Term
| List the three drugs that act against Na+ channels for action against focal/partial seizures |
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Definition
- Phenytoin
- Carbamazepine
- Lamotrigine
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Term
| List the two drugs that act on T-type Ca2+ channels |
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Definition
- Ethosuximide
- Dimethadione
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Term
| List the three drugs that act directly on GABAAR |
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Definition
Benzodiazepines
Barbiturates
Topiramate |
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Term
| List the two drugs that indirectly affect GABA |
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Definition
Gabapentin
Tiagabine
Viabatrin |
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Term
Phenytoin:
- type(s) of seizure(s) it treats
- mechanisms of treatment |
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Definition
- A.k.a. diphenylhydantoin (DPH, Dilantin)
- Useful against partial and generalized tonic-clonic seizure
- Acts on Na+, K+, Ca2+ conductances
- Blocks repetitive firing
- Use-dependent block of Na+ channel
- Binds preferentially to inactive channel
- Blocks Ca2+ influx
- Inhibit Ca2+ dependent secretory processes
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Term
Carbamazepine
- type(s) of seizure(s) it treats
- mechanisms of treatment |
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Definition
- prefered first-line drug for partial seizures
- related to tricyclic antidepressants
- similar action to phnytoin
- can be combined with phenytoin for refractory epilepsies (complementary action)
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Term
Ethosuximide
- type(s) of seizure(s) it treats
- mechanisms of treatment |
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Definition
- effective against absence seizures
- acts via suppression of T-type calcium channels
- especially good at absence seizures
- suppresses characteristic 3Hz spike-and-wave (thalamocortical oscillations
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Term
Valproic acid
- type(s) of seizure(s) it treats
- mechanisms of treatment |
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Definition
- effective against absence, myoclonic seizures, primary GTC seizures
- mechanisms unknown
- may involve increasing expression fo inhibitory peptides in brain
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Term
Phenobarbital
- mechanisms of treatment
- related drug |
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Definition
- potentiates GABAAR action
- allosteric modulator
- can activate GABAAR in the absence of GABAA
- oldest current antiseizure druge
- heavy sedative, but non-anaesthetic
- suppresses excitatory transmission
- Primodone is converted to phenobarbital
- less effective than carbamazepine, phenytoin
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Term
Benzodiazepines
- type(s) of seizure(s) it treats
- mechanisms of treatment
- potential problem(s) |
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Definition
- status epilepticus treatment (permanent state of seizure)
- direct potentiation of GABAAR
- tolerance is a big problem
- sedation is a problem
- addiction problem
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Term
Tiagabine
- mechanism of action |
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Definition
- GABA uptake inhibitor
- GABA remains in syanpse longer
- GAT-1 preference (forebrain and hippocampus - where most epilepsy happens)
- useful as adjunctive therapy, some use as monotherapy
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Term
Lamotrigine
- types of epilepsy treated
- mechanism of action
- potential problem(s) |
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Definition
- effective in partial and absence epilepsies
- action like phenytoin on Na+ and Ca++ channels
- potential drawback: rash
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