AED Flashcards
1
Q
Mechanism of action of Rufinamide
A
Prolong the inactivation state of Na channel
2
Q
Phenobarbital drug that can be used in insomnia
A
secobarbital
3
Q
Protein binding of PB
A
70%
4
Q
Can be used in Lennox Gastaut Syndrome
A
Felbamate
5
Q
oral source of lacosamide
A
Phenylalanine
6
Q
Half life of Zonisamide
A
1-3 days
7
Q
What are the mechanism of action of lamotrigine
A
Blockade of Na channel
Inhibit voltage Ca channel (N & P/Q Type)
Decrease synaptic release of glutamate
8
Q
This AED is similar to imipramine
A
Carbamazepine
9
Q
Maximum dose of Levetiracetam
A
3000mg/d
10
Q
This AED is an Sulfonamide derivatives
A
Zonisamide
11
Q
What drug increases its level when given lamotrigine
A
VPA
12
Q
Clinical use of phenytoin
A
Partial and generalized seizure (primary and secondary)
13
Q
Elimination of Phenytoin
A
First order kinetics
14
Q
Felbamate may cause this toxicity
A
Aplastic anemia
Hepatitis
15
Q
Peak level of CBZ is achieved at
A
6-8hours
16
Q
Half life of Vigabatrin
A
6-8 hours
17
Q
Effective plasma level of Felbamate
A
30-100mg/ml
18
Q
Elimination of Gabapentin
A
Renal
19
Q
Volume of distribution of PB
A
0.6L/kg
20
Q
Half lite of phenytoin
A
12-36h
21
Q
Drug interaction of Felbamate
A
Increase level of PHT and VPA
Decrease CBZ
22
Q
This AED is a substituted monosaccharide
A
Topiramate
23
Q
Peak concenration of lacosamide
A
1-4 hours
24
Q
If sulfonamide is added with phenytoin what will happen?
A
Displaces phenytoin from protein increasing its free drug concentration
25
AE of VPA
Elevation of liver profile, thrombocytopenia, hyperammonemia, spina bifida
26
Protein Binding of CBZ
70%
27
Absorption of Phenytoin in GI
Complete at 3-12 hrs
28
Most common toxicity of CBZ
Diplopia and ataxia
29
Half life of perampanel
70-110 hours
30
What AED has an antifolate activity
Lamotrigine
31
Drug interaction of ethosuximide
VPA decreases ETX
32
Bioavailability of lacosamide
100%
33
Half-life of lacosamide
13 hours
34
Half life of rufinamide
6-10 hours
35
Protein binding of VPA
90%
36
What is the metabolite of Primidone
Pb --> PEMA
37
What drug makes topiramate less effective
OCP
38
Mechanism of action of VPA
1. Blocks NMDA receptor mediated excitation
2. Increases GABA
3. facilitates glutamic acide decarboxylase (for GABA synthesis)
4. Potent inhibitor of histone deacetylase
39
Volume of distribution of VPA
0.15 L/kg
40
What is the mechanism of action of Lacosamide
Enhances slow inactivation voltage gated Na channel
| Binds to CRMP blocks BDNF and NT-3
41
What is the metabolite of Oxcarbazepine and its halflife
Eslicarbazepine
| 8-12 hours
42
Metabolism of Stiripentol
Inhibitor of CYP3A4 CYP1A2 and CYP 2C19 (increase the level of other AED)
43
half-life of lamotrigine
24 hours
44
Toxicity of Phenytoin
```
Nystagmus
Ataxia
Diplopia
Hirsutism
Hyperplasia of gingiva
Coarse facial
Osteomalacia
Decreased DTR
NADH2COD
```
45
Excretion of Phenobarbital is enhance by
Alkalinization of urine
46
This is an triazole derivatives
Rufinamide
47
This congener of phenytoin causes dermatitis, aggranulocytosis and hepatitis
Mephytoin
48
Mechanism of action of Perampanel
Acts at post synaptic AMPA receptor that shortens the repetitive discharge of neuronal system
49
Mechanism of action of Stiripentol
Enhances GABAergic transmission of Cl channel and GAB-A receptor
50
Mechanism of action of pregabalin and gabapentin
α2δ subunit-containing voltage-gated calcium channels
51
What is the mechanism of action of Phenobarbital (4)
Prolong opening of Cl channel (main)
Allosteric modulator on GABA-A
Suppress high frequency of Na conductance
At high dose: blocks L and N Type Ca Channel
52
Adverse effect of Retigabine
Decrease visual activity
| Blue skin discoloration (Potiga)
53
Clinical use of topiramate
1. monotherapy for partial and GTC
2. LGS
3. Infantile spasm and absence
4. migraine
54
Adverse effect of Vigabatrin
irreversible visual field defect
55
What is the mechanism of action of Zonisamide
1. reduces the low threshold of Ca T-type channel
56
Clinical use of CBZ
Partial and GTC seizure
Trigeminal neuralgia
Bipolar disorder
57
Mechanism of action of Retigabine
K channel facilitator
58
What is the mechanism of action of Levetiracetam
Binds to synaptic vesicle (SV2A)
59
What is the advantage of Eslicarbazepine
once daily dosing
60
Mechanism of action of OXazolidonedione
Raises threshold for seizure discharge after repetitive thalamic stimulation
61
Therapeutic level of CBZ
1-2g
62
Indication for acetazolamide
Catamenial Sz
63
TD of PB
15-30mcg/ml
64
Indication of Gabapentin
postherpetic neuralgia
| adjunct in GTC and Partial Sz
65
Adverse effect of perampanel
behavioral adverse reaction
66
What is improved in Oxcarbazepine
Toxicity profile
67
Half life of ethosuximide
40 hours
68
Clinical uses of Ethosuximide
Absence Seizure (Drug of choice)
69
AE of topiramate
Hypospadias
Urolithiasis
Glaucoma
70
Mechanism of action of Felbamate
NMDA receptor NRI-2B
| Barbiturate like potentiation of GABA-A receptor
71
What test should be done if patient is on Phenytoin?
Thyroid function test (has affinity with thyroid binding globulin)
72
Mechanism of action of Zonisamide
1. Blocks Na CHannel
| 2. Acts on T type voltage gated Ca Channel
73
Protein binding of perampanel
95%
74
Indication of Pregabalin
Partial Sz +/- secondary generalization
Fibromyalgia
Anxiety Disorders
75
Protein binding of topiramate
15%
76
Clinical use of Stirpentol
Adjunct with clobazam and VPA for refractor GTC
| Myoclonic epilepsy of infanct (SMEi, Dravets)
77
Half life of VPA
9-18 hours
78
Protein binding of Pregabalin
None
79
Volume of distribution of lamotrigine
1-1.4L/Kg
80
Anticonvulsant metabolite of CBZ
11-epoxide
81
Half-life of levetiracetam
6-8 hours
82
Half life of topiramate
20-30 hours
83
Drug interaction of perampanel
Induces CBZ and PHT
| When use with CBZ - half life is reduced to 25 hours
84
Mechanism of action of Tiagabine
inhibitor of GABA uptake
Inhibit GAT-1 than GAT 2 and 3
Increase intracellular GABA
85
This makes eslicarbazepine less effective if given with this drug
Oral contraceptives
86
What is the antiseizure agent of Phenobarbital
Barbituric Acid
87
Halflife of Phenobarbital
4-5 days
88
Mehanism of action of CBZ
Blocks Na
| Potentiate K
89
Therapeutic level of ethosuximide
60-100mcg/ng
90
Protein binding of Levetiracetam
10%
91
Peak concentration of VPA
2 hours
92
AE of Zonisamide
Cognitive impairment
93
CLinical use of lamotrigine
Adjunct therapy
monotherapy for partial Sz,
Absence sz, LGT
Bipolar disorders
94
Drug interaction of CBZ
Increase matanolism of PHT ETX and VPA
Increase staeady state of VPA
Decrease steady state of PHT and PBZ
95
Mechanism of action of Topiramate
1. Blocks voltage gated Na channel
2. Potentiate inhibitory effect of GABA
3. Depress action of Kainate on glutamate receptor
96
Half life of Gabapentin
5-8 hours
97
This drug enhances the effect of GABA by irreversibly inhibiting GABA-aminotransferase
Vigabatrin
98
Pharmacodynamics of Retigabine
Linear kinetics and absorption is not affected by food
99
Phenobarbital can worsen this type of seizure
Absence
| Infantile spasm
100
Half-life of Tiagabine
5-8 hours
101
Drug interaction of VPA
1. Inhibit metabolism of Pb PHT and CBZ
102
Mechanism of action of Phenytoin
Prolingation of inactivated Na channel
Blocks the persistence of Na channel
Decrease Ca permeability
103
Acetazolamide exerts its antiSz activity by
mild acidosis
104
Clinical indication of Phenobarbital
GTC and partial Seizure
105
Elimination half-life of stiripentol
Non-linear kinetics
106
Therapeutic level of VPA
25-30mg/kg/day
