Unit 4: Epilepsy and Anti-Seizure Agents Flashcards Preview

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Flashcards in Unit 4: Epilepsy and Anti-Seizure Agents Deck (43):
1

L1: Mechanism of Action? BZDs

Facilitates GABA transmission

2

L1: Mechanism of Action? Phenobarbital

Enhance GABA, inhibit glutamate

3

L2: Clinical Uses? Diazepam

Status epilepticus

4

L2: Clinical Uses? Ethosuximide

Absence Seizures

5

L2: Clinical Uses? Levetiracetam

Tonic-Clonic Seizures

6

L2: Clinical Uses? Phenobarbital

Adjunctive Agent

7

L2: Mechanism of Action? Carbamazepine

Blocks Na channels

8

L2: Mechanism of Action? Clonazepam

Inhibition of T-type Ca channels (BZD)

9

L2: Mechanism of Action? Ethosuximide

Inhibition of T-type Ca channels

10

L2: Mechanism of Action? Levetiracetam

Unknown/Ca channels

11

L2: Mechanism of Action? Phenytoin

Blocks Na channels

12

L2: Name 2 agents used in absence seizures

Ethosuximide, Valproate

13

L2: Name three non-medical treatments for epilepsy.

Ketogenic diet, surgery, vagal nerve stimulation

14

L2: What is the diagnosis? Generalized seizures and cognitive dysfunction with typical onset in early childhood; slow spike and wave EEG pattern, caused by infections, malformations or tuberous sclerosis

Lennox Gastaut Syndrome

15

L2: Which epilepsy treatment? Kidney stones, QT prolongation, bruising, pancreatitis, immunosuppression

Ketogenic diet

16

L2: Which epilepsy treatment? Temporary hoarseness, cough, shortness of breath

Vagal nerve stimulation

17

L2: Which pharmacologic agent? Diplopia, ataxia, n/v, Stevens Johnson sydnrome, rarely: blood dyscrasias or hepatotoxicity

Carbamazepine

18

L2: Which pharmacologic agent? Nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, rash

Phenytoin

19

L2: Which pharmacologic agent? Somnolence and development of tolerance

Diazepam

20

L2: Which type of seizure? Associated with fever, focal, longer than 15 minutes, recurs in less than 24 hours

Febrile complex

21

L2: Which type of seizure? Associated with fever, generalized, less than 15 minutes without recurrence within 24 hours

Febrile simple

22

L2: Which type of seizure? Involves simple behavrios such as chewing or picking at clothing

Partial complex

23

L2: Which type of seizure? Period of altered mental status unaccompanied by major motor manifestations

Partial complex, Absence

24

L2: Which type of seizure? Recurrent major motor seizures without regained consciousness between episodes

Status epilepticus

25

L2: Which type of seizure? Slower frequency EEG pattern than absence seizures

Partial simple and Partial complex

26

L3: Clinical Uses? Carbamazepine

Partial Seizures, Tonic-Clonic Seizures, Trigeminal neuralgia

27

L3: Clinical Uses? Lamotrigine

Partial or Generalized seizures, mania, migraine

28

L3: Clinical Uses? Valproate/Divalproex

Tonic-Clonic Seizures, Absence seizures

29

L3: Mechanism of Action? Absence Seizures

Inappropriate activation of T-type Ca channels

30

L3: Mechanism of Action? Gabapentin

GABA analog that decreases glutamate via VSSC action

31

L3: Mechanism of Action? Lamotrigine

Unclear/suppression of repetitive APs, inhbition of excitatory NTs, VSCC modulation

32

L3: Mechanism of Action? Tonic-Clonic Seziures

Loss of GABA tone (possible increased glutamate or Na channel excitation)

33

L3: Mechanism of Action? Valproate/Divalproex

Unclear/ potentiation of GABA, limits T-type Ca channels

34

L3: Name 3 agents used in status epilepticus as first-line treatment

Diazepam, Lorazepam, Midazolam

35

L3: Which 2 anti-seizure agents should be avoided in pregnant patients?

Valproate/Divalproex, Phenobarbital

36

L3: Which pharmacologic agent? Dizziness, ataxia, diplopia, skin rash, nausea, milder than phenytoin

Lamotrigine

37

L3: Which pharmacologic agent? Fatigue, somnolence, asthenia, dizziness

Levetiracetam

38

L3: Which pharmacologic agent? n/v, headache/dizziness, rarely: bone marrow suppresion, tongue pain, gum hypertrophy

Ethosuximide

39

L3: Which pharmacologic agent? n/v, weight gain, easy bruising, hepatotoxicity especially in patients

Valproate/Divalproex

40

L3: Which pharmacologic agent? Sedation and possible behavioral problems

Clonazepam

41

L4: Name 4 broad-spectrum anti-seizure agents

Phenobarbital, Diazepam, Valproate, Divalproex

42

L4: Name 5 agents used in Tonic-clonic (Grand mal) seizures

Valproate, Lamotrigine, Levetiracetam, Phenytoin, Carbamazepine

43

L4: Which 3 anti-seizure agents induce the CYP450 system?

Phenobarbital, Phenytoin, Carbamazepine