Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CPT (My own) > Anti-epileptic > Flashcards

Anti-epileptic Flashcards

(62 cards)

Start Studying
1
Q

Define the seizure?

A

Transient occurrence of symptoms due to abnormal electrical activity in the brain, leading to a disturbance of consciousness, behaviour, emotion, motor function or sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What receptor does glutamate act via?

A

NMDA receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What receptor does GABA act via?

A

GABAa receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the effects of glutamate on NMDA receptors in terms of the effect on cations

A

Cation channels: let in Na and Ca and let K out
Depolarises the membrane
More likely to fire an action potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the effect of GABA on GABAa receptors and which channel is acted on

A

Cl- channel
Hyperpolarise membrane
Less likely to fire action potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe a seizure in terms of the NTs

A

Loss of inhibitor signals (GABA)

Strong excitatory signals (Glutamate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some causes of seizures?

A

Genetic differences in brain chemistry/receptor structure
Exogenous activation of receptors- drugs
Acquired changes in brain chemistry- drug withdrawal, metabolic changes
Damages to any of these networks e.g. strokes or tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the general symptoms and signs of epilepsy?

A 
Not just shaking!
Loss of consciousness
Changes in muscle tone
Aura
Post octal period
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the signs and symptoms for generalised seizures?

A

Loss of consciousness often with changes in muscle tone and tongue biting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the signs and symptoms for tonic clonic seizures?

A

Initial hypertonic phase, followed by rapid clonus (shaking/jerking)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is epilepsy?

A

A tendency toward recurrent seizures unprovoked by a systemic or neurological insult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the actual definition of epilepsy?

A

Atleast two unprovoked seizures occurring more than 24 hrs apart
One unprovoked seizure and a probability of further seizures similar to the general recurrence risk after 2 unprovoked seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some potential stimuli for a reflex seizure?

A 
Photogenic
Musicogenic
Thinking
Eating
Hot water immersion
Reading
Orgasn
Movement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 3 classifications of a seizure?

A

Focal
Generalised
Unknown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

State some of the features/types of focal onset

A

Aware/impaired awareness
Motor/non-motor onset
Focal to bilateral tonic clonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

State some of the features/types of generalised onset

A

Motor- tonic/clonic

Non motor- absence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

State some of the features/types of unknown onset

A

Motor- tonic/clonic
Non motor- absence
Unclassified

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the difference between focal and generalised onset in terms of spread?

A

Focal- on 1 side of the brain, can spread but not rapidly

Generalised onset- bilateral involvement v rapidly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the difference between focal and generalised onset in awareness?

A

Generalised will always be unaware because too much of the brain is affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the distribution of generalised seizures

A

Originate at a point within and rapidly engage bilaterally distributed networks
Can include cortical and subcortical structures but not necessarily whole cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe the distribution of focal seizures

A

Originate within networks limited to one hemisphere and maybe discretely localised or more widely distributed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is another term for generalised seizure?

A

Grand mal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is another term for an absence seizure?

A

Petit mal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is another term for a focal seizure?

A

Partial seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is a provoked seizure and what can be inducers?
``` Seizure as a result of another medical condition, examples include: drug use or withdrawn Alcohol withdrawal head trauma and intracranial bleeding Metabolic disturbances CNS infections Febrile seizures in infants Uncontrolled hypertension ```
26
What is the key in treatment of unprovoked seizures?
It is key to treat both the siezure and the underlying condition. Unlikely to need prolonged AED treatment
27
What are some differentials for seizures?
``` SUncopal episodes e.g. vasovagal syncope Cardiac issues including reflex anorexic seizures, arrhythmias Movment disorders e.g. Parkinsons TIAs Migraines Non-epileptic attack disorders ```
28
What is always the initial management of a seizure?
A- Airway B- Breathing, sats reading/O2 C- circulation, expect high HR, wary of BP D- disability, will have reduced consciousness in general seizures E- recovery position
29
What is status epileptics?
A seizure lasting more than 5 mins or more, or multiple seizures without a complete recovery between them
30
What is the pharmacological treatment regime for status?
``` Wait 5 minutes Benzodiazepine Benzodiazepine x2 Phenytoin (or Levetiracetam) Thiopentone/anaesthesia (call ITU) ```
31
What are benzodiazepines?
Class of GABA agonist that increase Cl- conductance so more negative resting potential, less likely to fire No firing of neurones= no more seizure
32
What are some side effects of benzos?
Addiction, CVS collapse, airway issues
33
What can benzos also be used as?
Anxiolytics, sleep aids, alcohol withdrawal
34
What are the benzo options for status epilepticus?
IV Lorazepam Rectal Diazepam Buccal or intranasal Midazolam
35
What is the issue with using EEGs as an investigation for epilepsy?
Relies on capturing an episode or abnormal pattern but many people with epilepsy don't have abnormal EEGs
36
What is the imaging method of choice for diagnosis?
MRI | May detect vascular or structural abnormalities
37
What are the 6 main AEDs?
``` Carbamazapine Phenytoin Na Valorate Lamotrigine Levetiracetam Benzodiazepine ```
38
What is a serious outcome of epilepsy?
Sudden unexplained death in epilepsy (SUDEP)
39
What is the main mechanism of action of Carbamazepine?
Sodium channel blocker
40
How does blocking of Na channels in central neurones help epilepsy?
It slows down the recovery of neurones from inactive to closed which reduces neuronal transmission
41
What are the 3 states of Na channels, and at which state do Na channel blockers work?
Open Inactivated Closed Work at inactivated to increase refractory period
42
What are other uses of Carbamzepine?
Bipolar and chronic neuralgic pain
43
What are some side effects of Carbamazepine?
Suicidal toughts Joint pain Bone marrow failure
44
What is the mechanism of action of Phenytoin?
Na channel blocker
45
What are the uses of Phenytoin?
Status epileptics or as an adjunct in generalised seizures
46
Describe the metabolism of phenytoin
Zero order kinetics so it is eliminated at a constant rate so need to be careful about dosing
47
What are specific side effects for Phenytoin?
Bone marrow suppression Hypotension Arrythmias
48
What is the mechanism of action of Na Valporate?
Mix of GABA agonist effects and Na channel blocks as well as some Ca channel blocking
49
What does it say in the guidelines about Na Valporate?
1st line for generalised epilepsy
50
What are specific side effects of Na Valporate?
Liver failure Pancreatitis Lethargy
51
What is the MOA of Lamotrigine?
Na channel blocker and some Ca channel blocking
52
What is the main use of Lamotrigine?
Focal epilepsy | Used where Valporate is contraindicated
53
What is the MOA of Levetiracetam (Keppra)?
Synaptic vesicle glycoprotein binder, stops the release of NT into the cleft and reduced neuronal activity
54
What are the uses for Levetiracetam?
Focal and generalised seizures
55
What are the advantages of Levetiracetam?
Easy dosing Well tolerated Safe in pregnancy
56
What are the side effects of AEDs in general?
``` Tiredness/drowsiness Nausea/ vomiitng Mood changes and suicidal ideation Osteoporosis Rashes Anaemia, thrombocytopenia or bone marrow failure ```
57
What is the rash condition that could occur as a side effect and which drugs are most likely to cause it?
Steven Johnson Syndrome- mucocutaneous breakdown | Caused by Carbamazepine or Phenytoin
58
What are the implications of so many side effects of AEDs?
Anti-epileptics and warfarin need close monitoring Ideally patients shouldn't consume alcohol Valporate can increase concentration of other AEDs Carbamazepine and Phenytoin can impair antibiotic effectiveness and oral contraceptive effectiveness
59
What are some AEDs that induce CYP enzymes?
Phenytoin Carbamazepine Barbituates
60
What are some non AEDs that induce CYP enzymes?
Rifampicin Alcohol Sulphonylureas
61
What are some AEDs that inhibit CYP enzymes?
Valporate
62
Which AED is preferential in pregnant or potential conceiving mothers?
Lamotrigine and especially Levetiracetam

CPT (My own) (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions