Exam 2; Anti-Epileptic Agents Flashcards Preview

AU14 Pharmacology > Exam 2; Anti-Epileptic Agents > Flashcards

Flashcards in Exam 2; Anti-Epileptic Agents Deck (54):
1

Epilepsy is not a disease, but what

a condition; set of symptoms

2

True or False
epilepsy is generally not life threatening, the quality of life is greatly affected

True

3

What is an epileptic seizure

abnormal electrical activity originating in the brain; the brain equivalence of a heart arrthymia

4

What three things can an epileptic seizure result in

brief episodes of loss of consciousness
convulsive movements
disturbances of perception or behavior

5

What is a secondary cause of seizures

tumor/injury

6

What is a congenital cause of a seizure

site in the brain

7

What three different movements of ions can cause abnormal; focal activity in the brain

influx of Na
efflux of K
influx of Ca

8

Abnormal focal activity in the brain can lead to what

a spread of activity
inhibited by GABAergic neurons
activated by glutamate

9

This type of seizure lasts about 1-3 minutes

grand-mal (tonic-clonic)

10

What characterizes a grand mal seizure

severe muscle contraction
tonic; muscle contraction and extension
clonic; muscle twitching

11

What two things occur during a grand-mal seizure not related to muscle activity

aura; feeling like something is going to happen
loss of consciousness; confusion

12

These are 5-20 second lapses of consciousness; blank stare

petit-mal

13

Which group of people is most affected by petit-mal seizures

children
may end after puberty
a child could have hundreds of these a day

14

This is often the result of an injury of some kine; affects selective regions of the brain; defined by site of origin

partial seizures (40%)

15

What are the two types of generalized seizures (60%)

grand-mal
petit-mal

16

A simple partial seizure results in what

no loss of awareness

17

These partial seizures are in areas of the brain that control body motion

focal motor seizures

18

What are the two major symptoms of focal motor seizures

complex movements of the head and eyes
"march" starting in the finger and moving more proximally

19

What was the results of a sensory partial seizures

illusions
visual
auditory
olfactory

20

What are the results of behavioral partial seizures

laughter
nauseated
fearful
vocal patterns (like Tourette's)

21

What two symptoms could be seen post-seizure

may have post-seizure numbness or blindness

22

A complex partial seizure results in what

loss of awareness

23

What are three symptoms of complex partial seizures

starting followed by bizarre behaviors
alteration in feeling or behavior
associated with amnesia and confusion

24

This is a medical emergency; when someone has long and repeated grand mal seizures

status epilepticus

25

When someone undergoes status epileptics, what is occurring in their muscles

every muscle in their body is constricted
need to get oxygenated blood and therefor they die of cerebral asphyxiation

26

All anti-seizure medications decrease what

neuronal firing rate

27

anti-seizure medications may cause an increase in what

suicidal behavior

28

anti-seizure agents may act on these three locations

GABA neurons
glutamate neurons
ion channels

29

This drug inhibits Na channels in the brain, slowing the recovery rate of neurons

phenytoin

30

What is the therapeutic index of phenytoin

it is relatively low; will see toxic effects

31

Phenytoin is generally not what

a CNS depressant
can cause some sedation

32

What three things can result from high doses of phenytoin

respiratory depression
cardiovascular collapse
may cause nausea and ataxia

33

What two things can result from chronic use of phenytoin

gingival hyperplasia
vestibular effects; diplopia, ataxia, blurred vision

34

What are two major toxicities of phenytoin

teratogenic (fetal hydantoin syndrome)
life-threatening rash (Steven-Johnson syndrome)

35

This is the drug of choice for partial seizures, acts on Na channels; induces P450

carbamazepine

36

What are some symptoms of carbamazepine toxicity

blurred vision
diplopia
drowsiness
fetal defect (spina bifida)
aplastic anemia

37

This is for all but petit mal, activates GABAergic neurons and induces P450

phenobarbital

38

What are two toxicities of phenobarbital

sedation
drowsiness

39

These drugs activate GABAergic neurons

benzodiazepines; diazepam

40

This is a diuretic; carbonic anhydrase inhibitor which may increase CO2 in the brain leading to decreased activity

acetazolamide

41

These are the DRUGS OF CHOICE to treat petit mal

succinimides, ethosuximide

42

What is the mechanism of succinimides; ethosuximide

inhibits Ca channels in the CNS, slowing down neurotransmitters

43

What are two side effects of succinimides

GI upset; nausea and vomiting
drowsiness

44

This drug is used for all seizure types, it has multiple mechanisms

sodium valproate

45

what are three mechanisms of sodium valproate

decreases GABA breakdown
increases GABA synthesis
may also act on Na and Ca channels

46

What are 5 toxicities of sodium valproate

GI upset
CNS sedation
tremors
potentially fatal hepatitis
perhaps fetal damage; drop in IQ

47

These four agents to treat partial seizures activate GABA

topriamite
gabapentin
tigabine
vigabine

48

These four agents to treat partial seizures act on Na

lamotrigine
zonisamie
rufinamide
lacosamide

49

This agent to treat partial seizures acts on Ca

pregabalin

50

This agent to treat partial seizures acts on K

ezogabine

51

This agent to treat partial seizures blocks glutamate activity

perampanel

52

This agent to treat partial seizures has an unknown mechanism

levetiracetam

53

This is a high therapeutic benzodiazepine used to status epileptics; it suppresses neuronal activity without killing the patient

Diazepine

54

What are four special considerations in the treatment of epileptic seizures

patient must be educated
patient must be always monitored
drugs taken for a long time
mixed type of seizures