Pharm 15 - Seizure

Question 1

Inhibit electrical neurotransmission by use-dependent block of neuronal voltage-gated sodium channel. Strong treatment of focal and secondary generalized seizures.

Answer 1

Sodium Channel Inhibitor Mechanism

Question 2

Sodium Channel Inhibitor: slows the rate of recovery, increasing the threshold for firing. Targets channels that open and close at high frequencies. Major drug of choice for focal and tonic-clonic seizures. Affected by p450 drugs.

Answer 2

Phenytoin

Question 3

Sodium Channel Inhibitor: slows the rate of recovery. Used for focal seizures because it suppresses seizure foci and prevents spread. Metabolism is linear so is good for potential drug interactions. Number one for focal seizures.

Answer 3

Carbamazapine

Question 4

Sodium Channel Inhibitor: Can be used for focal, tonic-clonic, and absence seizures (after valproic acid and ethosuximide).

Answer 4

Lamotrigine

Question 5

inhibit the low-threshold T-type calcium channel

Answer 5

Ethosuximide and valproic acid

Question 6

inhibits the high-voltage-activated (HVA) calcium channel

Answer 6

Gabapentin

Question 7

Inhibit the low-threshold T-Type Calcium Channel at high concentrations and slows Sodium channel recovery at low concentrations. It also inhibits the activity of enzymes that degrade GABA.

Answer 7

Valproic Acid

Question 8

Inhibit the low-threshold T-Type Calcium Channel: First line for Absence Seizures and NOT effective for Focal or Tonic-Clonic Seizures.

Answer 8

Ethosuximide

Question 9

Inhibits the high-voltage-activated (HVA) calcium channel which results in decreased neurotransmitter release.

Answer 9

Gabapentin

Question 10

Potentiate GABA-mediated inhibition to increase chloride current through the channel

Answer 10

GABA CHANNEL POTENTIATOR Mechanism

Question 11

Potentiate GABA-mediated inhibition to increase chloride current through the channel: Focal and tonic-clonic seizures.

Answer 11

Benzodiazepines and Barbituates

Question 12

Potentiate GABA-mediated inhibition to increase chloride current through the channel: increases duration of Cl- channel opening. Used for focal and tonic-clonic seizures because it can make absence seizures worse.

Answer 12

Barbituate: Phenobarbital

Question 13

prevents GABA mediated hyperpolarization of the thalamus and thereby indirectly inactivates the T-type Ca2+ channel.

Answer 13

Clonazepam

Question 14

Benzodiazepines

Answer 14

Diazepam
Lorazepam
Midazolam
Clonazepam:

Question 15

Glutamate Receptor Inhibitor: inhibits glycine binding site of NMDA receptor-ionophore complex, resulting in suppression of seizure activity. Has a lack of sedative effects.

Answer 15

Felbamate

Question 16

Inhibits the high-voltage-activated (HVA) calcium channel which decreases release of neurotransmitter. More potent than gabapentin. Used with focal seizures and those with hepatic dysfunction since it is metabolized in the kidney.

Answer 16

Pregabalin

Question 17

Inhibits the enzyme GABA transaminase, increasing GABA in the brain. Used for infantile spasms and refractory focal epilepsy.

Answer 17

Vigabatrin

Question 18

Treatment of focal seizures and drop attacks in Lenox-Gastaut syndrome (childhood onset seizures. Similar to Felbamate.

Answer 18

Rufanamide