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

Exam 2; Anti-Epileptic Agents Flashcards

(54 cards)

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1
Q

Epilepsy is not a disease, but what

A

a condition; set of symptoms

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2
Q

True or False

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

A

True

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3
Q

What is an epileptic seizure

A

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

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4
Q

What three things can an epileptic seizure result in

A

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

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5
Q

What is a secondary cause of seizures

A

tumor/injury

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6
Q

What is a congenital cause of a seizure

A

site in the brain

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7
Q

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

A

influx of Na
efflux of K
influx of Ca

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8
Q

Abnormal focal activity in the brain can lead to what

A

a spread of activity
inhibited by GABAergic neurons
activated by glutamate

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9
Q

This type of seizure lasts about 1-3 minutes

A

grand-mal (tonic-clonic)

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10
Q

What characterizes a grand mal seizure

A

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

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11
Q

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

A

aura; feeling like something is going to happen

loss of consciousness; confusion

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12
Q

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

A

petit-mal

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13
Q

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

A

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

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14
Q

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

A

partial seizures (40%)

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15
Q

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

A

grand-mal

petit-mal

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16
Q

A simple partial seizure results in what

A

no loss of awareness

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17
Q

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

A

focal motor seizures

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18
Q

What are the two major symptoms of focal motor seizures

A

complex movements of the head and eyes

“march” starting in the finger and moving more proximally

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19
Q

What was the results of a sensory partial seizures

A

illusions
visual
auditory
olfactory

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20
Q

What are the results of behavioral partial seizures

A

laughter
nauseated
fearful
vocal patterns (like Tourette’s)

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21
Q

What two symptoms could be seen post-seizure

A

may have post-seizure numbness or blindness

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22
Q

A complex partial seizure results in what

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A

loss of awareness

23
Q

What are three symptoms of complex partial seizures

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A

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

24
Q

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

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A

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

AU14 Pharmacology (29 decks)

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