Neuro-Epileptic Drugs Flashcards by Michael Dennis

What is the definition of a seizure

Transient alteration of behavior due to disordered synchronous and rhythmic firing of brain neurons

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What class of drug is Oxcarbazepine

Prolonged fast inactivation voltage gated sodium channel

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What is the correlation between barbituates and needed levels of GABA

GABA independent

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Which class is gabapentin

Alpha calcium channel

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Which type of conditions can Calcium the T channels AEDs be used to treat

Petit mal aka absence seizures

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What is the mechanism of Vigabatrin

Blocks metabolism of GABA-T

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What is the general psychological risk associated with all AED

Depression and suicidal thoughts

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What are the AED indications for primidone

Tonic/colon seizures

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What are the sedating drugs given for treatment of nonconvulsive state epilepticus

Lorazepam
Diazepam
midazolam
Clonazepam

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Which class is ethosuximide

T type Calcium Channel inhibitor

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What drug class if Topiramate

AMPA receptor antagonist

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What is the mechanism of action for Tiagabine

Blocks the reuptake of GABA via GAT1, leading to increased concentration in the cleft

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What type of channel mediates the absence (petit mal) seizure

T type calcium channels

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What are the AED indications for phenobarbital

Broad spectrum

-Epilepsy

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What is the result of AED inducers taken with anticoagulants

Increase the clearance of warfarin, resulting in the increased risk for clots and thrombosis `

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Which class is levitiracetams (and all -racetams)

Synaptic vesicles 2A proteins which loads Glutamate into vesicles

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What are the AED indications for perampanel

Simple and complex seizures

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What is the side effect of giving valproic acid or lamotrigine

-Inhibits conjugation of grubs by UGT, resulting in the accumulation of parent drug

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What class of drug is lamotrigine

Prolonged fast inactivation voltage gated sodium channel

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How do AMPA receptors function

Ligands bind to the AMPA receptor and allow depolarization

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Which class is pregabalin

Alpha calcium channel

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Which class is clonazepam

Benzodiazepine (aka post synaptic GABAreceptor)

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What are the AED indications for lacosamide

Simple and complex seizures

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What is the mechanism of valproic acid

Blocks metabolism of GABA via GABA-T

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If a patients comes into the hospital with status epilepticus, what are the drugs given via the second IV

Fosphenyoin Phenytoin Valproic acid Levetiracetam

What is the correlation between benzodiazapines and needed levels of GABA

Benzodiazepines are GABA dependent

What is the result of AED inducers taken with HIV medications

Increases the clearance and increased risk of HIV replication

What are the side effects of vigabatrin

Progressive, permanent, bilateral concentric vision loss

What are the AED indications for diazepam

Epilepsy

What is the mechanism of action for benzodiazepines

-Bind to an allosteric GABA receptor binding site that potentiates GABA binding and hyperpolarization

What is unique about carbamazepine and its metabolism

Induces CYP450, which subsequently increases its own metabolism, so there is a drop in efficacy of the drug, leading to recurrent seizures

What are the AED indications for valproic acid

- Absence seizure - Broad spectrum seizure - Epilepsy

What are the AED indications for lamotrigine

Simple and complex Parital seizures

Which class is primidone

Barbituate (aka post synaptic GABAreceptor)

What drug class is perampanel

AMPA-receptor antagonist

What are the three general classes of AED that inhibit the post synaptic GABA receptors

- Barbituates - Benzodiazapines - Topiramate

Which class of drug is Tiagabine

Presynaptic GAT-1 inhibitor

What are the AED indications for Ethosuzimide

Absence seizures

What class if felbamate

NMDA receptor antagonist

What is the mechanism that some AED can cause osteoporosis

They induce CYP450, which causes vitamin D catabolism, resulting in lower circulating levels. This decreases absorption of Calcium in the intestine and subsequent increased PTH secretion and demineralization from bone

What are the AED indications for lorazepam

Epilepsy

What are the steps in the activation and depolarization of sodium voltage gated channels

1) Resting state (activation gate closed) 2) Open state (both open) 3) Fast-Inactivated (inactivation gate closed) 4) Inactivated closed (both gates closed)

Which class of drug is lacosamide

Prolonged fast inactivation voltage gated sodium channel

What class of drug is vigabatrin

Presynaptic GABA-T inhibitor

What are the side effects of carbamazepine

* Inducer of CYP-450 - Leukopenia/neutropenia/thrombocytopenia - Osteoporosis

How does the action of binding for the AED on voltage gated sodium channels effect when the AED can actually bind

AEDs can only bind to the pore when the activation gate is open, whcih is in the open state or the fast-Inactivated state

What are the AED indications for clonazepam

- Absence seizure | - Myoclonic seizure

What class of drug is valproic acid

Presynaptic GABA-T inhibitor

What is the effect of the the newer AEDs that are eliminated by the kidneys, rather than the liver

Patients with renal insufficiency must have their dose levels adjusted

Which drug class is Lacosamine

Enhanced slow inactivation voltage gated sodium channel

What class of drug is Carbamazepine

Prolonged fast inactivation voltage gated sodium channel

What is the definition of epilepsy

Acquired or inherited malformation of neuronal ion channels or NT systems that disrupt the electrical activity of the brain

Which class is phenobarbital

Barbituate (aka post synaptic GABAreceptor)

Which class of drug is valproic acid

Prolonged fast inactivation voltage gated sodium channel

What is the mechanism of an enhanced slow inactivation of sodium channels

Prolonged depolarized stimuli, the drug will reduce the amplitude and frequency of the sustained repetitive firing spikes

What are the AED indications for levetiracetam

Epilepsy

What are the AED indications for primidone

Simple and complex partial seizures

If a patients comes into the hospital with status epilepticus, what is the first drug given if IV is not available

Midazolam

What are the side effects associated with Phenytoin

* Inducer of CYP450 - gingival hyperplasia - hypothyroidism - CV risk - Hypocalcemia/Osteoporosis

What are the nonsedating drugs given for treatment of nonconvulsive state epilepticus

- Phenytoin - Fosphenytoin - Valproate - Levetiracetam - Lacosamide

Which AED drugs are associated with osteoporosis during chronic use

- Cabamazepine - Phenytoin - Phenobarbital - Valproic acid

What are the AED indications for phenytoin

Tonic/clinic seizures | -Epilepsy

What are the side effects of phenobarbital

* Inducer of CYP450 - CNS depression - Osteoporosis

Which class of drug is topirimate

Prolonged fast inactivation voltage gated sodium channel

What is the result of AED induces while taking OCs

Increases the clearance of the OC, resulting in increased risk of pregnancy

What are the AED indications for topiramate

Broad spectrum

Which class of drug is zonisamide

Prolonged fast inactivation voltage gated sodium channel

What is a generalized seizure

Seizure that involves both hemispheres

What is the binding site of AEDs with regards to those that bind to the voltage gated sodium channels

Binding site is in the interior of the sodium channel

Which class of drug is phenytoin

Prolonged fast inactivation voltage gated sodium channel

What allergic reaction is possible with the drug zonisamide

Allergic reaction to a sulfonamide

Which class is diazepam

Benzodiazepine (aka post synaptic GABAreceptor)

What are the AED indications for oxcarbazepine

Simple and complex partial seizures

What is meant when they say that sodium voltage gated AED are use dependent

Because they bind to the inside of the pore, they can only bind when the pore is open. Therefore, the amount of binding is proportional to the frequency that the channel is open

Which class of drug is Rufinamide

Prolonged fast inactivation voltage gated sodium channel

Which class is lorazepam

Benzodiazepine (aka post synaptic GABAreceptor)

What is a complex partial seizure

Starts in a localized cortical site and includes impairment of consciousness

What is the mechanism of action for Barbiturates

Bind to an allosteric binding site on GABA receptor and increased Chloride channel opening

Which class is Topiramate

GABA agonist - Sodium fast inactivator - AMPA receptor blocker

What is a simple partial seizure

Starts in a localized cortical region and included the Preservation of consciousness

What is the side effect of giving phenytoin, carbamazepine, or phenobarbital

Inducers of CYP 450 | Induces conjugation of drugs by UGT, resulting in the reduction of the parent drug

If a patients comes into the hospital with status epilepticus, what is the first drug given via IV

Lorazepam or diazepam

Which class is clobazam

Benzodiazepine (aka post synaptic GABAreceptor)

What are the characteristics of a sodium channel when it is in the inactivated state

Aka fast inactivated state | -Can not be deactivated directly or instantly because it is closed from the inside

What are the AED indications for carbamazepine

Broad spectrum

What are the kinetics associated with Phenyoin

Zero order

Neuro-Epileptic Drugs Flashcards

(86 cards)