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44 Cards in this Set
- Front
- Back
For which type of seizures can a point of onset be determined?
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partial seizures
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For which type of seizures can a point of onset NOT be determined?
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generalized seizures
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What type of seizure is "petit mal"?
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absence (generalized)
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What type of seizure is "grand mal"?
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tonic/clonic (generalized)
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What is the seizure indication for phenytoin?
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partial
generalized tonic/clonic |
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What is the primary mechanism for phenytoin?
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binds voltage-gated sodium channels and increases the refractory period
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What are three (3) ADRs related to phenytoin?
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nystagmus, diplopia, ataxia
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What is the mechanism for carbamazepine?
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sodium channel blocker
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What is the drug of choice for partial seizures?
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carbamazepine
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What is the advantage of oxcarbazepine over carbamazepine?
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less induction of P450s
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What is the mechanism for phenobarbital?
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GABAa agonist
(suppresses high-frequency repetitive firing from seizure focus) |
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What types of seizures is phenobarbital mostly used in?
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partial
generalized tonic/clonic |
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Phenytoin is a(n) (ionotropic/metabotropic) receptor
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ionotropic (ion channel in the receptor)
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How to metabotropic receptors work?
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use 2nd messengers
(no ion channel in the receptor) |
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What types of seizures is primidone used in?
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partial seizures
generalized tonic/clonic |
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What is the mechanism for vigabitran?
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inhibits GABA breakdown (inhibits GABA aminotransferase)
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What types of seizures is vigabitran used in?
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partial seizures
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What is the mechanism for lamotrigine?
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sodium channel blocker
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What types of seizures is lamotrigine used in?
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adjunctive in partial seizures
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What types of seizures is GABApentin used in?
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partial seizures
generalized tonic/clonic |
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What are two (2) other indications for gabapentin?
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neuropathic pain
postherpetic neuralgia |
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What types of seizures is topiramate used in?
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partial seizures
generalized tonic/clonic |
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What is the mechanism for tiagabine?
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inhibits GAT1
(inhibits GABA reuptake) |
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What types of seizures is tiagabine used in?
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adjunctive in partial seizures
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What is the mechanism for levetiracetam?
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affects allosteric modulations of GABA receptors
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What types of seizures is levetiracetam used in?
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partial seizures
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What is the mechanism for ethosuximide?
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Reduces low threshold (T type) calcium currents in neurons
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T type calcium channels are located in what part of the brain and are involved in what type of seizure?
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thalamic neurons
absence seizures |
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What is the mechanism of valproic acid? (2)
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sodium channel blocker
NMDA receptor blocker (increases GABA levels in brain) |
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What types of seizures is valproic acid used in?
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absence seizures
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What is the mechanism for trimethadione?
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blocks T type calcium channels
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Which benzo is used for continuous seizures?
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diazepam
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Which benzo is used for absence seizures?
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clonazepam
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Why are benzos safer than barbiturates/alcohol at high doses?
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benzos have a NON-linear relationship between dosage and CNS suppression
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True or False - Sedative/hypnotics do not cross the placental barrier, but can get into breastmilk
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False - sedative/hypnotics cross the placental barrier and get into breastmilk
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What is the mechanism for benzodiazepines?
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bind GABAa receptors and drive membrane potential towards chloride potential
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Benzodiazepines increase the (duration/frequency) of chloride channel opening
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frequency
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Barbiturates increase the (duration/frequency) of chloride channel opening
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duration
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True or False - Sedative/hypnotics develop tolerance
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True
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What are the possible mechanisms for tolerance of benzodiazepines? (2)
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downregulation of GABA receptors
increased rate of drug metabolism |
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What is the treatment for benzodiazepine overdose?
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flumenazil
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Which newer drug relieves anxiety without causing marked sedation or euphoria?
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buspirone
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What is an advantage of buspirone?
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no marked sedation or euphoria
no withdrawal - minimal abuse liability |
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Where does buspirone act?
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5HT1a and D2 receptors
(NOT GABA receptors) |