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PHRM 845 > SEIZURES > Flashcards

SEIZURES Flashcards

1
Q

myoclonic seizure

A

shock like contraction of muscles
isolated jerking

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2
Q

tonic seizure

A

in children
rigididy as a result of increased tone in extensor muscles

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3
Q

clonic seizure

A

babies and young children
rapid and repetitive movement

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4
Q

atonic seizure

A

sudden loss of muscle tone
patients fall if standing

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5
Q

tonic clonic

A

tonic phase - rigidity followed by clonic rapid motion

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6
Q

seizure definition

A

paroxysmal disorder of CNS by abnormal cerebral discharges with or without loss of consciousness

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7
Q

convulsion

A

attack manifested by involuntary muscle movements

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8
Q

epilepsy

A

repeated seizures due to damage, irritation, chemical imbalance in brain
- sudden electrical discharge

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9
Q

what kind of firing is in seizures

A

disordered, synchronus, rhythmic
synchronized hyperexcitability

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10
Q

seizure classifications

A

focal onset
generalized onset
unknown onset

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11
Q

focal onset location

A

comes from one place in the brain
being in temporal lobe

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12
Q

generalized onset location

A

all over the brain

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13
Q

focal seizures usually due to

A

lesion, head trauma, infection

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14
Q

generalized seizures description

A

loss of consciousness, both brain hemispheres, idiopathic, usually genetic

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15
Q

how do primary generalized seizures propagate

A

diffuse via interconnections between thalamus and cortex

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16
Q

difference in EEG for focal vs. generalized seizure

A

focal has different waves
generalized all has the same

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16
Q

aware focal seizures

A

no loss of consciousness
auras can occur
limited jerking of single part of body

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17
Q

impaired awareness focal seizures

A

most common
clouding of consciousness
repetitive motor behaviors
POSITICTAL STATE
aura common

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18
Q

generalized absence seizure typical

A

no convulsions, aura, postictal period, brief loss of consciousness
staring or eye flickering

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19
Q

generalized absence seizure atypical

A

slower onset than typical

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20
Q

do generalized tonic clonic have aura

A

no

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21
Q

do focal to bilateral have aura

A

brief aura

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22
Q

status epileptics definition and goal

A

seizure lasting > 30 mins
want to bring seizures within 60 minutes

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23
Q

does one seizure make an epilepsy

A

no

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24
Q

when should we stop drug therapy in seizures

A

gradually stopped who havent had seizures in 2-5 years

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25
Q

depolarization involves what

A

activation AMPA and NMDA by glutamate and Ca channels
influx of Ca

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26
Q

hyperpolarization involves what

A

activation GABA receptors and K+ channels
influx Cl and efflux K+

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27
Q

can we stop epilepsy drugs suddenly

A

no, higher risk for status epilepticus

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28
Q

drugs that increase risk of seizure

A

alcohol
bupriopion
theophylline
CNS stimulants
oral contraceptives
depressant withdrawal
clozapine

29
Q

MOA anticonvulsants

A

stabilize and reduce neuronal excitability

30
Q

drugs that decrease sodium influx, prolong inactivation of Na+ channels

A

carbemazepine
oxcarbazepine
phenytoin
lacosamide
lamotrigine
valproate

31
Q

drugs that decrease Ca influx

A

lamotrigine
ethosuximide
valproate

32
Q

drugs that increase GABA inhibition

A

barbituates
benzodiazepines
valproate
gabapentin
vigabatrin
tiagabine

33
Q

excitatory antagonists

A

felbamate
topiramate

34
Q

why are there few drugs targeting K channels

A

hERG target, bad side effects like arrythmias

35
Q

excitatory pre synaptic targets

A

Na channels
Ca channels

36
Q

excitatory post synaptic targets

A

NMDA
AMPA

37
Q

inhibitory pre synaptic targets

A

GABA transporter (GAT-1)
GABA transaminase (GABA-T)

38
Q

inhibitory post synaptic targets

A

GABA A and B receptors

39
Q

phenytoin MOA

A

binds inactive state Na channel
not isoform selective- other targets

40
Q

what is fosphenytoin

A

prodrug phenytoin IV

41
Q

phenytoin kinetics are

A

non linear, dose dependent

42
Q

phenytoin interactions

A

displaced from plasma proteins (increase blood level conc)
induces P450s (inc. conc of other drugs)

43
Q

side effects phenytoin

A

arrythmia
visual
ataxia - loss coordination
GI sx
hirsutism
rash

44
Q

carbemazepine and oxcarbazepine structure

A

tricyclic

45
Q

carbemazepine and oxcarbazepine MOA

A

binds and stabilizes inactivated state of Na channels

46
Q

carbemazepine and oxcarbazepine interactions

A

cyp450, increase its metabolism

47
Q

carbamazepine side effects

A

blurry vision, ataxia, GI, sedation, rash (Stevens Johnson sydrome),eosinophillia / DRESS

48
Q

lacosamide MOA

A

enhances inactivation of Na+ channels

49
Q

lacosamide toxicity

A

dermatological reactions, cardiac risk (PR interval), visual disturbances

50
Q

barbituates drugs

A

phenobarbitol
primidone

51
Q

who is phenobarbital drug of choice in

A

infants up to 2 months

52
Q

phenobarbital MOA

A

binds to allosteric site on GABA a a
increases DURATION Cl- channel opening

53
Q

phenobarbital toxicities

A

sedation, dependance (abuse)

54
Q

benzodiazepine drugs

A

diazepam
clonazepam

55
Q

diazepam use

A

tonic-clonic status epilepticus, rectal gel

56
Q

diazepine MOA

A

binds allosteric regulatory site on GABA - A receptor, increases FREQUENCY of Cl- channel opening events

57
Q

diazepam toxicity

A

sedation, physcial dependance, not useful for chronic treatment

58
Q

clonazepam use

A

acute treatment of epilepsy and absence seizures

59
Q

gabapentin and pregabalin MOA

A

increase GABA release, decrease Ca influx, reduce glutamate release

60
Q

vigabatrin MOA

A

irreversible inhibitor of GABA-T, which degrades GABA

61
Q

tigabine MOA

A

inhibits GAT-1, gaba transporter

62
Q

felbamate MOA

A

NMDA receptor antagonist

63
Q

felbamate toxicity

A

severe hepatitis

64
Q

topiramate MOA

A

AMPA and kainate antagonist

65
Q

ethosuximide MOA

A

blocks T type Ca channels in thalmic neurons

66
Q

lamotrigine MOA

A

inhibits Na and Ca channels

67
Q

lamotrigine side effect

A

skin rash, stevens johnson syndrome

68
Q

valproate MOA

A

inhibits Na and Ca chanels
increases GABA

69
Q

levitiracetam MOA

A

binds synaptic protein vessel SV2A, interferes with synaptic vessel release and neurotransmission
also interferes with Ca entry

70
Q

encephalopathy < 3 mo tx

A

phenytoin

71
Q

encephalopathy > 3 mo tx

A

levitracetam

PHRM 845 (32 decks)

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