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Flashcards in Anticonvulsants Deck (44):
1

What is epilepsy?

Chronic disorder characterized by recurrent seizures

2

What is the cause of primary epilepsy?

cause unknown

3

What is the goal of management for epilepsy?

Restoration of a normal pattern of activity

4

What are the two broad categories of seizures?

Partial
generalized

5

What are partial seizures?

Seizures that remain localized to one area of the brain, without LOC

6

Complex partial seizures usually start where in the brain? SSx?

Temporal lobe

Lip smacking, fumbling, scratching (no memory of events)

7

What are generalized seizures?

Abnormal electrical activity throughout the brain

8

What are tonic-clonic seizures?

LOC, with tonic spasms, followed by maximal tonic spasms

9

What is the tonic phase of a seizures?

Rigidity of all limbs, followed by a tremor that is actually an interruption of the tonis by relaxation

10

What is the clonic phase of a seizure?

Massive jerking of the body that slows over 0-120 seconds, usually leaving pt in a stuporous state

11

What is the physiological basis for seizures?

Abnormally excessive, synchronous, and rhythmic firing of hyperexcitable neurons

12

What are the four underlying causes of seizure development?

1. CNS injury
2. Congenital abnormality (birth trauma)
3. Genetic factors
4. Infections

13

What is the major genetic factor associated with seizures?

Defective genes coding for voltage gated ion channels, or GABA receptors

14

What are the ssx of complex partial seizures?

Impaired consciousness, dreamy disaffective state, and wwo automatisms

15

What are the ssx of absence (petit mal) seizures?

Impaired consciousness with staring spells, wwo eyeblink

16

Who usually has absence seizures? Prognosis?

Children, and is self-limiting

17

What are the characteristics of complex partial seizures?

Automatisms with affected consciousness

18

What are the four stages of generalized seizures?

1. Aura
2. Tonic phase
3. Clonic phase
4. Stuporous state and sleep

19

What are tonic seizures?

LOC with severe hypertonic spasms and autonomic effects

20

What are atonic seizures?

Sudden LOC with rhythmic clonic contractions, and autonomic effects

21

What are infantile spasms?

Recurrent myoclonic jerks of the body with sudden flexion or extension of the body and limbs

22

What is status epilepticus?

Continuous or very rapid recurring seizures, usually of the tonic-clonic type

23

What are the three stages of seizures development?

1. Initiation
2. Synchronization of surrounding
3. Propagation

24

What are the three main EPSPs in the CNS?

Na influx
Ca current
Paroxysmal depolarization

25

What are the four main IPSPs in the CNS?

K efflux
Cl influx
Pumps
Low pH

26

What percent of patients do not respond to antiepileptics?

20%

27

What percent of pts can antiepileptics completely eliminate seizures?

66%

28

What is the surgery that can be used to treat epilepsy?

Temporal lobe resection

29

What is the major issue with seizures?

Poorly controlled seizures are associated with a neuronal loss mediated by an excitotoxic process

30

What is the role of the vagus nerve in treating seizures?

Stimulation of it can reduce seizures

31

What are the three major drugs used to treat partial seizures?

Carbamazepine
Phenytoin
Valproate

32

What are the three major drugs used to treat tonic/clonic seizures?

Carbamazepine
Phenytoin
Valproate

33

What are the two major drugs used to treat absence seizures?

Ethosuximide
Valproate

34

What are the two major drugs used to treat myoclonic seizures?

Clonazepam
Valproate

35

What are the four major drugs used to treat status epilepticus?

Diazepam
Lorazepam
Phenytoin
Fosphenytoin

36

What are the three main MOA of anticonvulsants?

1. Decrease glutamate activity
2. Increase inhibitory GABA
3. Alter movement of ions across membrane (Ca)

37

What is the MOA of phenytoin?

Inactivation of VG Na channels

38

What is the MOA of carbamazepine?

Inactivation of VG Na channels

39

What is the MOA of lamotrigine?

Inactivation of VG Na and Ca channels

40

What is the MOA of ethosuximide?

Inactivation of VG Ca channels

41

What is the MOA of gabapentin?

Inactivation of VG Ca channels

42

What is the MOA of retigabine?

increase of K channel opening

43

What is the MOA of levetiracetam?

SV2A synaptic vesicle proteins

44

What is the MA of lacosamide?

CRMP-2