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35 Cards in this Set
- Front
- Back
What are some mechanisms for drugs to affect neurotransmission?
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-effect break down of nt in synaptic cleft
-post-synaptic receptor ∆s (↑/↓ regulate or ∆ affinity -alter re-uptake -∆ amount of nt releases -∆ amount of nt synthesized -∆ storage of nt (not allow) -∆ presynaptic membrane potential -membrane effects -presynaptic autoreceptors (-fb loop) |
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What is the definition of a seizure?
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an episode of sudden, transient disturbances in cerebral excitation (over excitation)
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when do seizures occur (neurophysiologically)?
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when a sufficient # of neurons begin to fire rapidly & in synchronized bursts
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What is the goal of drug therapy in epilepsy?
how is this done? |
inhibit firing of cerebral neurons
1. ↑ inhibitory effects of GABBA 2. ↓ effects of excititory nt's such as glutamate 3. alter Na & Ca mov't across neuronal membranes |
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What is the difference b/w partial and generalized seizures?
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partial only part of brain is involved
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what is an absences seizure?
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sudden, brief LOC, may or may not have motor signs
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what type of seizure involves muscle contraction in part of body and may or may not involve LOC
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myoclonic
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what do clonic, tonic, and clonic-tonic seizures all involve?
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muscle contraction throughout body & LOC
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what is a series of seizures s recovery of consciousness b/w attacks called?
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Status epilepticus
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What is the indication/use of Barbituates?
main SEs? |
drug of choice for controlling seizures in infants, may be used in adults (particularly for hard-to-control seizures)
sedation, drowsiness |
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what type of drug is phenobarbital (solfoton)?
What is its mechanism? |
Barbiturate
↑ Gabba & its inhibitory effect may block Na channels may block glutamate |
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Which types of drugs treat status epilepticus?
what are their SEs/ adverse effects? |
Benzodiazepines
sedation, behavioral ∆ tend to lead to tolerance/dependance |
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What are two examples Benzodiazepines used acutely and 1 used long term?
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acute: diazepam (Valium), lorazepam (Ativan)
long term: clonazepam (Klonopin) |
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What is its mechanism of Benzodiazepines?
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↑ Gabba's inhibitory effect
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What seizure meds can also be used to treat bipolar d/o?
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carboxylic acids
"I'm bi-winning...i win here and i win there" |
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what is an example of a carboxylic acid?
what is it's MOA? |
Valproic acid (Depakote)
Nobody f'ing knows! |
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what are the side effects of Valproic acid (Depakote)?
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GI distress + more
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Which seizure drug is sedation NOT a SE?
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Iminostilbenes
ex carbamazepine (Tegretol) |
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What are the primary indications for Iminostilbenes and hydantonis?
MOA? |
tonic-clonic or partial seizures
stabilize neuronal membrane |
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what is an example of Iminostilbenes?
SEs? |
carbamazepine (Tegretol)
dizziness, water retention, anemia |
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what is an example of a hydantoin?
SEs? |
phyenytoin (Dilantin)
include confusion & ataxia |
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what drugs Tx absence seizures?
what is an example of one? |
Succinimides
ethosuximide (Zarontin) |
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What is the MOA of succinimides?
Primary SE? |
reduce Ca currents, which limits spontaneous firing
GI distress |
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What is a second-generation seizure med?
what type of seizure does it Tx? |
gabapentin (Neurontin)
partial seizures |
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What are the SEs of gabapentin (Neurontin)?
MOA |
sedation, ataxia, dizziness
??, may increase GABA release |
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What was Neurontin origionally plannned to be?
What else does it Tx? |
spasmolytic
neuropathic pain |
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What are the main SEs to watch out for in pt's taking anti-seizure meds?
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sedation
ataxia GI disturbances behavior changes |
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What is the imbalance caused by PD?
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↓dopamine
↑ ACh |
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What is the primary drug Tx for PD?
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Levodopa
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what are the pros and cons of lovedopa?
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pro:very effective in improving PD symptoms for those who respond
con: prolonged use is associated with ↑ SE |
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what is the MOA of lovedopa?
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immediate precursor to dopamine which is able to cross BBB
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What is Sinemet or Sinemet CR?
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levodopa + carbadopa
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what is an example of peripheral decarboxylase inhibitor?
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carbadopa
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What are the SEs of Lovedopa?
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GI
Cardiovascular (precaution c CVD) (OH) Dyskinesias Behavior changes fluctuations in response (on-off phenomenon) |
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What SE of lovedopa is more of a problem when given s carbodopa?
what ab c carbodopa? |
s: GI
c: mental changes (not used in pt c psychoses) |