Lecture 9 Anticonvulsants Flashcards by Brendan Knapp

partial seizures:
affect one or both hemispheres?
most commonly originate where?

one;

medial temporal lobe

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partial seizures:
which kind is characterized by sensory disturbances and retained consciousness?
in which kind is consciousness lost?

simple,
complex

both can secondarily generalize

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generalized seizures:
\_\_\_\_ = stiffening then jerking;
\_\_\_\_ = lapses in awarenesss, 100s per day. 
\_\_\_\_\_ = drops to the floor, falls.
\_\_\_\_ = quick repetitive jerks

tonic-clonic;
absence;
atonic;
myoclonic

status epilepticus = continuous seizures ( > 5 min)

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MCC seizure by age:
kids =
adults =
elderly =

genetic (or febrile infection);
tumor;
stroke

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seizures are characterized by ____, _____ neuronal firing

synchronized, high frequency

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a _____ starts the seizure = excessive neuronal discharge due to imbalance in ratio of excitation/inhibition

paroxysmal depolarization shift

Na influx

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_____ = repeated stimulation sensitizes an area to become a focus

kindling

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frequency dependent block:
drug binds more avidly at ___ frequencies. drug (does or does not) dissociate between spikes?
block ____ each spike

higher;
does not;
accumulates

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voltage dependent block:

drug binds tighter at ____ Channel. ____ percentage of channels are always blocked

more depolarized;

higher

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phenytoin:

blocks ____ channels and prolongs _____. first line for ____. also used for ____ and ____

Na, inactivation;
status epilepticus (First line);
partial, tonic-clonic

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phenytoin side effects:
\_\_\_\_ hyperplasia;
2 eye effects ; 
dermatologic effect = 
teratogenic-causes \_\_\_\_ especially

gingival;
diplopia, nystagmus;
hirsutism;
cleft-palate

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phenytoin:
CYP \_\_\_\_;
cerebellar \_\_\_\_;
fun skin syndrome?
kinetics?

inducer;
ataxia;
SJS;
ZERO order

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carbamazepine:
blocks ___ channels. prolongs _____.
treats ____ and ____

Na;
inactivation state;
partial, tonic-clonic

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carbamazepine:
teratogenic
cerebellar \_\_\_\_;
blood problem = 
\_\_\_ toxicity

ataxia;
agranulocytosis/aplastic anemia;
liver

also nausea

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carbamazepine:
also first line for _____;
CYP ____

trigeminal neuralgia;

inducer

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ethosuximde:
blocks ____;
first line for _____.

T-Type calcium channels;

absence seizures

ethosuximide:
___ and ___ problems;
itching, depression

GI, sleep

benzodiazepines:
increase ____ action.
first line for acute _____ and seizure clusters

GABA-A;

status epilepticus

phenobarbital:
increase ____ action;
for ____ or ___ seizures

GABA-A;

tonic clonic, partial

phenobarbital:
CYP ____:
teratogenic;
cardio respiratory _____

inducer;

depression

gabapentin:
primarily blocks _____ channels.
somewhat increases ____ action;
mainly used for ___ seizures

Ca (N type);
GABA;
partial (Also general according to notes)

2 side effects of gabapentin:

sedation, ataxia;

also used for neuropathy, post-herpetic neuralgia FYI

lamotrigine:
mainly blocks ___ channels, inhibiting release of ____;
3 seizures its used for?

Na (also Ca according to notes);
glutamate;
abscence, partial (myoclonic), tonic-clonic

lamotrigine side effects:
2 skin probs:
myclonus;
eye problem =

severe rash, SJS;

diplopia

tigabine: increases ____ by ______; mainly for ____

GABA, reuptake; partial seizures something about GAT1 inhibition in notes

tigabine side effects: | somnolence, headache, ____ (psych), and notably _____

depression; | seizures

topiramate: blocks ____ channels, increases ____ action; used for ____ and ____

Na, GABA (and blocks NMDA according to notes); partial, tonic-clonic

topiramate effects: | mental ___, ____ (kidney effect), weight ____, ____ (eye effect)

dulling/sedation; kidney stones; | loss, glaucoma (and myopia)

valporate: ____ channel inactivation, inhibits _____; first line for ____; also for _____

increased Na; GABA transaminase --> increased GABA; tonic clonic; absence seizures

valproate effects: ____ toxicity, weight _____; teratogenic = ______; GI probs

liver; gain; neural tube defects

felbamate: used for refractory severe generalized and ____ seizures; fatal ____ or _____

myoclonic; | hepatotoxicity, aplastic anemia

levetiracetam: used for ___ and ____ seuzures; can cause ____ changes, ataxia, drowsiness

partial, tonic clonic; | personality/behavior

vigabatrin: inhibits _____; used for refractory _____ seizures. why is not used tho?

GABA transaminase = increased GABA; partial; high risk of permanent blindness

zonisamide: used for partial and ____ seizures; drowsiness, ____ impairment, severe _____

myoclonic; cognitive; rash