Anticonvulsants

Question 1

Phenobarbital MOA

Answer 1

GABA-A agonist

Question 2

Phenobarbital Therapeutic Uses

Answer 2

most widely used anticonvulsant - acute and maintenance

Question 3

Phenobarbital Adverse Effects

Answer 3

sedation
polyphagia
PU/PD
panting
hepatoxicity
blood dyscrasia
alter thyroxine levels

Question 4

Phenobarbital Metabolism

Answer 4

hepatic metabolism via CYP450 enzymes

Question 5

Pentobarbital MOA

Answer 5

GABA-A agonist

Question 6

Pentobarbital Therapeutic Uses

Answer 6

emergency treatment of acute seizures = short acting

Question 7

Primidone MOA

Answer 7

GABA-A agonist

Question 8

Primidone Therapeutic Use

Answer 8

refractory anticonvulsant if phenobarbital is not working

Question 9

Primidone Adverse Effects

Answer 9

hepatic toxicity

Question 10

Primidone Contraindications

Answer 10

DO NOT USE IN CATS

Question 11

Diazepam MOA

Answer 11

GABA-A agonist

Question 12

Diazepam Therapetuic Use

Answer 12

appetite stimulant for cats
anticonvulsant
(different dosages)

Question 13

Diazepam Adverse Effects

Answer 13

hepatic toxicosis in cats

Question 14

Is diazepam used for maintence of seizure disorders?

Answer 14

NO - tolerance and cross tolerance can develop

Question 15

Clonazepam MOA

Answer 15

GABA-A agonist

Question 16

Clonazepam Therapeutic Uses

Answer 16

anticonvulsant in cats - no hepatic damage
refractory treatment for dogs that do not respond to phenobarbital

Question 17

Clonazepam Adverse Effects

Answer 17

withdrawal syndrome - taper off the dose

Question 18

Clorazepate MOA

Answer 18

GABA-A agonist

Question 19

Clorazepate Therapeutic Uses

Answer 19

refractory condition
safe for cats

Question 20

WHat is Clorazepate metabolized into?

Answer 20

desmethyldiazepam - active metabolite of diazepam

Question 21

Midazolam MOA

Answer 21

GABA-A agonist

Question 22

Midazolam Therapeutic Use

Answer 22

acute anticonvulsant action

Question 23

Potassium Bromide MOA

Answer 23

compete with Cl- transport at GABA receptors = hyperpolarization
stabilizes neuronal CMs

Question 24

Potassium Bromide elimination/metabolism/half-life

Answer 24

glomerular filtration
tubular reabsorption
long elimination half-life

Question 25

Potassium Bromide Therapeutic Use

Answer 25

add onto phenobarbital therapy (refractory seizures) can be used alone if hepatic damage

Question 26

Potassium Bromide adverse effects

Answer 26

weakness depression ataxia bromism: coughing in cats

Question 27

Potassium Bromide special considerations

Answer 27

diets high with Cl- influence bromide secretion

Question 28

Zonisamide MOA

Answer 28

block Na and T-type Ca2+ channels - inhibits depolarization stabilizes neuronal membrane

Question 29

Zonisamide Adverse Effects

Answer 29

ataxia vomiting sedating

Question 30

Zonisamide ADME

Answer 30

rapid and complete abdorption wide distribution partly excreted unchanged partly undergoes glucuronidation

Question 31

Levetiracetam MOA

Answer 31

modulates Ca2+ dependent NT release binds SNARE protein 2A - prevents exocytosis

Question 32

Levetiracetam Therapeutic Uses

Answer 32

preferred for patients with liver dx more potent - used in refractory epilepsy

Question 33

Drug combinations for Levetiracetam

Answer 33

phenobarbital/potassium bromide

Question 34

Gabapentin MOA

Answer 34

binds a2-delta subunit of Ca2+v reduces Ca2+ influx - inhibits exocytosis of NT

Question 35

Gabapentin Therapeutic Uses

Answer 35

anticonvulsant neuropathic path

Question 36

Can Gabapentin cross the BBB?

Answer 36

requires amino acid transporter

Question 37

Gabapentin half-life

Answer 37

short

Question 38

Felbamate MOA

Answer 38

NMDA antagonist potentiates GABA mediated neuronal inhibition

Question 39

Felbamate therapeutic uses

Answer 39

local and generalized seizures refractory seizures (last option bc expensive)

Question 40

Carbamazepine MOA

Answer 40

inhibition of Navs

Question 41

Carbamazepine therapeutic uses

Answer 41

treat neuropathic pain and manic-depressive illness

Question 42

Carbamazepine ADME

Answer 42

slow absorption long elimination half-life hepatic metabolism