2- drugs for seizures

Question 1

what happens in the brain/neurons during a seizure

Answer 1

high frequency dischange of a group of neurons

starts in one area, then spreads

Question 2

what determines the symptoms of seizures

Answer 2

the site of primary discharge and the extent of the spread

Question 3

what happens with high frequency discharge (Seizure) in the motor cortex

Answer 3

convulsions

Question 4

what happens with high frequency discharge (Seizure) in the brain stem

Answer 4

loss of consciousness

Question 5

what is epilepsy

Answer 5

a disorder characterized by seizures

many different types with different origins, symptoms and causes

Question 6

what are tonic/clonic seizures

• how long do they last
• how affect consciousness
• main features

Answer 6

obvious physical effects via muscle contraction followed by relaxation
severe
loss of consciousness
can last minutes

Question 7

what are general absence seizures

• how long do they last
• how affect consciousness

Answer 7

affect consciousness, can be short (seconds)

Question 8

what are partial seizures

• how long do they last
• how affect consciousness
• main features

Answer 8

confined to specific regions with minimal spread, consciousness retained (may be altered), can last minutes

Question 9

what does tonic mean

Answer 9

loss of consciousness and muscle rigidity

Question 10

what does clonic mean

Answer 10

muscles rapidly relax and contract

Question 11

is glutamate excitatory or inhbitory to AMPA receptors

Answer 11

excitatory

Question 12

is glutamate excitatory or inhbitory to NMDA receptors

Answer 12

excitatory

Question 13

is GABA excitatory or inhbitory to GABA-A receptors

Answer 13

inhibitory

Question 14

which ion flows through when GABA binds to GABA-A

what does this cause

Answer 14

Cl

hyperpolarization

Question 15

which ions flow through when GLU binds to NDMA or AMPA

what does this cause

Answer 15

Na+, Ca++, K+

depolarization

Question 16

what are the 4 targets for pharmacological intervention in seizures

Answer 16

1. increase inhibitory influences (increase effects of GABA
2. inhibit AP (voltage-gated Na influx)
3. decrease spread of neuronal discharge (block low-voltage activated Ca channels)
4. decrease excitatory influences (decrease glu LGIC receptor activity)

Question 17

what are the common side effects of anti seixure drugs

Answer 17

sedation

Question 18

what does GABA-T (GABA-transaminase) do

Answer 18

metabolizes free GABA in the nerve endings and astrocytes

Question 19

what happens when you inhibit GABA-T

Answer 19

there will be more presynaptic GABA so that more can be released in depolarization events

Question 20

what is Vigabatrin

what kind of seizures is it good for

Answer 20

partial seizures

Question 21

how does Vigabatrin work

Answer 21

irreversible inhibitor of GABA-T

it may also inhibit GABA transporter

Question 22

how does Tiagabine work

Answer 22

inhibits GAT

allows more GABA to accumulate in synapse

Question 23

what does GAT do

Answer 23

transporter that removes GABA from the synaptic cleft

Question 24

which drug helps with fibromyalgia and anxiety

Answer 24

tiagabine

Question 25

what is use dependent block

Answer 25

when drugs preferentially bind to channels that have been open more firing, more block produced

Question 26

why does use-dependent block work best at high rates

Answer 26

there isnt enough time between firing events for the drug to leave the channel

Question 27

why is use dependent block okay for normal function

Answer 27

because at normal firing rates, the drug leaves the site before the next potential is initiated

Question 28

what kind of drug is carbamazepine

Answer 28

use dependent voltage-gated-sodium-channel blocker

Question 29

side effects of carbamazepine

Answer 29

severe motor/mental disturbances, hyponatremia (dilution of Na in blood) bone marrow depletion for Asians speeds up its own metabolism

Question 30

which drug is great for partial seizures

Answer 30

vigabtrin also tiagabine and carbamazepine

Question 31

which drug is good for most forms of epilepsy but not absence serizures

Answer 31

carbamazepine

Question 32

which drug is "add-on" therapy for partial seizures

Answer 32

tiagabine

Question 33

what do T-type low voltage activated calcium channels do in the brain

Answer 33

play a central role in depolarizing neurons and creating AP in the brain`

Question 34

what does ethosuximide do

Answer 34

blocks T-type calcium channels and prevents abnormal pattern of firing

Question 35

what kind of seizures is treatable with ethosuximide

Answer 35

absense serizures

Question 36

what makes absence seizures so different

Answer 36

there is a specific pattern of abnormal thalamocortical discharge (3Hz) this normally happens in non-REM sleep, but it happens in absence seizures

Question 37

what is common about AMPA and NMDA receptors

Answer 37

they are both excited by glutamate

Question 38

what is the role of AMPA and NMDA in seizures

Answer 38

they play a central role in foci of seizures and spreading excitation to surrounding neurons

Question 39

what is peramphanel

Answer 39

allosteric AMPA receptor inhibitor

Question 40

how selective is peramphanel towards AMPA

Answer 40

very

Question 41

how selective is peramphanel towards NMDA

Answer 41

none

Question 42

what types of seizures is perampanel good for

Answer 42

many types except for absense

Question 43

half life of perampanel

Answer 43

long, like 110hours

Question 44

side effects of perampanel

Answer 44

aggression, hostility and violence

Question 45

what aggrevates perampanel side effects

Answer 45

more in adolescents and alcoholics, also dose-dependent