Anti-Epileptic Drugs - Glutamate Flashcards

1
Q

With Epilepsy, there is a neuronal imbalance that causes increased CNS excitation. What are the molecules and their changes in levels that are associated with that?

A
Glutamate/Aspartate = increased = more excitation
GABA = decreased = less inhibition
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2
Q

The goal of Anti-epileptic drugs is to _____ glutamate actions and _____ GABA actions

A

Suppress glutamate and Enhance GABA

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3
Q

What are the 10 Na voltage gated channel blockers?

A
Carbamazepine
Oxcarbazepine 
Eslicarbazepine
Lamotrigine
Phenytoin
Topiramate
Valproic Acid
Lacosamide
Zonisamide
Rufinamide
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4
Q

What are the 10 Na voltage gated channel blockers?

A
Carbamazepine
Oxcarbazepine
Eslicarbazepine
Lamotrigine
Phenytoin
Topiramate
Valproic Acid
Lacosamide
Zonisamde
Rufinamide
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5
Q

Where do the Na voltage gated channel blockers work?

A

Pre-synaptic neuron

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6
Q

What is the IV form of Phenytoin?

A

Fosphenytoin

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7
Q

What is the main action of all 10 of the Na voltage gated channel blockers?

A

Prolong fast inactivation state

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8
Q

What Na voltage gated channel blocker also works to enhance the slow inactivation state?

A

Lacosamide

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9
Q

What are the 2 AMPA receptor blockers?

A

Topiramate

Perampanel

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10
Q

What are the 2 AMPA receptor blockers?

A

Topiramate

Perampanel

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11
Q

Where do AMPA receptor blockers work?

A

Post-synaptic

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12
Q

What is the NMDA receptor blocker?

A

Felbamate

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13
Q

What is the NMDA receptor blocker?

A

Felbamate

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14
Q

Where does the NMDA receptor blocker work?

A

Post-synaptic

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15
Q

Low-threshold T-type Ca++ channels mediate the activity of what type of seizures?

A

Absence seizures

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16
Q

The 2 drugs that block low-threshold T-type Ca++ channels will block what seizure type?

A

Absence seizures

  • Ethosuximide
  • Zonisamide
17
Q

What are the 2 low-threshold T-type Ca++ channel blockers?

A

Ethosuximide

Zonisamide

18
Q

What are the 2 low-threshold T-type Ca++ channel blockers?

A

Ethosuximide

Zonisamide

19
Q

Where do the low-threshold T-type Ca++ channels work?

A

Pre-synaptic

20
Q

What is the job of the SV2AP?

A

Closes the pre-synaptic vesicles that contain glutamate for release

21
Q

What are the 2 drugs that inhibit SV2AP?

A

Levetiracetam

Brivaracetam

22
Q

What are the drugs that inhibit SV2AP?

A

Levetiracetam

Brivaracetam

23
Q

Where do SV2AP inhibitors work?

A

Pre-synaptic

24
Q

What are the 2 drugs that block alpha-2-delta subunit of T-type Ca++ channels?

A

Gabapentin

Pregablin

25
Q

What are the 2 drugs that block alpha-2-delta subunit of T-type Ca++ channels?

A

Gabapentin

Pregabalin

26
Q

Which drug opens K+ channels (KCNQ) in order for K+ to leave the cell?

A

Ezogabine

27
Q

Which drug opens K+ channels (KCNQ) in order for K+ to leave the cell?

A

Ezogabine

28
Q

Ezogabine opens KCNQ K+ channels where?

A

Pre AND Post synaptic

29
Q

What are 2 side effects of Carbamazepine?

A

(Na voltage gated channel blocker)

  1. Self metabolism
  2. Decreases WBC’s
30
Q

What is 1 side effect of Phenytoin?

A

(Na voltage gated channel blocker)

1. Gingival Hyperplasia

31
Q

Which drug is both a Na voltage gated channel blocker and an AMPA receptor blocker?

A

Topiramate

32
Q

Which drug is both a Na voltage gated channel blocker and a low-threshold T-type Ca++ channel blocker?

A

Zonisamide

33
Q

All of the drugs in this deck affect which neuronal imbalance molecule that controls seizures?

A

Glutamate

– Decreasing!

34
Q

What gate must be open in order for Na voltage gated channel blockers to bind and work?

A

Activation gate must be open