Term
| What are the General mechanisims of all anti seizure medication |
|
Definition
decrease Na+, Ca++ influx (delay depolarization/prolong repolarization)
increase Cl- influx (hyperpolarize membrane)
|
|
|
Term
|
Definition
| Generation of repetitive action potentials |
|
|
Term
| Which drugs prolong the inactivation stage of the sodium channel .. what effect does this have? |
|
Definition
Stops the the high frequency Na+ channels thus stops the influx of sodium and prolongs the repolerization phase of the action potential.
Carbamezapine
Phenytoin
Sodium Valporate/ Valporic acid
Phenobarbitone |
|
|
Term
| Which anti seizure drugs prolong the opening of the CL- channels? |
|
Definition
Barbiturates
-phenobarbitol |
|
|
Term
| Which anti seizure drugs increase the frequency of opening of the Cl- channels? |
|
Definition
Benzodiazepines
lorazepam
diazepam
clonazepam .... |
|
|
Term
How do GABA transaminase inhibitors prevent seizures?
give examples of the drugs |
|
Definition
Open Cl- channels - increase the duration of hyperpolerization
Vaporate/ Valporic acid
Vigabatrin |
|
|
Term
What is the MOA of Valporate/ Valporic acid
Vigabatrin?
Use? |
|
Definition
Inhibits GABA transaminase thus stop the breakdown of GABA a (like MOA)
Thus it closes Na+ channels
opens Cl- channels
blocks Ca++ T channels
Antiseizure |
|
|
Term
What is the MOA of gabapentin?
what is it used in? |
|
Definition
Antiseizure
GABA analogue which effects the release of neurotransmitter via the REUPTAKE mechanism |
|
|
Term
| What are the different classes of drugs which affect the Cl- channel? |
|
Definition
Benzodiazepines
Barbiturates
GABA transimainase inhibitors - Valporate/ valporic acid |
|
|
Term
What drugs block the T- type Ca++ channels in the thalamus?
What are these drugs used to treat? |
|
Definition
Valporate/ valporic acid
Ethosuximide
Absence seizures |
|
|
Term
What drugs are used to treat absance seizures?
what is the MOA of these drugs? |
|
Definition
Ethosuxamide
Valporate/ Valporic acid
Block the slow threshold transient T type Ca++ channels in the thalamus |
|
|
Term
| Which drugs follow zero order kinetics? |
|
Definition
Phenytoin
Ethanol
Asprin
plasma concentration is not linearly associated with dose |
|
|
Term
| Which anti epileptic drugs are enzyme inducers? |
|
Definition
Phenytoyn
Carbamezapine
Phenobarbitone
|
|
|
Term
| Which anti epileptic is an enzyme inhibitor |
|
Definition
|
|
Term
| Which anti epileptic drugs are highly protein bound? |
|
Definition
Phenytoin
Valporic acid/ valporate
these are displaced by other highly protein bound drugs.. causing a higher free plasma concentration and toxicity |
|
|
Term
| What are the specific ADR's associated with carbamezapine |
|
Definition
Diplopia
Ataxia
Hyponeutremia (decrease Na+ leves associated with increased ADH)
|
|
|
Term
| What are the ADR's associated with Phenobarbitone? |
|
Definition
| CNS depression- sedation drowsiness |
|
|
Term
| What are the ADR's associated with valporic acid/ valporate? |
|
Definition
Hepatotoxicity - children
spina bifida - if taken during pregnancy |
|
|
Term
| What are the ADR's associated with ethosuxamide |
|
Definition
|
|
Term
| What are the ADR's of phenytoin |
|
Definition
gingivial hyperplasia
hirsituism
megaloblastic anemias
Nystagmus
Osteomalacia
|
|
|
Term
How would a patient present with generalised tonic colonic seizures?
how is it treated? |
|
Definition
sudennly fall become redgid & unconscious
then has vigorous regular muscle contraction.. shaking and convulsions
Valporate/ valporic acid
Phenytoin
Carbamezapine
Phenoparbitol |
|
|
Term
| What does an EKG demonstrate with a patient who has an absence seizure? |
|
Definition
| 3Hz spike and wave activity - due to low threshold T current are responsible for such convulsions |
|
|
Term
What are the clinical presentations of a patient with a complex partial seizure?
how is it treated? |
|
Definition
confused repetitive and inappropriate behaviour.. ie smacking or chewing
Phenytoin
Carbamezapine
valporate/ valporic acid |
|
|
Term
What are the clinical aspects of status eplicitus?
how is it treated? |
|
Definition
Generalised tonic colonic seizures occuring repetitively in quick successions
Diazepam |
|
|
Term
| WHat is used to treat febrile convulsions |
|
Definition
|
|
Term
| What are the other uses of carbamezapine? |
|
Definition
|
|
