Antiepileptics - session 22 Flashcards

(33 cards)

1
Q

What is the most common cause of recurrent seizures in dogs?

A

Idiopathic epilepsy

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2
Q

What is the most common cause of seizures in cats?

A

intracranial

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3
Q

If a dog/cat presents with cluster seizures. There is no history of seizures previously. What class of seizures should you consider?

A

intracranial

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4
Q

How is phenobarbital metabolized?

A

Liver

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5
Q

List the most common persistent AE associated with Phenobarbital

A

PU/PD

polyphagia

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6
Q

What steps should be taken when rapid elevation of ALT is noted in a dog taking phenobarbital?

A

Stop PB immediately, switch to alternative anti-epileptic drug

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7
Q

What AED is a risk factor for superficial necrolytic dermatitis in dogs?

A

Phenobarbital

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8
Q

Clinical signs of anprexia, sedation, ascites, and icterus are associated with what process?

A

Hepatotoxicity

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9
Q

At what frequency should animals receiving chronic PB therapy be evaluated?

A

every 6 months

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10
Q

What is a risk of administering Phenobarbital with a tetracycline?

A

P450 inhibitors can inhibit hepatic metabolism causing inc in serum conc and PB toxicity

P450 drugs: Chloramphenicol, tetracyclines, cimetidine, ranitidine, enilconazole

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11
Q

What drugs are P450 inhibitors?

A

H2 blockers:

  • cimetidine
  • ranitidine

antibiotics:

  • chloramphenicol
  • fluoroquinolones (enrofloxacin, marbofloxacin)

azole antifungals:

  • ketoconazole
  • enilconazole
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12
Q

What is the initial AED of choice in dogs with hepatic dysfunction?

A

potassium bromide

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13
Q

What AE does Potassium bromide have in cats that makes it contraindicated?

A

Fatal Progressive bronchitis

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14
Q

What are the dietary Chloride requirements when on KBr?

A

Keep normal Cl

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15
Q

What adverse effects are associated with KBr?

A

PU/PD, polyphagia - less dramatic then with PB

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16
Q

Which AED does not cause sedation?

17
Q

Which AEDs are a structural analog in GABA?

A

Gabapentin, Pregabalin

18
Q

Which AED can cause KCS?

19
Q

Which AED do patients rapidly develop tolerance to anticonvulsant effects?

20
Q

What is the preferred choice for chronic AED therapy in cats?

A

Phenobarbital

Diazepam = hepatotoxicity

21
Q

What AED’s are metabolized by the liver?

A
Phenobarbital
Zonisamide
Diazepam
Gabapentin (minor)
Felbamate
22
Q

Which AED is associated with dec tear production?

23
Q

Which AED is contraindicated in cats due to its association with potentially fatal drug-induced bronchitis?

A

Potassium Bromide

24
Q

Which anti-epileptic drug can be used as an at-home, rectally administered emergency treatment for cluster seizures?

25
What is the criteria for starting an antiepileptic?
- 3+ seizures in 24 hr - seizures >5min - 2+ seizures in 6 months - protracted severe or unusual
26
What AED is recommended as a second line AED with little evidence supporting its use as monotherapy?
Levetiracetam
27
What AED's can be used as monotherapy?
Phenobarbital, Potassium Bromide
28
Which AED causes acute fatal hepatic necrosis when administered orally to cats?
Diazepam
29
What 2 drugs have significant side effects in cats?
Potassium bromide - allergic bronchitis | Diazepam - hepatic necrosis
30
In dogs and cats, what is the most effective antiepileptic drug?
Phenobarbital
31
What class of AEDs is recommended as first line therapy to stop seizure activity with status epilepticus?
Benzodiazapines (Midazolam)
32
What is the goal of emergent anticonvulsant therapy?
stop all seizure activity immediately and prevent additional seizures for 24hr period
33
Which Benzodiazepine can be given IM?
Midazolam