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81 Cards in this Set
- Front
- Back
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involvement of motor cortex in a seizure causes ___
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convulsions
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involvement of HTh in a seizure causes ___
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peripheral autonomic discharge
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involvement of reticular formation in a seizure causes ___
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loss of consciousness
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simple partial seizure means
complex partial seizure means |
no loss of consciousness
consciousness is impaired |
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3 kinds of simple partial seizures
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motor
somatosensory autonomic |
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absence seizures are due to inappropriate ___ in ___
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Ca2+ channel opening
thalamus |
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___ seizures are commonly refractory to tx
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atonic
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absence seizures are aka
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petit mal
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4 AED mechanisms
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Na+ channel blockade
T-type Ca2+ channel blockade GABA_A potentiation Glu inhibition |
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phenytoin mechanism
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Na+ inhibition
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carbamazepine mechanism
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Na+ inhibition
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ethosuximide mechanism
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t-type Ca2+ channel inhibition
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phenobarbital mechanism
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GABA potentiation
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BDZ mechanism
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GABA potentiation
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valproate mechanism (2)
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GABA potentiation
Na+ channel blockade |
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3 new AEDs which inhibit Na+ channel
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lamotrigine
oxcarbazepine zonisamide |
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3 new AEDs which potentiate GABA
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vigabatrin
tiagabine gabapentin |
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2 new AEDs with unknown mechanism
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felbamate
topiramate |
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pheytoin interacts with ___ (3) because they ___
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sulfonamide
salicylate valproate decrease albumin binding |
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phenytoin doesn't work for ___ seizures
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absence
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phenytoin causes induction of
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hepatic enzymes
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phenytoin causes side effects when plasma conc exceeds ___
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100 mM
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5 mild phenytoin side effects
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nystagmus
diplopia vertigo ataxia headach |
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3 severe phenytoin side effects
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sedation
confusion epilepsy exacerbation |
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chronic phenytoin side effects
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gum hyperplasia
hirsutism (androgen effect) |
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phenytoin causes fetal ___
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malformation
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carbamazepine is very effective for ___ seizures and ___ pain
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partial complex
neuropathic |
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carbamazepine t1/2 decreases from ___ at first to ___
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30
15 |
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carbamazepine has more/less side effects than phenytoin
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less
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mild carbamazepine side effects include
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leukopenia
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severe carbamazepine side effects include ___ (2) disturbances
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mental
motor |
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___ is similar to carbamazepine but with fewer side effects and lower ___
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oxcarbazepine
potency |
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valproate has many/few side effects
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few
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3 valproate side effects
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hair thinning
hepatotoxicity teratogenic |
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psychiatric use of valproate
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manic-depression
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ethosuxamide is used for ___ seizures. it can ___ other kinds of epilepsy
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absence
exacerbate |
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valproate increases/decreases clearance of ethosuxamide
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decreases
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ethosuxamide has many/few side effects
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few
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2 ethosuxamide side effects
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GI distress
fatigue |
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phenobarbital is a ___
t1/2 is ___ h |
barbiturate
50-140 |
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4 phenobarbital side effects
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sedation
hepatotoxicity megaloblastic anemia HTN |
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diazepam can be given ___ (2)ly for status epilepticus
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IV
rectal |
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vigabatrin mechanism
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irreversible inhibition of GABA transaminase
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vagabatrin is eliminated by ___
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kidney
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vigabatrin is used for ___ (2)
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partial seizures
infantile spams |
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3 vigabatrin side effects
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drowsiness
dizziness weight gain |
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a long term vigabatrin symptom is ___
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visual field defects
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gabapentin acts on ___ (2)
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GABA metabolism
t-type Ca2+ channel |
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T/F: gabapentin is used as monotherapy for partial and tonic-clonic seizures
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false
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tiagabine mechanism
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inhibition of GAT-1 (GABA transporter)
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tiagabine has short/long t1/2
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short
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tiagabine is metabolized in liver but (unlike ___) doesn't ___
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phenytoin
induce hepatic enzymes |
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T/F: lamotrigine is used as monotherapy for partial seizures
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true
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lamotrigine is used for ___ (3) seizures
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partial
absence myoclonic |
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3 lamotrigine side effects
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dizziness
headache diplopia |
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felbamate increases/decreases concentrations of other AEDs
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increases
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felbamate is indicated for ___, such as ___
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children unresponsive to other meds
Lennox-Gastaut syndrome |
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Lennox-Gastaut presents at age ___
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1--5
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topiramate t1/2
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30 h
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topiramate has more/less side effects than phenytoin
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less
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T/F: topiramate is teratogenic
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true
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topiramate should be used as ___
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adjuvant tx
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3 topiramate applications
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Lennox-Gastaut
West syndrome absence seizures |
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renal side effect of topiramate
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urolithiasis
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zonisamide t1/2
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60--80 h
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zonisamide has many/few side effects and many/few drug interactions
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few
none |
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4 teratogenic AEDs
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phenytoin
phenobarbital valproate topiramate |
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5 hepatotoxic AEDs
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phenytoin
phenobarbital valproate carbamazepine felbamate |
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incidence of fetal malformations in general population is ___.
incidence of fetal malformations in epileptic women is ___. |
2%
3% |
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with epileptic mothers, risk for fetal malformations increases with ___
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number of AEDs
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fetal hydantoin syndrome includes ___ (4)
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facial dimorphism
cleft lip and palate cardiac defects nail dysplasia |
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6 drugs for simple partial, complex partial and 2' generalized tonic-clonic
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valproate
lamotrigine carbamazepine phenytoin gabapentin topiramate |
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3 drugs for absence seizures
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valproate
lamotrigine ethosuxamide |
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3 drugs for myoclonic seizures
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valproate
lamotrigine clonazepam |
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3 drugs for atonic seizures
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valproate
lamotrigine felbamate |
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7 drugs for tonic-clonic seizures
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valproate
lamotrigine carbamezapine phenytoin gabapentin topiramate oxcarbazepine |
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4 drugs for status epilepticus
the preferred drug is ___. |
diazepam
phenytoin clonazepam phenobarbital diazepam |
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5 AEDs for manic depression
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valproate
lamotrigine carbamazepine oxcarbazepine topiramate |
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2 AEDs for migraine prophylaxis
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valproate
gabapentin |
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AED for anxiety disorder
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gabapentin
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3 AEDs for neuropathic pain
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lamotrigine
carbamazepine (trigeminal neuralgia) gabapentin (diabetic neuropathy) |
