Week 9 - epilepsy, mood Flashcards
(13 cards)
Clobazam, clonazepam
Class: Benzodiazepines
Indication: epilepsy
MOA: Bind to GABAa recepotors and potentiate the inhibitory effects of GABA by increases Cl- influx to hyperpolarisation, leading to less rapid firing and preventing the spread of the seizure.
Adverse effects: sedation, tolerance
Phenytonin
Class: Anticonvulsants
Indication: focal and generalised tonic-clonic seizures
MOA: bind to Na+ channels and prolong their inhibited state, stopping the efflux of Na+, preventing rapid firing and spread of the seizure.
Adverse effects: ataxia, bad eye movements, gum overgrowth, decrease BMD
Carbamazepine
Class: Anticonvulsants
Indication: simple and complex focal seizures
MOA: bind to Na+ channels and prolong their inhibited state, stopping the efflux of Na+, preventing rapid firing and spread of the seizure.
Adverse effects: drowsiness, ataxia, dizziness
Lamotrigine
Class: Anticonvulsants
Indication: focal or generalised tonic-clonic
MOA: bind to Na+ channels and prolong their inhibited state, stopping the efflux of Na+, preventing rapid firing and spread of the seizure.
Adverse effects: drowsiness, ataxia
Valporate
Class: Anticonvulsants
Indication: absence, tonic-clonic, myoclonic and focal (partial) seizures
MOA:
-Na+ inhibitor, helping keep them in the inactive state.
-potentiates the effects of GABA
-inhibits T-type Ca2+ channels to limit excitatory neurotransmission.
Adverse effects: known teratogen, can cause neural tube defects in babies such as spinal bifida or anencephaly.
Topiramate
Class: Anticonvulsant
Indication: focal (partial) and generalised tonic-clonic
MOA: has multiple:
- Block Na channels,
- Block AMPA receptor (similar to the NMDA excitatory receptor that responds to glutamate)
- Enhance GABA effects
Adverse effects: weight loss and fatigue.
Levetiracetam
Class: Anticonvulsant
Indication: focal (partial) or generalised
MOA: unknown but is postulated that it modulates excitatory (glutamate) neurotransmission
adverse effects: behavioural effects, insomnia, drowsiness
Escitalopram, paroxetine, sertraline
Class: SSRI (serotonin)
Indication: Depression
MOA: Inhibiting reuptake of serotonin at 5-HT receptors = leaves more in gap = more effect in post-synaptic neuron (less degraded)
Adverse effects: N/D, agitation, insomnia, sexual dysfunction
Venlafaxine, Duloxetine
Class: SNRI (serotonin and noradrenaline)
Indication: depression
MOA: Inhibiting reuptake of serotonin (5-HT) and noradrenaline
= leaves more in gap = more effect in post-synaptic neuron (less degraded)
Adverse effects: nausea, constipation, orthostatic hypotension, sweating.
Amitriptyline, nortriptyline
Class: tricyclic antidepressants (TCA)
Indication: depression
MOA: inhibits uptake of serotonin and noradrenaline (less degraded) and inhibits cholinergic (A1), histamine (H1), and serotonergic receptors.
adverse effects: orthostatic hypotension (blocks alpha-1 recpeotors leading to reduced vasoconstriction), blurred vison, dry mouth, constipation-(blocks muscarinic), they can also prolong the QT interval, increasing the risk of arrhythmias.
Mirtazapine
Class: tricyclic antidepressants
Indication: depression
MOA: blocks 5-HT2 and 3 receptors on postsynaptic neuron = increase transmission of serotonin at 5HT1 (increase mood)
Blocks A2 adrenergic receptors = increase NA and S.
adverse effects: Increase appetite, weight gain, sedation, peripheral oedema.
Clozapine
Class: atypical antipsychotic
Indication: schizophrenia
MOA: binds to d1-5 receptors + serotonin, muscarinic, histaminergic = decrease mesolimbic pathway (decrease positive symptoms)
adverse effects: Fatal agranulocytosis (decrease in neutrophils) = increase in risk of infections
Lithium
Class: mood stabaliser
Indication: bipolar
MOA: enters through sodium channels, increases serotonin synthesis and decreases dopamine synthesis
adverse effects: nausea, diarrhoea, metallic taste, weight gain, hypothyroidism
