Anticonvulsant

Question 1

Seizure

Answer 1

spontaneous firings of neurons

convulsion

Question 2

convulsion

Answer 2

activation of motor neurons leading to involuntary contraction of skeletal muscle

Question 3

simple partial seizure

Answer 3

least complicated, minimal spread. affects only on muscle group. no loss of consciousness, person still alert and remembers what happens

Question 4

complex partial seizure

Answer 4

spreading to other areas of brain: altered consciousness, automatism

Question 5

Absence seizure (petit mal)

Answer 5

less severe; sudden onset and abrupt cessation, brief loss of consciousness (could have little motor jerking of eyelid), impaired consciousness

Question 6

When is absence seizure most commonly found

Answer 6

children under 15

Question 7

Phases of Tonic- clonic

Answer 7

1. aura
2. tonic phase:muscle tensing, rigidity of all extremities
3. clonic phase: convulsion–>uncontrolled shaking body
4. Stuporous state and sleep: confusion, amnesia, nausea

Question 8

what type of seizures is common in children?

Answer 8

atonic, absence (petit mal)

Question 9

clonic and myoclonic

Answer 9

loss of consciousness w/rhythmic clonic contractions phase, sudden flexion/extension of body and limbs

Question 10

infantile spasm

Answer 10

epileptic syndrome. NOT a seizure type. recurrent myoclonic jerks

Question 11

Status Epilepticus

Answer 11

continuous or very rapid recurring seizures that require immediate therapy

Question 12

what are the main targets of anticonvulsant drugs?

Answer 12

Na and Ca channels to inhibit firing of certain hyper-excitable cerebral neurons, or increasing effects of GABA

Question 13

what agents block T type channels of the Ca channels

Answer 13

ethosuximide, valprate

Question 14

inhibiting Ca channels is effective against what seizure?

Answer 14

Absence seizure

Question 15

which agents block L type Ca channels

Answer 15

lamotrigine, topiramate, gabapentin

Question 16

What agents block AMPA receptors

Answer 16

phenobarbital, topiramate, lamotrigine

Question 17

which agent blocks NMDA receptors

Answer 17

Felbamate

Question 18

what agents tx absence seizure

Answer 18

ethosuximide, valproate, lamotrigine, topiramate

Question 19

what drugs are used for status epilepticus

Answer 19

diazepam, lorazepam, phenytoin, fosphenytoin

Question 20

which drugs block the inactivated state of Na channels

Answer 20

phenytoin, carbamazepine, Lamotrigine

Question 21

Phenytoin function

Answer 21

blocks inactivated state of Na channels, increase release of GABA

Question 22

phenytoin clinical use

Answer 22

main drug for tonic clonic, partial seizure, status epilepticus

Question 23

what is the main drug for tonic-clonic (grand mal)

Answer 23

phenytoin

Question 24

what agent can cause gingival hyperplasia

Answer 24

phenytoin

Question 25

what agent can cause fetal hydantoin syndrome

Answer 25

phenytoin

Question 26

How is Fosphenytoin diff from phenytoin

Answer 26

Newer drug, more soluble able to use IV or IM route

Question 27

what is carbamazepine used for

Answer 27

clonic tonic seizure, partial seizures, trigeminal neuralgia,, bipolar, acute alcohol withdrawal

Question 28

what anticonvulsants also treat manic phase in bipolar disorder

Answer 28

Valproic acid and carbamazepine

Question 29

what is the number one drug to treat trigeminal neuralgia

Answer 29

carbamazepine

Question 30

whats the difference between oxacarbazepine?

Answer 30

oxacarbazepine has a LONGER active metabolite and fewer drug interaction

Question 31

what are carbamazepine side effects

Answer 31

SIADH: fluid retention, hyponatremia Tetraogenic

Question 32

what metabolizes into phenobarbital

Answer 32

primidone

Question 33

whatis most commonly used for neonatal seizures

Answer 33

phenobarbital

Question 34

clinical use for phenobarbital

Answer 34

neonatal seizure, status epilepticus

Question 35

Main drug for Status epilepticus

Answer 35

benzodiazepine: DIazepam!

Question 36

ethosuximide MOA

Answer 36

blocks ttype Ca channels; inactive metabolite

Question 37

what agents can cause tetraogenic side effect?

Answer 37

carbamazepine, valproic acid

Question 38

whats the common drug used for neuropathic pain

Answer 38

gabapentin

Question 39

gabapentin MOA

Answer 39

blocks presynaptic Ca channels

Question 40

Gabapentin clinical use

Answer 40

generalized tonic seizure, partial seizure, neuropathic pain

Question 41

what causes steven johnson syndrome

Answer 41

mixing of valporoic acid and Lamotrigine-->toxicity-->bad rash-->SJ syndrome

Question 42

lamotrigine MOA

Answer 42

blocks Na and Ca channels

Question 43

Felbamate mOA

Answer 43

blocks Na channels and glutamate receptors

Question 44

Which agent specficially inhibits GABA reuptake

Answer 44

Tiagabine

Question 45

what drugs do you want to avoid with pregnancy, why?

Answer 45

phenytoin (fetal hydatoin syndrome) , tetraogenic:Carbamazepine, valproic acid

Question 46

what type of elimination is phenytoin

Answer 46

zero-order elimination

Question 47

what decreases phenytoin metabolism

Answer 47

barbiturates: high concentration of phenobarbital, warfarin increased pheny

Question 48

what is the difference between spasticity and spasm

Answer 48

Spasticity: exaggerated muscle stretch reflex due to injury in CNS spasm: injury is local and NOT in CNS

Question 49

which drug has Steven johnson syndrome side effect

Answer 49

Lamotrigine

Question 50

which drug is used for muscle spasm? spasticity?

Answer 50

baclofen: spasticity diazepam: spasm