Pharmacology - Seizures

Front 1

Types of generalized seizures

Back 1

Tonic-clonic
myoclonic
absence

Front 2

types of partial seizures

Back 2

simple
complex

Front 3

type of seizure that originates in and involves both hemispheres of the brain

Back 3

generalized seizure

Front 4

type of seizure that does not have a local onset

Back 4

generalized seizure

Front 5

type of seizures that involve a loss of consciousness

Back 5

generalized seizures

Front 6

type of seizures where motor manifestations are bilateral

Back 6

generalized seizure

Front 7

also called "grand mal" seizures

Back 7

tonic-clonic

Front 8

Seizures that involve full body motor convulsions with loss of consciousness

Back 8

tonic-clonic

Front 9

"tonic"

Back 9

spasms with muscular contractions

Front 10

"clonic"

Back 10

convulsive spasms with rapidly alternating rigidity and relaxation

Front 11

type of seizures where pt may lose bowel and bladder control

Back 11

tonic-clonic seizures

Front 12

Seizures have
brief motor convulsions
often confined to one part of body
may spread and become generalized

Back 12

myoclonic seizures

Front 13

also called petit mal seizures

Back 13

absence seizures

Front 14

Seizures that involve a brief impairment of consciousness with sudden onset

Back 14

absence seizures

Front 15

Seizures that may involve staring or rapid eye blinking

Back 15

absence seizures

Front 16

absence seizure duration

Back 16

10 seconds to two minutes

Front 17

seizure often seen occurring in young children

Back 17

absence seizure

Front 18

Difference between simple partial seizure and complex partial seizure

Back 18

Complex seizure involves loss of consciousness (less than 2 minutes)

Front 19

sometimes called "psychomotor" seizure

Back 19

complex partial seizure

Front 20

involves some type of characteristic movement, usually "purposeless" (lip smacking)

Back 20

complex partial seizure

Front 21

Goal for antiepileptic drugs

Back 21

decrease the excitability of cells in the brain and reduce the incidence and severity of seizures

Front 22

Purpose for use of anticonvulsants used for seizures

Back 22

used to stop seizures that are already occuring (not prevention)

Front 23

Indications for barbiturates

Back 23

partial seizures and control of tonic-clonic seizures
drug of choice in neonatal seizures

Front 24

adverse effects of barbiturates

Back 24

sedation
hypotension'depression
decreased cognitive function
rash

Front 25

Drug examples of hydantoins

Back 25

phenytoin (dilantin)
fosphenytoin (cerebyx)

Front 26

Trade name for phenytoin

Back 26

dilantin

Front 27

Trade name of fosphenytoin

Back 27

cerebryx (Hydantoin)

Front 28

Indications for hydantoins

Back 28

partial seizures and tonic-clonic generalized seizures
no used for absence

Front 29

first-line antiepileptic (drug class) for primary generalized convulsive and partial seizures

Back 29

hydantoins

Front 30

Trade name of carbamazepine

Back 30

tegretol

Front 31

Indications for gabepentin (neurontin)

Back 31

adjuctive** therapy for partial seizures, not effective as primary treatment

Front 32

Seizure that can be manifested as a sensory change (numbness) or muscle twitches

Back 32

simple partial seizures

Front 33

seizures that involve a limited area of the brain and usually confined to one body part, brief in duration with no loss of consciousness

Back 33

simple partial seizures

Front 34

seizure that may spread or become tonic-clonic

Back 34

complex partial seizures

Front 35

Drug class of phenobarbital and primidone (mysoline)

Back 35

Barbiturates

Front 36

Generic name of mysoline

Back 36

primidone (Barbiturate)

Front 37

Dosing for barbiturates

Back 37

start low and titrate upward
bedtime administration because of CNS effects
oral solid/liquid, IM, IV dosage forms

Front 38

Reason for barbiturates having many drug-drug interactions

Back 38

phenobarbital is a potent enzyme inducer

Front 39

Drug reserved for patients who have failed other antieileptics and may be useful in refractory status epilepticus

Back 39

Barbiturates (phenobarbital)

Front 40

Adverse effects of hydantoins

Back 40

drowsiness
gingival hyperplasia
hirsutism
rash

Front 41

Warning for oral phenytoin doses and tube feedings

Back 41

separate by at least 2 hours

Front 42

Main drug-drug interaction of hydantoins (phenytoin)

Back 42

an enzyme inducer

Front 43

first-line antiepileptic for primary generalized convulsive and partial seizures

Back 43

hydantoins

Front 44

Generic name for tegratol

Back 44

carbamazapine (partial seizures and generalized tonic-clonic seizures)

Front 45

Indications for carbamazepine (tegretol)

Back 45

partial seizures and generalized tonic-clonic seizures

Front 46

first choice agent for complex partial seizures

Back 46

carbamazepine (tegretol)

Front 47

adverse effects of carbamazepine (tegretol)

Back 47

nausea
blurred vision
dizziness
rash

Front 48

more serious adverse effects of carbamazepine (tegretol)

Back 48

hyponatremia
bone marrow suppression
liver disturbances
less CNS effects than many other antiepileptics

Front 49

Dosing for carbamazepine (tegretol)

Back 49

No parentarel forms/ oral forms of suspension, tablet, capsule
dosed 2-4x/day (doesn't last very long)
bedtime administration to minimize CNS effects

Front 50

Drug-drug interactions with Carbamazepine (tegretol)

Back 50

autoinducer, induces its own metabolism and the metabolism of various other drugs

Front 51

first-line therapy for newly diagnosed partial seizures

Back 51

carbamazepine (tegretol)

Front 52

Generic name of Trileptal

Back 52

oxcarbazepine - seizure medication

Front 53

Indications for oxcarbazepine (trileptal)

Back 53

monotherapy or adjunctive therapy for partial seizures

Front 54

Adverse effects of oxcarbazepine (trileptal)

Back 54

dizziness
nausea
rash
fewer effects than phenytoin, valproic acid, carbamazepine

Front 55

Drug-drug interactions of oxcarbazepine (trileptal)

Back 55

makes oral contraceptives less effective

Front 56

Oxcarbazepine (trileptal) therapeutic uses

Back 56

potential first line drug for partial seizures and primary generalized convulsive seizures

Front 57

Risk factors (other than LDL) for CHD - coronary heart disease

Back 57

Age
family history
smoking
hypertension
low HDL
Negative risk factors

Front 58

Age risk factors for CHD (other than LDL)

Back 58

Men > 45 y/o
Women > 55 y/o or premature menopause without ERT

Front 59

LDL goal of pt without CHD < 2 risk factors

Back 59

<160 mg/dL

Front 60

LDL goal of pt without CHD >2 risk factors

Back 60

<130 mg/dL

Front 61

LDL goal of pt with CHD or risk equivalents (diabetes...)

Back 61

< 100 mg/dL

Front 62

Bile Acid Sequestrant drugs

Back 62

Cholestyramine (Questran)
colestipol (Colestid)
Colesevelam (welchol)

Front 63

Generic name of Questran

Back 63

Cholestyramine (Bile Acid Sequestrant)

Front 64

Generic name for Colestid

Back 64

Colestipol

Front 65

Generic name for Welchol

Back 65

Colesevelam

Front 66

MOA of Bile Acid Sequestrants

Back 66

Bind bile acids in the intestine;
prevents absorption
therefore liver uses LDL in body to make more cholesterol for bile acids

Front 67

Adverse effects of Bile Acid Sequestrants

Back 67

belching
bloating
constipation
unpleasant taste and texture

Front 68

Dosing for Bile Acid Sequestrants

Back 68

start at 1 scoop BID, increasing to up to 6 scoops /day
before meals

Front 69

Sequestrant Questions to ask patient

Back 69

Are fasting TG > 250 mg/dL?
Currently constipated?
Taking multiple medications?
Prior use?
Willing and able?

Front 70

Niacin MOA

Back 70

reduction in hepatic production of VLDL

Front 71

Common ADRs of Niacin

Back 71

flushing
pruritis
rash
urticaria

Front 72

Prophylaxis of ADRs of Niacin

Back 72

take with food
use SR (slow release) product
start w/low dose and increase as tol.
ASA before dose
don't take with hot foods or ethanol

Front 73

Generic name for Nicotinic Acid

Back 73

Niacin

Front 74

Potentially serious ADRs with Niacin

Back 74

hepatotoxicity
gastritis/GI bleeding
hyperglycemia
gout
myalgias

Front 75

Relative contraindications with Niacin

Back 75

diabetes
active gout
PUD
severe gastritis

Front 76

Niacin dosing

Back 76

1-2 grams/day divided TID

Front 77

Max tolerated Niacin per day

Back 77

8 grams

Front 78

Best drug for raising HDL cholesterol

Back 78

Niacin (Nicotinic Acid)

Front 79

Statins (are also known as)

Back 79

HMG CoA Reductase Inhibitors

Front 80

Statin MOA

Back 80

Inhibition of intracellular synthesis of cholesterol

Front 81

Potentially Serious ADRs of HMG CoA Reductase Inhibitors (Statins)

Back 81

hepatotoxicity
myopathy - aches, weakness, soreness
confirm w/CPK

Front 82

Statin drug interactions

Back 82

gemfibrozil

Front 83

Cholesterol reductions associated with statins

Back 83

moderate LDL reductions
can stabilize plaque, less chance of breaking off

Front 84

Fibric Acid Derivitive drugs

Back 84

Genfibrozil (lopid)
fenofibrate (tricor)

Front 85

MOA of Fibric Acid Derivitive drugs

Back 85

catabolism of VLDL

Front 86

Major effect of Fibric Acid Derivitives

Back 86

decrease triglycerides

Front 87

MOA of ezetimibe

Back 87

inhibits transport of cholesterol across the intestinal wall

Front 88

Indications for ezetimibe

Back 88

monotherapy
usually used in combination with a statin for the treatment of primary hypercholesterolemia (approx 15% reduction in LDL)

Front 89

contraindications for ezetimibe

Back 89

active liver disease

Front 90

Common ADRs for ezetimibe

Back 90

well tolerated
h/a
diarrhea

Front 91

Adjunctive therapy and monotherapy for partial seizures refractory to other agents
may be useful alternative therapy in absence seizures (not indicated)

Back 91

lamotrigine

Front 92

To decrease adverse effects (rash) of lamotrigine

Back 92

low doses with SLOW titration upward

Front 93

Drug-drug interactions for lamotrigine

Back 93

does not inhibit or induce liver enzymes
does not interfere with oral contraceptives

Front 94

adjunctive treatment of partial seizures in adults
ADJUNCT ONLY

Back 94

levetiracetam

Front 95

drug-drug interactions of levetiracetam

Back 95

no known, does not induce or inhibit liver enzymes