Pharmacology-Ch24-Antiseizure Drugs

Front 1

how are gabapentin and vigabatrin eliminated?

Back 1

kidney, largely in unchanged form

Front 2

how is lamotrignine eliminated?

Back 2

hepatic glucuronidation

Front 3

what is the MOA of phenytoin, carbamazepine and lamotrignine?

Back 3

block voltage gated sodium channels in neuronal membranes, this action is rate dependent (ie dependent on the frequency of neuronal discharge)

Front 4

what is the MOA of benzos?

Back 4

increase the frequency of chloride channel opening; and facilitate the inhibitory effect of GABA

Front 5

what is the MOA of barbituates?

Back 5

they inhance the inhibitory effects of GABA but interact with a different receptor site on the chloride ion channels that results in an increased DURATION of chloride channel opening

Front 6

what enzyme is an important enzyme in the termination of the action of GABA?

Back 6

GABA transaminase

Front 7

GABA transaminase is irreversibly inactivated by this drug?

Back 7

Vigabatrin (and can be inhibited at very high doses of Valproic acid)

Front 8

what is the MOA of ethosuxamide?

Back 8

inhibits low threshoold (T type) Ca2+ currents, especially in thalamic neurons that act as pacematers to generate rhythmic coritcal discharge. a similar action is reported for valproic acid

Front 9

what is the MOA of felbamate?

Back 9

blocks NMDA receptors.

Front 10

what is the MOA of topiramate?

Back 10

blocks sodium channels and potentiates the actions of GABA and may also blocjk glutamate receptors

Front 11

what are the DOC for tonic clonic and partial seizures?

Back 11

valproic acid, carbamazepine, phenytoin

Front 12

what is another name for tonic-clonic seizures?

Back 12

grand mal

Front 13

what is the DOC for absence seizures?

Back 13

ethosuximide and valproic acid (preferred because they cause minimal sedation)

Front 14

what is teh DOC for myoclonic seizure?

Back 14

valproic acid

Front 15

what is the DOC for Status epilepticus?

Back 15

IV diazepam or lorazepam is usually effective in terminating attacks and providing short term control

Front 16

for prolonged therapy for status epilepticus what is the treatment regimine?

Back 16

IV phenytoin is usually used becuase it is highly effective and less sedating than benzos or barbituates-

Front 17

what is the toxicity of phenytoin?

Back 17

cardiotoxicity (perhaps because of its solvent propylene glycol)

Front 18

what version of phenytoin is safer?

Back 18

fosphenytoin (water soluble)

Front 19

what is the DOC in infantile spasms?

Back 19

corticotropin and corticosteroids are commonly used

Front 20

what is the side effect of corticotropin and corticosteroid use for infantile spasms?

Back 20

characteristic cushingoid side effects

Front 21

what are the antiseizure drugs that are effective in management of Bipolar disorder?

Back 21

valproic acid, carbamazepine, phenytoin, and gabapentin (also lamotrignine)

Front 22

what is the DOC for trigeminal neuralgia?

Back 22

carbamazepine

Front 23

what antiseizure drug is effective in treating pain of neuropathic origin including postherpetic neuralgia?

Back 23

gabapentin

Front 24

what antiseizure drugs have some value in treating migraines?

Back 24

gabapentin and phenytoin

Front 25

what are the SE of benzos?

Back 25

sedation, tolerance, dependence

Front 26

what are SE of carbamazepine?

Back 26

diplopia, ataxia, enzyme induction, blood dyscrasias, teratogenic, oxycarbazine is less toxic

Front 27

what are the SE of ethosuximide?

Back 27

GI distress, lethargy, headache

Front 28

what are the SE of felbamate?

Back 28

aplastic anemia, hepatotoxicity

Front 29

what are the SE of gabapentin?

Back 29

sedation, dizziness, behavioral changes

Front 30

what are the SE of lamotrignine?

Back 30

sedation, ataxia, STEVEN-JOHNSON SYNDROME

Front 31

what aer the SE of levetiracetam?

Back 31

arthenia, dizziness, sedation

Front 32

what are the SE of phenobarbital?

Back 32

sedation, enzyme induciton, tolerance, dependence

Front 33

what are the SE of phenytoin?

Back 33

nystagmus, diplopia, ataxia, sedation, GINGIVAL HYPERPLASIA, hirusutism, anemias, enzyme induction, teratogenic

Front 34

what are the SE of topiramate?

Back 34

sedation, mental dulling, renal stones and weight loss

Front 35

what are the SE of valproic acid?

Back 35

GI distress, hepatotoxicity (which is 0Rare but possibly fatal), inhibition of drug metabolism, teratogenic

Front 36

what are the SE of vigabatrin?

Back 36

sedation, weight gain, agitation confusion and psychosis

Front 37

what are the SE of zonisamide?

Back 37

somnolence, dizziness, agitation, severe rash (STEVEN-JOHNSON Syndrome)

Front 38

nural tube defects are associated with which antiseizure drug?

Back 38

valproic acid and carbamazepine

Front 39

what antiseizure drug is associated with craniofacial anomalies?

Back 39

carbamazepine

Front 40

what antiseizure drug is associated with fetal hydantion syndrome?

Back 40

phenytoin

Front 41

what drug is used to treat a benzo overdoes?

Back 41

flumazenil

Front 42

which antiseizure drug is associated with fatal hepatoxicity?

Back 42

valproic acid

Front 43

which antiseizure drug has caused skin rashes and life threatening stevens-johnosn syndrome or toxic necrolysis?

Back 43

Lamotrignine

Front 44

which antiseizure drug has been associated with aplastic anemia and acute hepatic failure?

Back 44

felbamate (this limits its use to refractory seizure states)

Front 45

how do you prevent withdrawl symptoms when stopping an antiseizure med?

Back 45

withdrawl the med slowly to avoid increased seizure frequency and severity