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CNS Drugs > Antiepileptics > Flashcards

Antiepileptics Flashcards

1
Q

Anti-epileptics/ anticonvulsants and drug class.

A 
Hydantoin: Phenytoin
Iminostilbenes: Carbamazepine 
Dialkylacetate: Valproic acid
Suxinamides: Ethosuximide
GABA analogs: Gabapentin, pregaba, vigabatrin and baclofen
Phenyltriazine: Lamotrigine
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2
Q

Phosphate ester of phenytoin, rapidly hydrolyzed to pheny in vivo. Neutral pH 7 so less irritating

A

Fosphenytoin

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3
Q

Why Phenytoin Na when injected is irritating?

A

must be buffered to an alkaline pH to maintain solubility thus very irritating when injected.

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4
Q

Phenytoin and Carbamazepine MOA via Na.

A

P: decreases Na content of nerve in brain, dec. excitability of cells for seizures
C: blocks Na channels, reducing abnormal impulses in brain

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5
Q

Phenytoin SEs.

Explain Hydantoin syndrome.

A 
Gingival hyperplasia (needs mouth hygiene) tx= Chlorhexidine 0.15%, encephalopathy blood dyscrasias, nystagmus hirsutism, SJS
Hy Syndrome: congenital defect: cleft palate
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6
Q

Phenytoin metabolism. Similar to what drug?

A

Metabolized by p-hydroxylation followed by conjugation similar to Phenobarbital.

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7
Q

Carbamazepine SEs.

A

Rash, inc. liver enzymes, neutropenia

Chronic: drowsiness vertigo SJS aplastic anemia coma hyper irritability convulsions resp depression

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8
Q

Topiramate SEs.

A

cognitive dysfunction headache, KIDNEY STONES and WEIGHT LOSS

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9
Q

Clobazam SEs.

A

Tolerance, insomia depression dizziness drowsiness light headedness ataxia

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10
Q

True absence seizures

A

petit mal- 10-30 secs causes alteration of consciousness, starts w occasional blinking (Nystagmus)

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11
Q

Sudden brief involuntary jerking of facial lim and trunk muscles or all body.

A

Myoclonic seizures

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12
Q

DOC for petit mal.

What drugs not to be used?

A

Ethosuximide

-Avoid Pheny and Carb

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13
Q

Tonic-clonic seizure is also called? And separately signs or symptoms.

A

Grand mal. Tonic- gen. in children, muscle stiffening (tone)

Clonic- musc contraction w relaxation, sudden loss of consciousness, become rigid, falls to ground, lasts 1 min.

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14
Q

DOC for partial, tonic clonic sz and trigeminal neuralgia.

DOC for partial and generalized seizures.

A

Carbamazepine

Lamotrigine

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15
Q

Phenytoin dosage forms and percentages.

A

100% -susp and chewable,

Pheny 90% Na 10% -caps and IV

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16
Q

BZPs:
DOC for status epilepticus.
Highest tolerance.

A
  • Diazepam

- Clobazam

17
Q

DOC for trigeminal neuralgia. Avoid with what because it decreases its bioavailability?

A

Gabapentin. Avoid w antacids

18
Q

Antiepileptics that decreases efficacy of OCPs.

A

Carbamazepine, Phenytoin, Clonazepam

DI: Lorazepam (highest)

19
Q

Antiepileptics that do not decrease efficacy of OCPs.

A

Gabapentin (least), Valproic acid, Lamotrigine

20
Q

Antiepileptics that cause SJS SE.

A

Carbamazepine, Valproic acid, Divalproex

21
Q

Phenobarbital and Phenytoin stimulates this type of organ enzyme.

A

Hepatic microsomal enzymes.

22
Q

Antiepileptics indicated for diabetic neuropathy and post hepatic neuralgia.
DOC for trigeminal neuralgia.

A

Pregabalin and Gabapentin (DOC)

23
Q

Alternate antiepileptic DOC in pregnancy, why?

A

Lamotrigine, low teratogenicity

24
Q

Monitoring parameters for Phenytoin.

A

Plasma pheny levels, liver function test, CBC, BP, vital signs (with IV use)

25
Q

Antiepileptics that reduce Ca surrent through T-channels.

A

Ethosuximide, Valproic acid and Valproate

26
Q

Antiepileptics that reduces NMDA receptor activation.

A

Felbamate

27
Q

Type of seizure, loss of consciousness and involvement of both hemispheres, can be subdivided by EEG and clinical manifestation.

A

Generalized seizure.

28
Q

Type of seizure that occurs to children from 3 months-5 years old due to high fever.

A

Fabrile seizure

29
Q

Explain simple partial seizure

A

Simple partial: consciousness not impaired, motor symptoms jerking, lip smacking, chewing, eye dilated, sweating, with behavioral symptoms

30
Q

Explain complex partial seizure.

A

consciousness impaired, begin as simple, with or without automatism: picking at cloths, visual auditory hallucinations

31
Q

DOC for myoclonus and tonic clonic sz?

And this drug is 2nd choice for what?

A

Valproic acid

Absence seizure

CNS Drugs (11 decks)

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