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845 IP Test 2 > Antiepileptics Masserano > Flashcards

Antiepileptics Masserano Flashcards

(50 cards)

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1
Q

Epilepsy definition

A

Two or more recurrent seizures unprovoked associated with an excessive neuronal discharge

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2
Q

Seizure recurrence evaluation

A
  1. Problems with compliance?
  2. Pharmacokinetic factors?
  3. Increase dose?
  4. Change med?
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3
Q

Focal seizures

A

Previously partial seizures and start in cells on one side of the brain

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4
Q

Generalized seizures

A

Previously primary generalized, start on both sides of the brain at onset

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5
Q

Focal aware seizures

A

Awareness remains intact even if the person is unable to respond or talk

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6
Q

Focal impaired awareness

A

If awareness is impaired or affected at any time during a seizure even if a person has a vague idea of what happened

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7
Q

Focal motor seizure

A

Some type of movement occurs during the event

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8
Q

Focal non-motor seizure

A

Other symptoms that occur first such as changes in sensation, emotion, or thinking

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9
Q

Auras

A

Describes the symptoms patients may feel before a seizure

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10
Q

Generalized motor seizure

A

Generalized tonic (stiffening) clonic (jerking) seizures

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11
Q

Generalized non-motor seizures

A

Absence seizures that involve brief changes in awareness, staring, and repeated movements like lip smacking

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12
Q

Impaired awareness onset

A

May begin as focal seizure that spreads to larger portion of the temporal lobe and impair consciousness

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13
Q

Absence or Petit Mal

A

No aura, focus, postictal state. Freeze behavior of blank stare where the thalamus is involved. Spike and dome on the EEG

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14
Q

Tonic-clonic or Grand Mal

A

Massive discharge of all the motor neurons in the cortex. Tonic = contraction of all voluntary muscles. Clonic = contraction and relaxation

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15
Q

Drugs that are effective in focal/generalized seizures

Prolong inactivation of Na channels

A 
Carbamazepine
Oxcarbazepine
Phenytoin
Zonisamide
Lamotrigine
Valproic acid
Topiramate
Rufinamide
Lacosamide
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16
Q

Enhance Neuronal GABA inhibition

A

Benzos, Barbiturates, vigabatrin, tiagabine

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17
Q

Reduce glutamate excitation

A

Keppra, felbamate, topiramate, perampanel

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18
Q

Inhibit Ca currents

A

Ehosuximide and valproic acid

Gaba

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19
Q

Enhances outward potassium currents

A

Ezogabine

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20
Q

Which drugs increase clearance of oral contraceptives

A

Phenytoin, carbamazepine, phenobarbital, oxcarbazepine.

Should receive supplemental vitamin D and calcium

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21
Q

Phenytoin and fosphenyotin therapeutic uses

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A

Focal seizures, general tonic-clonic and status epilepticus, trigeminal neuralgia

22
Q

Valproic acid and phenyotin interxns

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A

Competes for CYP2C9 and will inhibit warfarin metabolism and produce hypoprothombinemia

23
Q

Phenytoin toxicities

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A 
Cerebellar-vestibular
Hirsutism
*Osteopenia*
Anemia
Steven-johnsons syndrome
Gingival hyperplasia: good dental hygiene is important
24
Q

Carbamazepine therapeutic uses

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A

Focal seizures, generalized tonic-clonic, neuropathic pain, bipolar disorder

25
Carbamazepine box warnings
Aplastic anemia and agranulocytosis | Serious dermatologic rxns (SJS)
26
Lamotrigine therapeutic uses
Focal seizures Primary tonic-clonic seizures Add-on for focal seizures with secondary tonic-clonic seizures Bipolar disorder
27
Lamotrigine black box warning
Steven-johnsons syndrome
28
Zonisamide therapeutic use
Add-on for focal seizures and can be used for generalized tonic-clonic
29
Zonisamide contraindications
History of kidney stones
30
Rufinamide therapeutic use
Adjunctive treatment of seizures associated with Lennox-gastaut syndrome in children 4 years and older
31
Locasamide therapeutic use
focal seizures and is a CV with similarities to benzos
32
Valproic acid MOA
Prolongs inactivation period of Na channels | Reduces Ca++ T currents
33
Valproic acid therapeutic uses
Adjunct for all seizure types and sole treatment for focal seizures and complex absence seizures
34
Depakote adverse effects
GI symptoms Box warnings: hepatitis, teratogenic, pancreatitis Pregnancy category D (X with migraines)
35
Phenobarbital MOA
Facilitates GABAa receptor activity and potentiating the effects of GABA.
36
Phenobarbital therapeutic uses
Focal and generalized tonic-clonic | Emergency control of certain acute convulsive episodes
37
Tiagabine MOA and therapeutic use
Inhibits GABA transporter GAT-1 in both neurons and glia | Add-on for focal seizures
38
Vigabatrin MOA
Irreversible inhibition of GABA transaminase
39
Vigabatrin therapeutic uses
Add on for focal seizures and infantile spasms
40
Vigabatrin box warnings
Vision loss
41
Keppra MOA
Binds to synaptic vesicle protein 2A and acts on glutamate transmission
42
Keppra therapeutic uses
Focal seizures Myoclonic seizures General tonic-clonic seizures
43
Gabapentin MOA
reduce calcium by modulating the voltage gated calcium channel alpha1 subunit
44
Topiramate MOA
AMPA/kainate antagonist | Prolongs inactivation period of Na+ channels
45
Topiramate side effects and contraindications
Pregnancy category D and contraindicated for history of kidney stones
46
Perampanel MOA
AMPA/glutamate receptor antagonist
47
Perampanel black box warning
Psychiatric and behavioral adverse rxns
48
Felbamate MOA
Antagonist of glycine binding site on NMDA receptor
49
Felbamate Black box warnings
Aplastic anemia and hepatic failure
50
Ethosuximide MOA
Ca++T currents in the Thalamus preventing oscillatory firing characteriistics of asbence seizures

845 IP Test 2 (2 decks)

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