Anticonvulsants Flashcards
(49 cards)
True or false: All epileptic episodes are accompanied by convulsions.
False. Not all, but majority. Some just involve loss of consciousness
What is the difference between primary and secondar epilepsy? Which is more common? How does treatment duration for each differ?
Primary (70%) - No specific cause. chronic drug treatment
Secondary (30%) - Known cause for seizure (e.g. stroke, illness), treat till underlying cause is gone
What are the 2 types of partial seizures?
Simple
Complex
What are the 5 types of generalized seizures?
Tonic Clonic Absence Myoclonic Febrile Seizures Status Epilepticus
Partial epilepsy originates from _ within the cortex. If the electrical activity spreads throughout the cortex, then you have a _
Small group of neurons (seizure focus)
Generalized tonic clonic seizure
A seizure characterized by no impairment of consciousness, non-spreading focal motor, sensory, autonomic or psychic disturbances is a _
Simple Partial seizure
A seizure characterized by impaired consciousness, dream-like state with/without automated movement and electrical activity that can spread through out the cortex is _
Complex partial seizure
A seizure that spreads through out both hemispheres of the brain, accompanied by immediate loss of consciousness and may or may not be convulsive is a _
Generalized seizure
A seizure characterized by a period of rigid extension of trunk and limbs accompanied by a loss of consciousness, followed by a period of rhythmic contraction of limbs is a _. This is also known as _
Tonic clonic seizure
Grand mal
A seizure characterized by a brief loss of consciousness, patient staring followed by rapid eye blinking, usually in patients aged 3 - puberty is a _. This is also known as _
Absence seizure
Petit mal
A seizure characterized by short episodes of muscle contractions that may reoccur over several minutes is _. The major cause of this type of seizure is _
Myoclonic
Permanent neurological damage
A seizure characterized by tonic clonic convulsions in young (up to 5 years) feverish children is _
Febrile seizures
A seizure characterized by repeated seizures without recovery of consciousness between them, with seizures lasting up to 30 minutes is _.
Status epilepticus
A type of seizure characterized as a medical emergency and carries risk of cardiovascular collapse and permanent brain damage is _
Status epilepticus
Would you expect more/less blood flow to an area of the brain involved with the onset of a seizure?
More blood flow
Three main objectives of antiepileptic drugs are _
Block origin of seizure activity
Block spread
Block syncronization of neuronal activity
4 antiepileptic drugs that work by inhibiting voltage gated sodium channels, thus extending the refractory period of neurons are _
Carbamazepine
Phenytoin
Lamotrigine
Valproic acid
2 antiepileptic drugs that work by inhibiting voltage gated calcium channels, thus inhibiting rhythmic activity of neurons are _
Ethosuxamide
Valproic acid
2 classes of antiepileptic drugs that enhance GABAergic inhibitory neurotransmission are _. What 2 other “individual” drugs have the same effect?
Benzodiazepine
Barbiturates
Valproic acid
Gabapentin
What type of calcium channels are responsible for the rhythmic firing activity of neurons and are thus the targets of valproic acid and ethosuxamide?
T-type calcium channels
What is the way to treat status epilepticus?
- Begin IV rapid acting antiepileptics (e.g. diazepam)
- support CV and repiratory function
- Follow with IV long acting antiepileptic (e.g. phenytoin)
What is the drug of choice for treating epilepsy in adult? What types of seizures is it good for? What types of seizures is it not good for?
Phenytoin
Good - Partial simple, partial complex, tonic clonic
Bad - Absence
What is the mechanism by which phenytoin works?
Blocks voltage gated sodium channels, blocks repeated firing
Under what conditions is phenytoin administered orally? IV? Does it bind plasma proteins? What are the 2 CYP enzymes that metabolize it? What is a prodrug for phenytoin that is used IM and IV?
Orally (chronic), IV (emergency)
Binds highly (90%) to plasma proteins
CYP2C9 and CYP2C19
Fosphenytoin
