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Pharmacology and Therapeutics 2 Y2 > Anticonvulsants > Flashcards

Anticonvulsants Flashcards

1
Q

How to diagnose epilepsy

A

Electroencephalography (EEG) or MRI

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2
Q

Summarise the fundamental causes of epilepsy/seizures

A

Due to either an increase in excitatory transmission or a decrease in inhibitory transmission

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3
Q

5 different seizure types?

A

Tonic-clonic seizures – loss of consciousness-> muscle stiffening-> jerking/twitching-> deep sleep-> wakes up
Absence seizures – brief staring episodes with behavioural arrest
Tonic/atonic seizures – sudden muscle stiffening/sudden loss of muscle control
Myoclonic seizures – sudden, brief muscle contractions
Status epilepticus – > 5 min of continuous seizure activity

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4
Q

What are Tonic-clonic seizures

A

loss of consciousness-> muscle stiffening-> jerking/twitching-> deep sleep-> wakes up

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5
Q

What type of seizure involves loss of consciousness-> muscle stiffening-> jerking/twitching-> deep sleep-> wakes up

A

Tonic-clonic seizures

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6
Q

What are Absence seizures

A

brief staring episodes with behavioural arrest

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7
Q

What type of seizure involves brief staring episodes with behavioural arrest

A

Absence seizures

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8
Q

What are Tonic/atonic seizures

A

sudden muscle stiffening/sudden loss of muscle control

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9
Q

What type of seizure involves sudden muscle stiffening/sudden loss of muscle control

A

Tonic/atonic seizures

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10
Q

What are Myoclonic seizures

A

sudden, brief muscle contractions

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11
Q

What type of seizure involves sudden, brief muscle contractions

A

Myoclonic seizures

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12
Q

What is Status epilepticus

A

> 5 min of continuous seizure activity

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13
Q

What type of seizure involves > 5 min of continuous seizure activity

A

Status epilepticus

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14
Q

Simple vs complex seizures

A

Simple – retained awareness/consciousness

Complex – impaired awareness/consciousness

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15
Q

What drugs are used for Status epilepticus

A

Diazepam

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16
Q

What drugs are used for Tonic/atonic seizures

A

Valproate

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17
Q

What drugs are used for Absence seizures

A

Ethosuximide
lamotrigine
valproate

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18
Q

What drugs are used for Tonic-clonic seizures

A

Carbazepine
lamotrigine
valproate

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19
Q

What drugs are used for myoclonic

A

levetiracetam
topiramate
valproate

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20
Q

What drugs are used for simple partial/complex partial seizures

A

carbamazepine
lamotrigine
levetiracetam
valproate

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21
Q

What drug is used in ALL forms of epilepsy

A

Sodium valproate

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22
Q

Glutamate receptors? (3)

A

NMDA, AMPA and kainate

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23
Q

What is SVA2

A

Synaptic vesicle associated (SV2A) protein allows vesicle attachment to presynaptic membrane

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24
Q

what is the name of the protein which allows vesicle attachment to presynaptic membrane

A

SVA2

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25
families of drugs used as anti-convulsants?
VOLTAGE-GATED Na+ CHANNEL BLOCKER VGCC blockers Glutamate exocytosis inhibitors Glutamate receptor antagonist
26
Example of VGSC antagonist
Carbamazepine or LAMOTRIGINE
27
Example of VGCC antagonist
Ethosuximide
28
Example of SV2A inhibitor?
Levetiracetam
29
Glutamate receptor antagonist
topiramate
30
topiramate is an example of a ....
Glutamate receptor antagonist
31
Levetiracetam is an example of a
SVA2 inhibitor
32
Ethosuximide is an example of a
VGCC antagonist
33
Carbamazepine is an example of a
VGSC antagonist
34
What type of seizures are VGSC antagonists indicated in
- Tonic-clonic seizures
35
What type of seizures are VGCC antagonist indicated in
- Absence seizures
36
What type of seizures are SVA2 inhibitor indicated in
- Myoclonic seizures
37
What type of seizures are glutamate receptor antagonists indicated in
- Myoclonic seizures
38
What type of seizures is sodium valproate good for
All
39
What type of seizures are BDZ good for?
status epilepticus
40
What type of drug is indicated for Myoclonic seizures
Glutamate receptor antagonist
41
What type of drug is indicated for status epilepticus
BDZ
42
What type of drug is indicated for Absence seizures
VGCC antagonists (and lamotrigine)
43
What type of drug is indicated for tonic-clonic seizures
VGSC antagonists
44
What type of drug is indicated for tonic/atonic
sodium valproate ONLY
45
What type of seizure is the only effective treatment sodium valproate
Tonic/atonic
46
What seizures is lamotrigine used for
Tonic-clonic | Absence
47
What seizures is valproate used for
All
48
What seizures is carbamazepine used for
Tonic clonic
49
What seizures is ethosuximide used for
Absence
50
What seizures is topiramate used for
Myoclonic
51
What seizures is diazepam used for
Status epilepticus
52
What seizures is levitarecetam used for
Myoclonic
53
What seizures is ONLY valproate used for
Tonic atonic
54
How does CARBAMAZEPINE work?
- Stabilises inactive state of Na+ channel, reducing neuronal activity
55
How does LAMOTRIGINE work?
- Inactivates Na+ channels by blocking® reducing glutamate neuronal activity
56
How does ETHOSUXIMIDE work?
- T-type Ca2+ channel antagonist ® reduces activity in relay thalamic neurones
57
How does LEVETIRACETAM work?
- Binds to synaptic vesicle associated protein (SV2A) ® preventing glutamate release
58
How does TOPIRAMATE work?
- Inhibits NMDA & kainate receptors | - Also affects VGSCs & GABA receptors
59
Onset and half life and indications of carbamazepine
- Onset of activity within 1 hour (FAST) - 16-30-hour half-life (LONG) Indications: - Tonic-clonic seizures; partial seizures
60
Onset and half life and indications of lamotrigine
- Onset of activity within 1 hour (FAST) - 24-34-hour half-life (LONG) Indications: - Tonic-clonic seizures; absence seizures
61
Onset and half life and indications of ethosuximide
- Long half-life (50 hours) Indications: - Absence seizures
62
Onset and half life and indications of levetiracetam
- Fast-onset (1 hour); half-life (10 hours) Indications: - Myoclonic seizures
63
Onset and half life and indications of topiramate
- Fast-onset (1 hour); long half-life (20 hours) Indications: - Myoclonic seizures
64
Onset and half life and indications of valproate
- Fast onset (1h); half-life (12h) | Indicated for all
65
Onset and half life and indications of diazepam
- Rectal gel - Fast-onset (within 15 min); half-life (2 hours) Indicated for status epiliticus
66
How does valproate work?
- Inhibits GABA transaminase increases GABA-mediated inhibition - Means there is more GABA going around, also as GABA is metabolized to glutamate it means there’s less glutamate about
67
How does diazepam work?
- GABA receptor, PAM increases GABA-mediated inhibition

Pharmacology and Therapeutics 2 Y2 (24 decks)

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