Seizure Drugs

Front 1

In nerves,
1) what is the excitatory neurotransmitter?
2) what is the inhibitory neurotransmitter?

Back 1

1) glutamate
2) GABA

Front 2

What are 4 ways to quiet the activity in nerves?

Back 2

1) inhibit the release of glutamate from pre-synapse
2) increase the release of GABA from pre-synapse
3) inc the action of GABA
3) inh the propagation of action potential from post synapse

Front 3

How can we inhibit the release of glutamate from pre-synapse?
(3 ways)

Back 3

Inhibit depolarization of pre-syn neuron
1) inactivate Na "leaky" channels
2) block Na "leaky" channels
3) block Na voltage gated channels

Front 4

How can we inhibit the inhibit the propagation of action potential from the post-synapse?

Back 4

Block T-type Ca channels (ie voltage-gated Ca channels)

Front 5

3 drugs that INACTIVATES Na "leaky" channels

Back 5

1) Phenytoin
2) Carbamazepine
3) Valproic acid

Front 6

1 drug that BLOCKS Na "leaky" channels

Back 6

Topiramate

Front 7

1 drug that BLOCKS voltage-gated Na channels?

Back 7

Lamotrigine

Front 8

2 drugs that inc GABA release

Back 8

1) Gabapentin
2) Valproic acid

Front 9

2 drugs that inc GABA action

Back 9

1) Phenobarbital
2) Benzos (lorazepam, diazepam)

Front 10

1 drug that blocks T-type (ie voltage gated) Ca channels at the thalamus

Back 10

Ethosuxamide

Front 11

Ethosuximide can only be used to treat what type of seizure?

Back 11

Absence (its 1st line)

Front 12

Benzos (lorazepam, diazepam) can only be used to treat what kinds of seizures?

Back 12

Status epilipticus

Front 13

Definition of status epilipticus

Back 13

= recurrent tonic-clonic seizures that last for at least 30 min

Front 14

2 drugs that can be used to treat Absence sizures

Back 14

1) Ethosuximide: 1st line
2) Valproic acid

Front 15

1st line for ACUTE status epilepticus

Back 15

Benzo (diazepam, lorazepam)

Front 16

1st line for Phx for status epilepticus

Back 16

Phenytoin

Front 17

define general seizure

Back 17

lose conciousness

Front 18

Define partial simple seizure

Back 18

no loss of conciousness

Front 19

Define partial complex seizures

Back 19

no loss of conciousness, but involves post-ictal incontinence, lip smacking, deja-vu, confusion

Front 20

8 types of generalized seizures

Back 20

I May FAL on MAT
1) Infantile spasms
2) Myotonic seizures
3) Febrile Seizures
4) Atonic Seizures (dropsies, frontal lobe seizures)
5) Lennox- Gasteaux syndrome
6) Mixed
7) Absence seizures
8) Tonic-Clonic Seizures

Front 21

describe infantile spasms

Back 21

intense muscle spasms (salaam seizures) in < 1 y/o

Front 22

describe mytonic seizures

Back 22

intense muscle spasms (salaam seizures) in > 1 y/o

Front 23

describe febrile seizures

Back 23

fever, < 20 min, nl neuro exam and EEG before and after seizure, 6 mo to 6 years

Front 24

describe atonic seizures

Back 24

is a generalized seizure that involves the ENTIRE frontal lobe
"dropies"

Front 25

describe tonic clonic seizure

Back 25

stiff- jerk- stiff- jefk

Front 26

There are 2 types of seizures that start off as partial, but can become generalized

Back 26

1) temporal lobe seizure
2) Benign Rolandic seizures

Front 27

describe temporal lobe seizures

Back 27

hallucinate (aura) before any time of seizure

Front 28

describe Benign Rolandic Seizures

Back 28

-occur at early part of morning
-eyes flutter
-will outgrow it

Front 29

First line for generalized seizure in adults

Back 29

***Phenytoin
(but also Carbamazepine, Valproic acid)

Front 30

1st line for generalized seizure in kids

Back 30

Phenobarbital

Front 31

1st line for febrile seizures

Back 31

acetominaphen

Front 32

1st line for temporal lobe seizures

Back 32

carbamazepine

Front 33

1st line for myotonic seizures

Back 33

valproic acid

Front 34

1st line for mixed seizures

Back 34

valproic acid

Front 35

describe Lennox Gasteaux Syndrome

Back 35

hundreds of seizure every , us. in MR kid < 7 y/o

Front 36

1st line for Lennox Gasteaux Syndrome

Back 36

Lobectomy

Front 37

1st line for Benign Rolandic Seizures

Back 37

nothing, observe

Front 38

1st line for infantile spasms
1st line for infantile status

Back 38

spasms (Salaam)= ACTH injections, WQB said prednisone
epilipticus= Barbituates

Front 39

Drugs that lower the seizure threshold

Back 39

1) Tramadol (opiate agonist)
2) Buproprion (anti-depressant)
3) INH
4) Imepenem (antibotic)
5) Ticlodipine (ADP rec blocker)
6) Clozapine
7) Erythramycin
8) Metoclopramide

Front 40

S/E of Benzos and Barbs

Back 40

"STD"
Sedation
Tolerance
Dependence

Front 41

Which, benzos or barbs
1) induce P450?
2) inc hepatic synthesis of clotting factors?

Back 41

1) Barbs
2) Barbs

Front 42

Carbamazapine
MOA:
uses:
S/E:

Back 42

MOA: block Na "leaky" channels
uses: DOC for rapid cycle bipolar, DOC for temporal seizures, DOC for trigeminal neuralgia
S/E: "DALLAASS"
1) Doplopia
2) Ataxia
3) Liver tox
4) Liver induce P450
5) Agranulocytosis
6) Aplastic anemia
7) SIADH
8) Steven Johnson

"CARbemazepine to DALLAASS"

Front 43

S/E of Ethosuximide

Back 43

etho"SUS"imide, "eFGH"
1) Steven Johnson
2) Urticaria
3) SLE-like synd
4) Fatigue
5) GI
6) Headache

Front 44

S/E of phenytoin

Back 44

"LIGHTS AND MMPS"
LAD
Induce P450
Gingival hyperplasia
Hirsutism
Teratogenic
Sedation
Ataxia
Nystagmus
Diplopia
Megaloblastic anemia
Malignant hyperthermia
Peripheral neuropathy
SLE-like synd
Steven Johnson Syndrome

Front 45

S/E of valproic acid

Back 45

MOA: blocks Na leaky channels, increase GABBA release
uses: bipolar, DOC for myotonic seizures, DOC for mixed seizures
S/E:
*NTD
liver tox
*drug induced panc
sedation

Front 46

Lamotrigine S/E

Back 46

Steven-Johnson synd

Front 47

Gabapentin S/E

Back 47

sedation, ataxia

Front 48

Topiramate S/E

Back 48

sedation, mental dulling, kidney stones, skinny

Front 49

Primidone
MOA:
uses:
S/E:

Back 49

MOA: metabolized to phenobarbital and phenylethylmalonamide (PEMA)
uses: seizures, essential tremor
S/E: less lethargy that phenobarbital

Front 50

How does phenytoin cause gingival hyperplasia?

Back 50

inc expression of PDGF (platelet derived growth factor)

Front 51

Li
MOA:
uses:
time before has therapeutic effect:
tox:

Back 51

MOA: stabilizes neuron's membrane
uses: DOC for chronic bipolar, seizures
therepeutic effect in 2-3 weeks
tox:
1) desensitizes ADH rec: nephrogenic DI
2) blocks PTH rec in kidney: hyPERca, hypOp
3) blocks iodine rec on thyroid: hypothyroid sx's
4) Ebsteins anomaly in fetus

tremors, fasciculations, ataxia, hypOthyroid, cardiac conduction defects, teratogeninc (Ebsteins anomoly)

Front 52

Seizure drugs that cause Steven Johnson synd

Back 52

1) Carbamazepine
2) Ethosuximide
3) Lamotrigine
4) Phenytoin

Front 53

Seizure drugs that cause SLE-like syndrome

Back 53

1) phenytoin
2) Ethosuximide

Front 54

What predisposes to Li toxicity?

Back 54

Any drug that inc Na reabsorption, bc Li follows Na.

Ex: Thiazides, NSAIDS

Front 55

What illness is a/w infantile spasms?

Back 55

Tuberous sclerosis