Unit 2- Anticonvulsants Flashcards

1
Q

Anticonvulsants

A

Reduce frequency of neuron firing to block seizure initiation and propagation

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2
Q

Anticonvulsant Metabolism

A

Metabolized too quickly in dogs, cats metabolize slowly and poorly

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3
Q

Anticonvulsant MOA

A

Activate GABA Cl- channels, bind GABA A receptor, inactivate Na+ and Ca++ conductance

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4
Q

Anticonvulsant Adverse Effects

A

Rapid cessation effect, liver and serum enzyme induction, and hepatotoxicity in dogs

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5
Q

Barbiturate MOA

A

Phenobarbital, Pentobarbital, Primidone, activate GABA gated Cl- channels

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6
Q

Benzodiazepine MOA

A

Diazepam, Midazolam, Clonazepam, and Lorazepam GABA A receptor agonists

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7
Q

Hydantoin MOA

A

Phenytoin targets sodium channels

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8
Q

Valproic Acid MOA

A

Acts via Cl- channels

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9
Q

Gabapentin MOA

A

Synthetic GABA analog inhibiting voltage gated Ca++ channels

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10
Q

Levatiracetam MOA

A

Binds to synaptic vesicle protein 2A

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11
Q

Felbamate MOA

A

Unknown

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12
Q

Zonisamide MOA

A

Inhibits Na+ and Ca++ channels

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13
Q

GABA

A

Major inhibitory neurotransmitter, controls fear and anxiety, inhibits activity of neurons

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14
Q

Phenobarbital

A

Produces anticonvulsant effect at lower doses than those needed to cause sedation

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15
Q

Phenobarbital Uses

A

Long term seizure control

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16
Q

Phenobarbital Adverse Effects

A

Sedation, PU/PD, polyphagia, dogs develop a tolerance to sedative effects

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17
Q

Primidone

A

Metabolized to phenobarbital in dogs, not for use in cats

18
Q

Primidone Adverse Effects

A

Decreased serum albumin, elevated liver enzymes, and serious liver damage

19
Q

Pentobarbital

A

Terminates seizures at an anesthetic dose, used for status epilepticus

20
Q

Status Epilepticus

A

Seizure lasting longer than 5 mins or more than one seizure within 5 minutes

21
Q

Pentobarbital Adverse Effects

A

CNS Depressant, excitement during anesthesia recovery

22
Q

Benzodiazepine Uses

A

Anticonvulsants, tolerance is built up quickly in dogs, may be a maintenance anticonvulsant in cats

23
Q

Diazepam

A

Used in cats for seizure control, used in dogs for status epilepticus and cluster seizures

24
Q

Diazepam Adverse Effects

A

Changes in behavior, cats can develop acute fatal hepatic necrosis

25
Q

Midazolam

A

More potent than diazepam, used for status epilepticus, muscle relaxation, tranquilizer, and appetite stimulant, readily crosses BBB

26
Q

Midazolam Adverse Effects

A

Mild respiratory depression, vomiting, restless behavior and agitation, local irritation

27
Q

Clonazepam

A

Rapid development of drug tolerance

28
Q

Clonazepam Adverse Effects

A

Drug resistance, GI disturbance

29
Q

Lorazepam

A

Safely used in geriatric dogs and patients with liver disease, short term use in dogs, maintenance use in catss

30
Q

Lorazepam Adverse Effects

A

Increased appetite, anxiety

31
Q

Hydantoins

A

Impractical in dogs

32
Q

Valproic Acid

A

Controls seizures in dogs short term, not evaluated in cats

33
Q

Valproic Acid Adverse Effects

A

GI toxicity, hepatic toxicity, sedation, ataxia, behavioral changes, dermatologic effects, hematologic effects, pancreatitis, edema

34
Q

Potassium Bromide MOA

A

Enters neurons via Cl- channels to cause hyperpolarization

35
Q

Potassium Bromide

A

Takes months to achieve stable plasma combinations, used in combo with barbiturates and benzodiazepines to treat refractory seizures in dogs

36
Q

Potassium Bromide Adverse Effects

A

Transient sedation, GI toxicity, PU/PD, polyphagia, lethargy, irritability, aimless walking, pancreatitis, asthma in cats

37
Q

Gabapentin Adverse Effects

A

Sedation, ataxia, polyphagia, can cause seizures after rapid discontinuation

38
Q

Levetiracetam

A

Used for refractory canine epilepsy

39
Q

Levetiracetam Adverse Effects

A

GI disturbance, changes in behavior, drowsiness, may cause seizures after rapid disruption

40
Q

Felbamate

A

Used for patients with local and generalized seizure, used in brain tumor or cerebral infarct

41
Q

Felbamate Adverse Effects

A

Liver dysfunction, bone marrow depression, generalized tremor, dry eye

42
Q

Zonisamide

A

Used for patients with local and generalized seizures, useful in brain tumor or cerebral infarct