Anti-epileptic drugs Flashcards

1
Q

What is an epileptic seizure defined as?

A

‘A transient occurrence of signs and/or symptoms due to abnormal or excessive or synchronous neuronal activity in the brain’

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2
Q

What are the 4 phases of a seizure?

A
  1. Prodromal phase
  2. Aura
  3. Ictus
  4. Post-ictal phase
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3
Q

What occurs during the prodromal phase of a seizure?

A

Before the seizure begins
Animal exhibits behavioural changes such as whining and hiding
Hours to days before seizure

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4
Q

What behaviour can be seen from an animal in the aura phase?

A

Pacing, barking, salivating

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5
Q

Which phase is the seizure proper? What occurs in this phase?

A

Ictus

Involuntary muscle movements, twitches and changes in tone

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6
Q

What occurs in the post-ictal phase?

A

Consists of a period of time in which the animal may be disorientated, shows changes in appetite, thirst and toileting

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7
Q

1 seizure in 24 hours is called?

A

An isolated seizure

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8
Q

What is a cluster of seizures?

A

2 or more seizures within 24 hours

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9
Q

When seizures last over 5 minutes or there are multiple seizures without returning to normal this is called?

A

Status epilepticus

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10
Q

Where are epileptic seizures localised in the brain?

A

Forebrain

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11
Q

Compare a focal and a generalised seizure

A

Focal - specific site in the cerebrum

Generalised - involving the whole of both hemispheres

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12
Q

What are the signs of a focal seizure?

A

Motor abnormalities
Facial twitching
Unprovoked aggression

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13
Q

What are the signs of a generalised seizure?

A

Loss of consciousness

Bilateral convulsions

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14
Q

What is the primary cause of seizures in the brain?

A

Imbalance of excitation and inhibition in the neurotransmission

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15
Q

What is the role of AEDs?

A

They cannot cure seizures/epilepsy as this is not a disease in its own right
They can reduce/suppress seizure activity and reduce the progression of clinical signs
Seizures can be life-threatening

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16
Q

What are the 3 broad categories of MOA anti-epileptic drugs?

A
  • Enhance the action of GABA
  • Suppress the action of glutamate
  • Modulate the movement of cations
17
Q

What are the aims of AEDs?

A
  • Reduce frequency of seizures
  • Reduce severity of seizures
  • Minimise side effects of drugs
18
Q

What is classified as a response to treatment?

A

50% or more reduction in seizure activity

19
Q

Give 4 examples of first-line AEDs

A
  • Phenobarbital
  • Potassium bromide
  • Imepitoin
  • Diazepam
20
Q

How do first line AEDs work?

A

Enhances GABA induced chloride ion conductance

21
Q

How is phenobarbital administered?

A

Orally or IV

22
Q

Which first line AED is not suitable for use in cats?

A

Potassium bromide

23
Q

How does Imepitoin act as a first line AED?

A

Acts as a partial agonist at the benzodiazepine site of the GABA receptor, which potentiates the action of GABA

24
Q

Which of the first line AEDs reaches a steady state first?

A

Imepitoin

25
Q

Which AED can be used for emergency treatment but not chronic management?

A

Diazepam

26
Q

Give some examples of add-on AEDs

A

Gabapentin
Pregabalin
Levetiracetam
Zonisamide

27
Q

What are the possible functions of Add on AEDs?

A

Enhance the action of GABA

Decrease glutamate release