 35

Irreversilbly inhibits GABA aminotransferase and promotes the accumulation of GABA at the synapse thus increasing GABA activity and thus inhibiting high frequency neuronal firing.

Front 36

What AED is indicated in children only in special circumstances like Lennox-Gastaut syndrome because it causes life threatening rashes?

Back 36

Lamotrigine (Lamictal)

Front 37

What is the MOA of Lamotrigine (Lamictal)

Back 37

Inactivates voltage and use dependent Na+ channels and Blocks Ca+2 Channels.

Front 38

What AED is a GABA + lipophilic hexane ring that does NOT activate GABA receptors but it is eliminated unchanged in the KIDNEYS.

Back 38

Gabapentin (Neurontin)

Front 39

What AED is blocks Na+ channels, increases GABa inhibitory actions decreses AMPA-kainate currents AND is also used for migrane headache prophylaxis?

Back 39

Topiramate (Topamax)

Front 40

What AED is the the DOC for Absence (Petit Mal) seizures?

Back 40

Ethosuximide (Zarontin)

Front 41

What is the MOA of Ethosuximide (Zarontin) ?

Back 41

decreases low threshold T-type Ca2+ currents in the thalamus and prevent pacemaker current responsible for rhythmic cortical discharge

Front 42

What is the DOC for absence seizures concomitant with tonic-clonic seizures?

Back 42

Valproic Acid (Depakote)

note: the DOC for absence seizures alone is Ethosuzimide.

Front 43

What BZDs are the DOC for status epilepticus?

Back 43

Diazepam (Valium) and Lorazepam (Ativan)