Term
|
Definition
|
|
Term
| What is the Mechanism of Action of the Hydantoins? (Phenytoin, Fosphenytoin) |
|
Definition
Stabilizes voltage-gated Na channels in inactivated state Blocks Ca channels to lesser extent
(at higher concentrations) |
|
|
Term
| What anti-epilepsy drug inhibits phenytoin metabolism? |
|
Definition
|
|
Term
| How does the rate of elimination vary with Phenytoin? |
|
Definition
| Dose-dependent Intially First order Later Zero order |
|
|
Term
| What drug does phenytoin compete with for CYP2C9? |
|
Definition
|
|
Term
| What drugs does Phenytoin reduce? |
|
Definition
Carbamazepine
Oral Contraceptives |
|
|
Term
| What chronic toxicities can present with Phenytoin use in children? |
|
Definition
Gingival hyperplasia
Coarsened facial features
Hirsutism |
|
|
Term
|
Definition
| Water soluble phosphoester of phenytoin |
|
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Term
| What was the 1st non-sedative anticonvulsant? What is it used to treat? |
|
Definition
Phenytoin
Simple or Complex Partial seizures
Generalized tonic-clonic seizures |
|
|
Term
| What is Fosphenytoin indicated for? |
|
Definition
Acute treatment of Status Epilepticus
Partial and generalized tonic-clonic if parenteral route is wanted |
|
|
Term
| What are the Barbiturates used for seizures? |
|
Definition
|
|
Term
| What is Phenobarbital used to treat? |
|
Definition
Partial seizures
Generalized Tonic-clonic |
|
|
Term
| What is the mechanism of the Barbiturates? (Phenobarbital) |
|
Definition
Enhances GABA-A receptor mediated Cl- flux by prolonging opening of channel
Blocks AMPA receptors- less extent
Block Na and Ca channels - High conc. |
|
|
Term
| What drug interactions does Phenobarbital have? |
|
Definition
Inducer of CYP2B6 and UGTs
Enhancing metabolism of many AEDs
Reduce effect of Oral Contraceptives |
|
|
Term
| What AED is related to TCAs and is used as a mood-stabilizer for manic depressive disorder? |
|
Definition
|
|
Term
| What is the drug of choice for partial seizures? |
|
Definition
Carbamazepine
Also used for generalized tonic-clonic seizures |
|
|
Term
| What is the mechanism of Carbamazepine? |
|
Definition
Inhibition of Na channels
Prolongs recovery from inactivated state |
|
|
Term
| How is Carbamazepine metabolized? |
|
Definition
by CYP2C9 and CYP3A4 to an Active metabolite
Clearance slow after inital dose, becomes faster with increaseing dose |
|
|
Term
| What are common side effects of Carbamazepine? |
|
Definition
Blood Dyscrasias
Diplopia and ataxia |
|
|
Term
| What drugs decrease Carbamazepine levels? |
|
Definition
|
|
Term
| What Drugs does Carbamazepine decrease? |
|
Definition
Levels of Valproate, Lamotrigine, Tigabine, Topiramate Haloperidol
Efficacy of Oral Contraceptives |
|
|
Term
| What drugs decrease the metabolism of Carbamazepine? |
|
Definition
Propoxyphene
Erythromycin
Cimeticine
Fluoxetine
Isoniazid |
|
|
Term
| What is the drug of choice for Absence seizures? |
|
Definition
|
|
Term
| What drug inhibits the low threshold T-type Ca current in thalamic neurons? |
|
Definition
|
|
Term
| What are the Pharmacokinetics of Ethosuximide? |
|
Definition
Complete absorption from GI
Does not penetrate Fat
Not Protein Bound
Metabolized by hydroxylation
Slow clearance |
|
|
Term
| What drug can decrease the clearance of Ethosuximide if co-administered? |
|
Definition
|
|
Term
| Why is Valproic Acid Effective in the treatment of absence, myoclonic, partial and tonic-clonic seizures? |
|
Definition
Stabilizes inactive Na Channels
Decreases Ca current in thalamic neurons
Stimulate GABA synthesis + inhibit GABA degradation |
|
|
Term
| What does Valproic Acids inhibition of UGTs cause? |
|
Definition
| inhibits its own metabolism |
|
|
Term
| What drugs have reduced metabolism from Valproate's inhibition of CYP2C9? |
|
Definition
Phenobarbital
Phenytoin
Carbamazepine |
|
|
Term
| What Benzodiazepines are used for the treatment of seizures? |
|
Definition
Clonazepam
Diazepam
Lorazepam |
|
|
Term
| What Benzodiazepine is used for absence, myoclonic, and atonic seizures? |
|
Definition
|
|
Term
| What is the drug of choice given IV for status epilepticus? |
|
Definition
|
|
Term
| What Benzodiazepine can be given IV for status epilepticus, and is longer acting than the Drug of Choice for status epilepticus? |
|
Definition
|
|
Term
| What is the mechanism of the Benzodiazepines? |
|
Definition
| Potentiates GABA-A receptor function by increasing the probability of chloride channel opening |
|
|
Term
| What drug is an analog of GABA, and may increase GABA release? What is it used for? |
|
Definition
Gabapentin
Adjunct for partial seizures, neuropathic pain and neuralgia |
|
|
Term
| What anti-seizure drug is used as an adjuct of mono-therapy in refractory partial seizures, with or without secondary generalized tonic-clonic seizures? |
|
Definition
|
|
Term
| What is the mechanism of Topiramate? |
|
Definition
Inhibits voltage-gated Na channels & decreases Ca current
Enhances GABA-A receptor currents
Inhibits AMPA-kainate receptors |
|
|
Term
| What AED has broad spectrum activity against infantile spasm, myoclonic, and generalized and atypical absence seizures? |
|
Definition
|
|
Term
| Parital, Simple or Complex (with secondarily generalized) 1st choice 2nd Choice |
|
Definition
Carbamazepine
Phenytoin, Valproate, Gabapentin, Zonisamide |
|
|
Term
| Generalized tonic-clonic 1st Choice 2nd Choice |
|
Definition
Carbamazepine
Phenytoin, Valproate |
|
|
Term
| Absence 1st choice 2nd choice |
|
Definition
|
|
Term
| Atypical Absence, Myoclonic, Atonic 1st choice 2nd Choice |
|
Definition
|
|
Term
Status Epilepticus
1st choice
2nd choice |
|
Definition
Diazepam
Lorazepam
Phenytoin |
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|
