T2 Anti-Epileptic Drugs

Front 1

Name the two types of partial (focal) seizures and define.

Back 1

SIMPLE PARTIAL: involves a focal neurological symptom that can be motor, sensory, or psychomotor. consciousness is always retained. COMPLEX PARTIAL: the initial focus of abnormal discharge spreads to both hemispheres (patient loses consciousness) and experiences postictal (postseizure) confusion. majority of complex originate in teh temporal lobe

Front 2

Name the seizure that involves 1st a LOC, rigidity, loss of bowel and bladder, then jerking movements of the entire body.

Back 2

Generalized Tonic-Clonic or Grand Mal seizure

Front 3

Name the seizure that involves: usually children, very brief LOC, 3Hz spike-and-wave discharge on EEG, may occur dozens of times a day, and involves a low threshold of Ca2+ in the thalamic neurons.

Back 3

absence seizures (Petite Mal)

Front 4

Name the seizure that involves rhythmic jerking of all muscles, LOC, marked autonomic manifestations.

Back 4

Clonic seizures

Front 5

Name the seizure that involves non-rhythmic, rapid jerking with brief bursts of multiple spikes in the EEG.

Back 5

myoclonic seizures

Front 6

Name the epileptic syndrome that is characterized by brief recurrent myoclonic jerks fo the body with sudden flexion or extension of the body and limbs; attacks are fragmentary and often bilateral; also known as West Syndrome.

Back 6

Infantile Spasms

Front 7

Define Epilepsy.

Back 7

group of chronic syndromes characterized by recurrent seizures with periods of consciousness.

Front 8

Define seizures.

Back 8

sudden,transitory, and uncontrolled episodes from abnormal discharging of neuronal cells with associated motor, sensory,or behavioral changes; excessive firing of neurons

Front 9

Convulsions appear in what types of seizures?

Back 9

all Generalized Tonic-Clonic Seizures and Simple Partial and Complex Partial Seizures if the focal neuronal discharge includes motor centers. Convulsion are MOTOR manifestations

Front 10

Explain the tonic and clonic phases of the Grand mal or Generalized Tonic-Clonic seizure.

Back 10

TONIC: sustained powerful muscle contraction (involves all body musculature) which arrests breathing. EEG: rhythmic high freq., high voltage discharges; CLONIC PHASE: alternating contraction and relaxation, EEG: groups of spikes and periodic neuronal depolarizations with clusters of action potentials.

Front 11

The older epileptic drugs are targeted toward what?

Back 11

Na+ channels blocking

Front 12

The newer anti-epileptic drugs are targeting what?

Back 12

Glutamate (NMDA, AMPA, Kainate) inhibitors and GABA agonists

Front 13

What is the drug of choice for Partial seizures?

Back 13

both simple and complex partial seizures are treated with Phenytoin and Carbamazepine; alternative options: valproic acid, phenobarbital, primidone

Front 14

What is the drug of choice for absence seizures?

Back 14

1st: Ethosuximide(inhibits Ca influx through T-type channels in thalamus) 2nd: Valproic Acid(inactivates Na+ and increases GABA; not to be used in children - possible hepatic failure)

Front 15

What is the drug of choice for Myoclonic seizures?

Back 15

Valproic acid (enhances GABA)

Front 16

What is the primary treatment for status epilepticus?

Back 16

use diazepam then phenytoin

Front 17

What is the drug of choice for Febrile seizures in kids?

Back 17

Phenobarbital

Front 18

What is the drug of choice for Generalized Tonic Clonic (grand mal)?

Back 18

Phenytoin or Valproic acid

Front 19

Name this drug. the oldest anti-epileptic that's main S/E is sedation. MOA prolongs opening of Cl- channels, blocks GLU and Ca2+.

Back 19

Phenobarbital

Front 20

These drugs all inhibit vitamin K and may cause hemorrhage in a fetus.

Back 20

Carbamazepine, Phenobarbital, Phenytoin, and Primidone (CP3)

Front 21

Do not use these drugs during pregnancy for fear of congenital defects.

Back 21

valproic acid (spina bifida), topiramate (limb agenesis and hypospadias) and zonisamide (teratogenic in animals)

Front 22

These drugs not only induce the cytochrome P-450 mechanism and cause certain drugs (warfarin, vitamins, TCAs, theophylline, and steroid hormones) to become less potent (shorter T1/2), but they also cause vitamin K deficiencies.

Back 22

Carbamazepine, Phenobarbaital, Phenytoin, and Primidone and cigarettes

Front 23

These drugs cause an increase in availability of drugs that are metabolized by the P-450 system; aka. they inhibit the P-450 enzyme system.

Back 23

erythromycin, verapamil, trimethoprim/sulfa, propoxyphene, cimetidine. - given with drugs that utilize the P-450 system can cause drug overdose

Front 24

What are the anti-epileptic drugs main MOA?

Back 24

to block the intitiation of abnormal electrical discharge and prevent the spread of abnormal discharge to other areas

Front 25

Anti-epileptic drugs are used in many other neuropsychiatric disorders including:

Back 25

tremor, spasticity, movement disorder; Migraines; Psychiatry; and Chronic pain

Front 26

List the 3 Glutamate receptors in the brain.

Back 26

NMDA, AMPA, and Kainate

Front 27

Name the new AED that has many times replaced Carbamazepine because of less side-effects.

Back 27

Lamotrigine (inhibits glutamate, blocks Na channels, prevents repetitive firing); however possible s/e is Stevens Johnson syndrome.

Front 28

What benzodiazepine is efficacious in treating absence seizures and myoclonic seizures by increasing the frequency of Cl- channels? Its biggest S/E: sedation.

Back 28

clonazepam

Front 29

What is the main side-effect of benzodiazepines?

Back 29

sedation

Front 30

what is the difference in partial and generalized seizures?

Back 30

partial start in one area (if its complex partial it will go from the focal area and migrate to both hemispheres and cause LOC); generalized start in both hemispheres and have LOC too