Term
| what are the 4 epilepsy drugs that work by decreasing Na influx |
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Definition
oxycarbasepine
carbamazepine
lamotrigene
phenytoin |
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Term
| what are the 5 epilepsy drugs that are mixed MOA |
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Definition
valproic acid
zonlsamide
topiramate
Gabapentin
pragabalin |
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Term
| what are the 7 epilepsy drugs that interact with GABA |
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Definition
clonazepam
lorazepam
diazepam
primidone
tigabine
vigabatrin
phenobarbital |
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Term
| what are the 5 epilepsy drugs that i categorized as other |
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Definition
gabapentin
lavetfracetam
pregabalin
acetazolamide
ethosuxamide |
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Term
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Definition
stops spread from focus
no effect on seizure threshold
increases inactive state of voltage sensitive Na channels
acts using monohydroxy metabolite |
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Term
|
Definition
stops spread from focus
no effect on seizure threshold
decrease Na influx by prolonging inactive state |
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Term
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Definition
increases inactivated Na channels
inhibits release of glutamate |
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Term
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Definition
decreases Na influx into neurons by prolonging active state
stabilizes neuronal membranes
reduces spread from focus
no effect on seizure threshold |
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Term
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Definition
increase inactivation of Na channels (at different site than phenytoin and carbamazepine)
reduces threshold Ca currents in thalamic neurons (weaker than ethosuxamide)
increases GABA inactivating GABA T-transaminase |
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Term
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Definition
increases inactive state of Na channels
inhibits T type Ca channels |
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Term
|
Definition
relative to fructose
blocks Na channels
increases GABA actvity
blocks glutamate receptors |
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Term
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Definition
long acting BDZ
GABA CL ionophore complex
CIV |
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Term
|
Definition
long acting BDZ
GABA CL ionophore complex |
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Term
|
Definition
long acting BDZ
GABA CL ionophore complex |
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Term
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Definition
relative to phenobarbital
same MOA but effective metabolites do work (phenobarbital, phenylethlmalonamide) |
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Term
|
Definition
| blocks GABA uptake into presynaptic terminals |
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Term
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Definition
| irreversibly inhibit GABA transaminase |
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Term
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Definition
enhance GABA inhibition
increase threashold for neuronal firing
inhibit spread of seizure activity from discrete focus |
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Term
|
Definition
GABA analong increases synthesis and release
decreases glutamate and aspartate release
binds A2 subunit of voltage dependent Ca channels |
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Term
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Definition
steroselective binding site in synaptic plasma membrane in CNS
inhibit firing without affecting mornal excitability prevents hypersynchronization of epileptiform burse firing and propogration of seizure activity
binds to specific synaptic protein SV2A that effects excitability |
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Term
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Definition
analong of GABA increases GABA synthesis and release (more potent than gabaentin)
decreases glutamate and aspratate release
blocks Na channels |
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Term
|
Definition
| carbonic anhydrase inhibitor |
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Term
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Definition
| reduce low threshold T Ca currents in thalamic neurons |
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Term
| which epilepsy drugs have a MOA that decreases Na influx (8) |
|
Definition
oxycarbazepine
carbamazepine
lemtrigene
phenytoin
valproic acid
zonidamide
topiramate
pregabalin |
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Term
| which epilepsy drugs have a MOA that acts through a metabolite or is a prodrug (2) |
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Definition
|
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Term
| which epilepsy drugs stop spread from a focus (3) |
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Definition
oxycarbamepine
carbamepine
phenytoin
phenobarbital
levetfracetam |
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Term
| which epilepsy drugs inhibit release of glutamate (4) |
|
Definition
lamotrigene
topiramate
gabapentin
pregabalin |
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Term
| which epilepsy drugs stabilize neuron membranes (3) |
|
Definition
phenytoin
phenobarbitol - increase threshold
levetfracetam - inhibit firing wo affecting normal excitability, prevents hypersynchronization and propogation of seizure |
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Term
| which epilepsy drugs reduce threshold of Ca currents (4), which type of channel |
|
Definition
vaproic acid - at T channels in thalamic neurons
zonlsamide - at T channels in thalamic neurons
gabapentin - A2 subunit of voltage dependent Ca channels
ethosuxamide - at T channels in thalamic neurons |
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Term
| which epilepy drugs interact with GABA (11), how |
|
Definition
valproic acid - inactivate GABA T-transaminase
topiramate - increase GABA activity
clonazepam - GABA Cl ionophore complex
lorazepam - GABA Cl ionophore complex
diazepam - GABA Cl ionophore complex
primidone - enhance GABA inhibition
tigabine - block reuptake
vigabatrin - irreversibly inhibit GABA transaminase
phenobarbital - enhance inhibition
gabapentin - increase synthesis and release
pregabalin - increase synthesis and release |
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Term
| which epilepsy drug blocks carbonhc anhydrase inhibition |
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Definition
|
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Term
|
Definition
dizzy, somomn, fatigue, coodrination difficulty
hyponatremia
30% cross hypersensitivty to carbamazepine |
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Term
|
Definition
stupor, coma, resp depression, drowsiness, vertigo, ataxia, blurred vision
nausea, vomiting, hyponatremia, rash
aplastic anemia, agranulocytosis, thrombocytopenia
can induce serious liver disease (get function testing!) |
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Term
|
Definition
benign rash
serious rash (esp in kids): SJS, toxic epidermal necrosis |
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Term
|
Definition
CNS depression: ataxia, behavior change, confusion, hallucinations, drowsiness
gingival hyperplasia
corse facial features in kids
histurism, GI upset, rash, lymphadenopathy, purple glove
anti-arrhythmic (dont stop abruptly)
interferes with B12 metabolism causing megaloblastic anemia
fetal hydnation syndrome (worse in 1st trimester) cleft lip/palate, congenital heart disease, slow growth, MR |
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Term
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Definition
liver failure, pancreatitis, weight gain, insulin resistance
hyperammonemia encephalopathy (VHE)
hepatotoxic at theraputic doses by elevating enzymes esp in kids <2yo |
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Term
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Definition
dizzy, solumn, fatigue, coordination difficulty, psychosis
renal stones, weight loss, sweating,
teratogenic |
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Term
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Definition
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Term
|
Definition
| porconvulsive effect can cause status epilepticus |
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Term
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Definition
|
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Term
|
Definition
good threshold between effective dose and CNS depression
kids: depresses cognative performance
sedation, ataxia, vertigo, morbiliform rash, CT disorders |
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Term
|
Definition
dizzy, solumn, fatigue, coordination difficulty
caution with impaired renal flow/dialysis |
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Term
|
Definition
less fatigue that gabapentin
CV drug: some people feel high and report withdrawl symptoms |
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Term
|
Definition
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Term
|
Definition
| drowsiness, nausea, vomiting, 10% eosinophilia, blood dysracias |
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Term
| interactions with carbamazepine 6 |
|
Definition
metabolism initiation: cemetidine, diltiazem, erythromycin, isonizad, propoxyphene
never use in primary generalized seizure Na inhibition makes seizure worse |
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Term
| interactions with phenytoin 10 |
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Definition
inhibit phenytoin metabolism: dicumarol, cimetidine, sulfonamides, isoniazid
phenotyin increases P450: anti-epileptics, anti-coagulants, contraception, doxycycline, methodone, levodopa
stimulates phenytoin metabolism: carbamasepine
never use in primary generalized Na inhibition makes seizure worse |
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Term
| interactions with zonisamide |
|
Definition
| decreases OC effectiveness |
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Term
| interactoins with phenobarbital |
|
Definition
| drugs with hepatic metabolism, induces P450 enzymes |
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Term
| interactions with gabapentin |
|
Definition
| none, able to use other AED |
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Term
| phenytoin administaration, why |
|
Definition
oral or IV
IM percipitates at site of injection
oral absorption is slow but complete in duodenum |
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Term
| zonisamide metabolism and elimination |
|
Definition
metabolized in liver
eliminated in kidney |
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Term
|
Definition
| IV for status epilepticus |
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Term
|
Definition
|
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Term
|
Definition
| 90% metabolized by hepatic hydroxylation |
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Term
| which epilepsy drugs can you use in pregnancy |
|
Definition
| phenytoin - supplement folate |
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Term
|
Definition
|
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Term
|
Definition
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|
Term
| which epilepsy drugs can be used for partial seizure 7 |
|
Definition
oxycarbazepine
lamotrigene
topiramate
vigabatrin
gabapentin
levetfracetam
pregabalin |
|
|
Term
| which epilepsy drugs can be used for neuralgia (3), which type |
|
Definition
carbamasepine - trigeminal
gabapentin - neuropathic pain
pregabalin - peripherial |
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Term
| which epilepsy drugs tx status epilepticus 4, which are DOC 2 |
|
Definition
phenytoin
lorazepam DOC
diazepam DOC
phenobarbital |
|
|
Term
| which epilepsy drugs tx absence seizure 3, which are DOC |
|
Definition
valproic acid
acetazolamide - alt
ethozuximide - DOC |
|
|
Term
| which epilepsy drugs tx tonic / clonic seizure |
|
Definition
|
|
Term
| which epilepsy drug tx febrile seizure |
|
Definition
|
|
Term
|
Definition
firing of areas of neurons in brain (primary focus) which is anatomically normal
possibly inbalance of GABA: GABA transaminase elimase halts GABA to ensure balance in communication, if GABA is lacking it causes seizure |
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|
Term
| what percipitates a seizure 5 |
|
Definition
change in blood gas, pH, electrolytes, glucose
increase in glutamate activity |
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Term
| explain dual order kinetics |
|
Definition
low blood levels: rate of metabolism proportional to blood level (1st order)
high blood levels: disporportional increase in concentration, steady state may not be reached before toxicity occurs (zero order kinetics) hepatic hydroxylation is filled up. makes t1/2 of drug meaningless |
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