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Neuro Path (2nd Year) > Anti-Epileptics > Flashcards

Anti-Epileptics Flashcards

Anti-Epileptics (92 cards)

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1
Q

antieplipetic Cyp450 Inducer (5)

A

phenobarbital
ethosuximide
phenytoin
carbamazepine
tobacco

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2
Q

antieplipetic Cyp450 inhibitor (5)

A

erythromycin
Ca channel blockers
trimethoprim/sulfa
fluconazole
valproate
valproate
lorazepam
lamotrigine

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3
Q

levetiracteam relationship inducers/inhibitrs

A

does neither b/c not really metabolized

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4
Q

older people have more or less albumin

A

less

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5
Q

is renal excretion in older people increased or decreased

A

decreased

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6
Q

neonates have higher or lower protein binding than adults

A

lower

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7
Q

neonates have higher or lower metabolic rate when it comes to drugs when compared to adults

A

higher

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8
Q

do kids need higher or lower dose of durgs

A

higher b/c higher metabolism

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9
Q

pregnancy needs higher or lower does of anti-epileptics

A

higher

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10
Q

5 classes of drugs that interact w/ Anti epileptics

A

birth control
coumadin
anti-depressants
cholesterol-lowering
chemo

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11
Q

Phenobarbital use

A

all seizures except absence

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12
Q

Phenobarbital route

A

PO, IV

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13
Q

Phenobarbital half life

A

100 hours

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14
Q

Phenobarbital is metabolized where

A

liver

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15
Q

Is Phenobarbital inducer of liver enzymes?

A

yes

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16
Q

Phenobarbital toxicity (3)

A

hyperactivity in kids, sedation in adults, joint issues

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17
Q

Phenobarbital mechanism

A

GABA agonist
opens Cl channels
hyperpolarization

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18
Q

Phenytoin Use and best use

A

all seizures except absence. best used for focal and secondarily generalized seizures

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19
Q

Phenytoin mechanism

A

blocks voltage gated Na channels

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20
Q

where is phenytoin metabolized?

A

liver

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21
Q

what happens to metabolism when phenytoin is metabolized at high doses?

A

0 order kinetics

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22
Q

phenytoin half life

A

variable 6-24 hrs

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23
Q

phenytoin toxicity (3)

A

gingival hyperplasia, osteomalacia, ataxia

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24
Q

phenytoin relationship w/ weight

A

neutral

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25
Benzo Use (4)
very effective for all seizure types--withdrawal, sedatives, anxiolytics
26
benzo drug of choice for...
Status epilepticus, alcohol withdrawal, withdrawal seizures
27
benzo mechanism
agonist at GABA receptor
28
benzo route
PO, IV
29
benzo toxicity (3)
sedation, depression, withdrawal
30
benzo caveat
addiction, tachyphylaxis
31
benzo metabolized where? is it an enzyme inducer
liver no
32
funny story for carbamazepine
funny story: carbamazepine: carbs, need chewing= trigeminal neuralgia. carbs are food, need salt= Na channel blockade. Carbs are food= weight gain
33
carbamazepine mechanism
Na channel blockade
34
carbamazepine route
oral
35
carbamazepine half life
12 hours
36
where is carbamazepine metabolized/
liver
37
carbamazepine drug interactions (2)
ca channel blockers and macrolide antibiotics
38
carbamazepine most effect dru for
focal seizures/ epilepsy
39
carbamazepine side effects
steven Johnson syndrome
40
carbamazepine relationship w/ weight
gain
41
Carbamazepine use: best use and other uses (4)
best for focal and secondarily generalized seizures. Mood stabilizer trigeminal neuralgia
42
ethosuximide use
absence
43
ethosuximide mechanism
blocks T type calcium channels (mainly in thalamus)
44
ethosuximide route
oral
45
ethosuximide half life
12-24 hours
46
ethosuximide toxicity
sedation, GI distress, occasional behavioral changes
47
ethosuximide metabolized where. Is it an inducer?
liver mild inducer
48
valproate funny story
Valproate funny story: valproate is a pro works on seizure, migraine, and bipolar. P= Potassium channels
49
Valproate Use (3)
all seizure types, migraine, and bipolar most effective drug
50
Valproate mechanism
not well understood maybe Na channels maybe increase GABA maybe affects Ca and K conductance
51
Valproate route
oral and IV
52
valproate half-life
15 hours
53
valproate toxicity
GI, weight gain, menstrual problems, hair loss, thrombocytopenia, pancreatitis, hepatic encephalopathy
54
valproate relationhip w/ weight
gain
55
valproate metabolized where. Is it an inducer?
liver not a major inducer
56
Gabapentin Mechanism
increases GABA levels in brain. May block Ca channels
57
Gabapentin route
PO
58
Gabapentin half life
6 hours
59
Gabapentin toxicity
sedation, GI distress, pedal edema
60
gabapentin relationship w/ weight
gain
61
Gabapentin use (5)
partial and secondarily generalized seizures. Anxiolytic sedative anti-spasmodic peripheral neuropathy
62
gabapentin is metabolized where? inducer?
not metabolized not an enzyme inducer
63
lamotrigine funny story
funny story: skin rashes are lame, Stevens Johnson is lame
64
Lamotrigine mechanism
blocks release of glutamate pre-synaptically and blocks Na post synaptically
65
Lamotrigine route
oral
66
Lamotrigine metabolism
renally excreted after glucoronidation
67
lamotrigine half life
24 hours
68
lamotrigine toxicity
allergic rash 5-10%
69
lamotrigine special use
preferred drug for pregnancy
70
lamotrigine relationshiop w/ weight
neutral
71
Lamotrigine use
all seizures Bipolar neuropathic pain
72
topiramate funny story
takes care of all top problems: seizures, migraines, neuropathic
73
topiramate metabolized where?
some hepatic, mostly renal
74
topiramate inducer?
not an inducer
75
topiramate half life
24 hours
76
topiramate route
oral
77
topiramate toxicity
sedation, aphasia, parasthesias , kidney stones
78
topiramate relationshiop w/ weight
loss
79
topiramate use
seizures except absence migraine prevention neuropathic pain
80
topiramate mechanism
Na channel blockade GABA agonist glutamate antagonist
81
levetiracetam funny story
levetriacetam = vesicles
82
Levetiracetam mechanism
not super well known..might block Ca channels and maybe stops vesicles from being released
83
Levetiracetam metabolized where? inducer?
2/3 excreted renally unchanged. some renal hydrolysis. not protein bound. not inducer
84
Levetiracetam toxicity
cognitive and behavioral probelms
85
Levetiracetam route
IV and oral
86
levetriacetam special use
good for pregos
87
levetiracetamrelationship w/ weight
neutral
88
Levetiracetam use
and generalize seizers swiss army knife of seizure meds favorite anti epileptic in hospitals
89
Which AEDs work on GABA
Barbs benzos topiramate
90
Which AEDs work on glutamate
lamotrigine, topiramate
91
Which AEDs work on Na
Phenytoin Carbamazepine Valproate topiramate lamotrigine
92
Which AEDs work onCa
ethosuximide

Neuro Path (2nd Year) (6 decks)

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