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44 Cards in this Set

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