p.30
Epilepsy: Definition and Diagnosis
What characterizes epilepsy?
Spontaneous recurrent seizures.
What occurs during an absence attack?
Momentary absence or dissociation from the present.
p.66
Status Epilepticus: Management and Treatment
What should a single seizure lasting more than 5 minutes be considered?
Potential Status Epilepticus.
p.48
Mechanisms of Action of AEDs
How do Na+ channel blockers affect seizure activity?
They reduce high frequency firing without affecting physiological firing.
What are clonic seizures characterized by?
Repeated or rhythmic, jerking muscle movements.
How can seizures be classified?
As focal or generalized, based on how the abnormal brain activity begins.
p.59
Pharmacology of Antiepileptic Drugs
What are pleiotropic AEDs?
Antiepileptic drugs that act on multiple targets to increase efficacy.
p.61
Pharmacology of Antiepileptic Drugs
What is the absorption characteristic of most AEDs when given orally?
Complete or near complete absorption.
p.60
Side Effects and Drug Interactions
What role do many AEDs play in relation to cytochrome P450 enzymes?
Many AEDs are notable inducers of cytochrome P450 enzymes.
p.17
Epilepsy: Definition and Diagnosis
What is the basis for diagnosing conditions related to epilepsy?
Diagnosis is based on symptoms, physical signs, and the results of an electroencephalogram (EEG).
Which body parts are usually affected by clonic seizures?
The neck, face, and arms.
p.18
Epilepsy: Definition and Diagnosis
Why is it essential to diagnose the type of epilepsy?
Because management depends on the type of epilepsy and seizures.
p.68
Alternative Uses for Antiepileptic Drugs
Which AEDs are used for neuropathic pain?
Gabapentin, pregabalin, and carbamazepine.
p.53
Mechanisms of Action of AEDs
What type of Ca2+ currents are involved in absence seizures?
T-type (transient) Ca2+ currents.
What are myoclonic seizures?
Sudden brief jerks or twitches of arms and legs.
p.3
Epilepsy: Definition and Diagnosis
What are the main symptoms of epilepsy?
Seizures, unusual behavior, sensations, and sometimes loss of awareness.
p.49
Pharmacology of Antiepileptic Drugs
Which antiepileptic drugs primarily act on Na+ channels?
Phenytoin and Carbamazepine.
p.29
Treatment Options for Epilepsy
What factors influence the choice of drugs for epilepsy treatment?
Type of seizure, type of epilepsy, likely side effects, other medical conditions, potential drug interactions, age, gender, and cost.
What are common behaviors observed during a complex partial seizure?
Staring into space and repetitive movements.
p.60
Side Effects and Drug Interactions
Which classic AEDs are strong inducers of cytochrome P450 enzymes?
Phenytoin, carbamazepine, phenobarbital, and primidone.
p.51
Pharmacology of Antiepileptic Drugs
What type of drug is Carbamazepine?
A tricyclic antidepressant used for partial seizures.
p.5
Treatment Options for Epilepsy
Do some people with epilepsy require lifelong treatment?
Yes, some people require lifelong treatment to control seizures.
p.66
Status Epilepticus: Management and Treatment
What is Status Epilepticus (SE)?
More than 30 minutes of continuous seizure activity.
p.31
Mechanisms of Action of AEDs
What is one mechanism that can lead to seizures and epilepsy?
Increased or unopposed excitatory effect.
What is a key characteristic of complex partial seizures?
They cause a change or loss of consciousness or awareness.
What sensations may be altered during focal seizures?
Emotions, smell, feel, taste, or sound.
p.30
Mechanisms of Action of AEDs
What is epileptogenesis?
The sequence of events that converts a normal neuronal network into an epileptic network.
p.22
Mechanisms of Action of AEDs
How do impulses conduct through the nervous system during a seizure?
Through axons to nerve endings.
What is a psychic symptom that may occur during a seizure?
Feelings of fear, anxiety, or déjà vu.
p.17
Epilepsy: Definition and Diagnosis
What imaging techniques may be used in the diagnosis of epilepsy?
Computed tomography (CT or CAT scan) or magnetic resonance imaging (MRI).
What are focal seizures with impaired awareness also known as?
Complex partial seizures.
What causes absence seizures?
Oscillations between the thalamus and cortex generated by T-type (transient) Ca2+ currents in the thalamus.
p.31
Mechanisms of Action of AEDs
What effect can contribute to seizures by being reduced or inhibited?
Inhibitory effect in the brain.
What are some common signs and symptoms of seizures?
Temporary confusion, staring spells, uncontrollable jerking movements, loss of consciousness, and psychic symptoms like fear or anxiety.
p.61
Pharmacology of Antiepileptic Drugs
In what situation is Fosphenytoin administered intramuscularly?
In cases of frequent repetitive seizures when intravenous access cannot be established.
p.29
Treatment Options for Epilepsy
How do other medical conditions affect drug choice in epilepsy treatment?
They may influence the safety and efficacy of certain medications.
p.16
Status Epilepticus: Management and Treatment
What is status epilepticus?
An emergency state of continuous seizure activity lasting more than five minutes or frequent recurrent seizures without regaining full consciousness in between.
p.29
Treatment Options for Epilepsy
What role do potential drug interactions play in selecting epilepsy medications?
They can affect the effectiveness and safety of the treatment.
p.10
Common CNS Conditions
What difficulty do people with narcolepsy often experience?
They find it difficult to stay awake for long periods of time.
p.29
Treatment Options for Epilepsy
Why is the age and gender of a patient considered in drug selection for epilepsy?
They can influence drug metabolism and side effects.
Do typical febrile seizures generally cause long-term effects?
No, they do not generally cause long-term effects.
How can seizures affect the body?
They can affect any process coordinated by the brain.
What is a seizure?
The clinical manifestation of abnormal and excessive excitation and synchronization of cortical neurons.
p.35
Pharmacology of Antiepileptic Drugs
What is a key characteristic of the absorption of AEDs?
They have good oral absorption and bioavailability.
p.56
Pharmacology of Antiepileptic Drugs
What effect would K+ channel agonists have on brain activity?
They would decrease hyperexcitability in the brain.
p.22
Epilepsy: Definition and Diagnosis
What is the primary cause of seizures?
Abnormal firing of impulses.
p.60
Side Effects and Drug Interactions
What is a characteristic of autoinducers among AEDs?
They increase their own metabolism.
p.16
Status Epilepticus: Management and Treatment
What are the risks associated with status epilepticus?
Increased risk of permanent brain damage and death.
p.62
Status Epilepticus: Management and Treatment
What is the role of Diazepam in seizure management?
It terminates repetitive seizures and can be administered by family members at home.
p.32
Pharmacology of Antiepileptic Drugs
What is the goal of using antiepileptic drugs?
To maximize quality of life by minimizing seizures and adverse drug effects.
p.55
Mechanisms of Action of AEDs
What may be one mechanism of action for Gabapentin and Pregabalin?
Inhibition of neurotransmitter release.
p.44
Mechanisms of Action of AEDs
What is the role of GABA B receptors?
They are presynaptic autoreceptors and also postsynaptic, mediated by K+ currents, causing an increase in the inactive state of the neuron.
Can atypical febrile seizures be associated with long-term effects?
Yes, they can be associated with long-term effects.
p.45
Mechanisms of Action of AEDs
What effect does Clonazepam have on T-type Ca2+ channels?
It leads to their inactivation in the reticular formation.
p.45
Mechanisms of Action of AEDs
What neurotransmitter release does Clonazepam prevent?
The vesicular release of excitatory neurotransmitters.
p.5
Treatment Options for Epilepsy
What are the two main approaches to treating seizures in epilepsy?
Medications and sometimes surgery.
p.3
Epilepsy: Definition and Diagnosis
What is epilepsy?
A central nervous system disorder characterized by abnormal brain activity, causing seizures or unusual behavior.
p.58
Pharmacology of Antiepileptic Drugs
What is one action of several antiepileptic drugs (AEDs) regarding neurotransmitter release?
They regulate neurotransmitter release from the presynaptic terminal.
What are focal seizures?
Seizures that result from abnormal activity in just one area of the brain.
p.59
Pharmacology of Antiepileptic Drugs
Can you name some examples of pleiotropic AEDs?
Felbamate, lamotrigine, topiramate, and valproate.
What is associated with specific forms of epilepsy?
Major classifications of seizures.
p.49
Mechanisms of Action of AEDs
What happens when Na+ channels are bound by certain AEDs?
The time that the inactivation gate of the channel is closed is prolonged.
What type of movements may occur during a seizure?
Uncontrollable jerking movements of the arms and legs.
p.22
Mechanisms of Action of AEDs
What role do neurotransmitters play in seizures?
They help conduct impulses across the synapse to the next neuron.
p.65
Treatment Options for Epilepsy
Why is monotherapy preferred in epilepsy treatment?
It leads to better patient compliance and fewer adverse effects.
p.63
Pharmacology of Antiepileptic Drugs
What processes are involved in the metabolism of most AEDs?
Hydroxylation or conjugation.
p.44
Mechanisms of Action of AEDs
What is the function of GABA A receptors?
They are post-synaptic, act as Cl- channel openers, and prevent action potential generation.
p.51
Pharmacology of Antiepileptic Drugs
What effect does Carbamazepine have on P450 enzymes?
It induces P450, resulting in an increase in its own metabolism.
p.63
Pharmacology of Antiepileptic Drugs
How does Gabapentin differ from most AEDs in terms of metabolism?
Gabapentin undergoes no metabolism and is excreted unchanged by the kidney.
p.34
Treatment Options for Epilepsy
What factors should be considered when choosing antiepileptic drugs?
Seizure type, epilepsy syndrome, pharmacokinetic profile, interactions with other medical conditions, efficacy, expected adverse effects, cost, age, and gender.
p.69
Mechanisms of Action of AEDs
What are the main mechanisms by which antiepileptic drugs exert their effects?
Antiepileptic drugs work by modulating neurotransmitter release, enhancing inhibitory neurotransmission, and inhibiting excitatory neurotransmission.
p.72
Pharmacology of Antiepileptic Drugs
How does Carbamazepine affect GABA receptors?
Potentiates GABA receptors.
p.72
Pharmacology of Antiepileptic Drugs
What is the effect of Phenytoin on glutamate release?
Decreases glutamate release.
p.5
Treatment Options for Epilepsy
Can seizures in epilepsy be controlled for most people?
Yes, they can be controlled in the majority of people with epilepsy.
What characterizes tonic-clonic seizures?
Abrupt loss of consciousness, body stiffening and shaking, and sometimes loss of bladder control or biting tongue.
p.48
Mechanisms of Action of AEDs
What role do Na+ channels play in seizures?
Neurons fire at high frequencies during seizures, which is dependent on Na+ channels.
p.18
Epilepsy: Definition and Diagnosis
What factors are crucial for the management of epilepsy?
The type of epilepsy and the type of seizures.
p.56
Pharmacology of Antiepileptic Drugs
What role do K+ channels play in neuronal firing in the CNS?
They have important inhibitory control and repolarize the membrane to end action potentials.
p.58
Pharmacology of Antiepileptic Drugs
In addition to regulating neurotransmitter release, what other actions do AEDs have?
They act on ion channels or receptors.
p.29
Treatment Options for Epilepsy
Why is the type of seizure important in drug selection for epilepsy?
Different seizures may respond better to specific medications.
What other neurological disorders can complex partial seizures be confused with?
Migraine, narcolepsy, or mental illness.
p.67
Status Epilepticus: Management and Treatment
What medications are used as preventers after initial treatment for Status Epilepticus?
Phenytoin or phenobarbital (longer acting).
What involuntary movement may occur during focal seizures?
Jerking of a body part, such as an arm or leg.
p.44
Pharmacology of Antiepileptic Drugs
What is GABA in the context of epilepsy?
The major inhibitory neurotransmitter in the CNS.
p.54
Side Effects and Drug Interactions
How does the sedative effect of Ethosuximide compare to other AEDs?
It is less sedating than other AEDs.
p.32
Pharmacology of Antiepileptic Drugs
Are there any 'anti-epileptogenic' drugs currently available?
No, there are currently no 'anti-epileptogenic' drugs available.
p.55
Treatment Options for Epilepsy
For what types of seizures are Gabapentin and Pregabalin used in add-on therapy?
Partial seizures and tonic-clonic seizures.
p.52
Mechanisms of Action of AEDs
What additional mechanisms does Lamotrigine have?
Inhibits glutamate release and possibly Ca2+ channels.
p.45
Mechanisms of Action of AEDs
How does Clonazepam affect GABA A receptors?
It selectively activates GABA A receptors.
p.6
Epilepsy: Definition and Diagnosis
What causes epilepsy?
Abnormal activity in the brain.
p.53
Pharmacology of Antiepileptic Drugs
Why are general Ca2+ channel blockers not effective as AEDs?
They have not proven to be effective in treating epilepsy.
p.68
Alternative Uses for Antiepileptic Drugs
Which AEDs are indicated for bipolar disorder?
Lamotrigine and carbamazepine.
p.48
Mechanisms of Action of AEDs
What is the relationship between action potential generation and Na+ channels?
Action potential generation is dependent on Na+ channels.
p.68
Alternative Uses for Antiepileptic Drugs
What AEDs can be used for migraine and trigeminal neuralgia?
Levetiracetam, valproate, topiramate, and gabapentin.
p.31
Mechanisms of Action of AEDs
What is the relationship between excitatory and inhibitory effects in the context of seizures?
An increase in excitatory effect and a decrease in inhibitory effect disrupts equilibrium, leading to seizures.
How can seizure symptoms vary?
Seizure symptoms can vary widely among individuals.
What is one type of seizure symptom?
Some people may simply stare blankly for a few seconds.
p.54
Side Effects and Drug Interactions
What common side effect does Ethosuximide cause?
Gastrointestinal disturbances.
p.39
Mechanisms of Action of AEDs
What do AEDs block to prevent seizure generation?
Voltage-gated inward positive currents, specifically Na+ or Ca++.
p.46
Treatment Options for Epilepsy
What type of drug is Phenobarbital?
A barbiturate used for partial seizures, especially in neonates.
p.39
Mechanisms of Action of AEDs
What does it mean that many AEDs are pleiotropic?
They act via multiple mechanisms.
In what condition do febrile seizures typically occur?
In a child who is neurologically and developmentally normal.
p.64
Pharmacology of Antiepileptic Drugs
Why can the most appropriate AED be chosen to reduce side effects?
Because many AEDs have overlapping, pleiotropic actions.
p.34
Pharmacology of Antiepileptic Drugs
How does the pharmacokinetic profile influence the choice of antiepileptic drugs?
It affects the absorption, distribution, metabolism, and excretion of the drug.
p.45
Side Effects and Drug Interactions
What is a potential downside of using Clonazepam?
It may lose effectiveness due to the development of tolerance.
p.37
Pharmacology of Antiepileptic Drugs
What is the significance of Topiramate in epilepsy treatment?
It is a newer antiepileptic drug effective for various types of seizures.
p.24
Overview of CNS Drugs
What happens at the synapse when an action potential reaches the axon terminal?
Neurotransmitters are released into the synaptic cleft.
p.24
Overview of CNS Drugs
What is the significance of myelin sheaths in nerve axons?
They increase the speed of impulse transmission through saltatory conduction.
p.26
Overview of CNS Drugs
What is the main inhibitory action of the brain?
To inhibit unnecessary parts of the brain.
p.49
Mechanisms of Action of AEDs
How do Phenytoin and Carbamazepine affect sodium channels?
They block voltage-dependent sodium channels at high firing frequencies.
p.66
Status Epilepticus: Management and Treatment
What defines two or more seizures in the context of Status Epilepticus?
Sequential seizures spanning a period without full recovery between them.
p.67
Status Epilepticus: Management and Treatment
What are the initial treatments for Status Epilepticus?
Diazepam and lorazepam IV (fast, short acting).
What are some spontaneous sensory symptoms associated with focal seizures?
Tingling, dizziness, and flashing lights.
p.32
Pharmacology of Antiepileptic Drugs
What is an antiepileptic drug?
A drug that decreases the frequency and/or severity of seizures in people with epilepsy.
Which muscles are usually affected by tonic seizures?
Muscles in the back, arms, and legs.
What are common characteristics of absence seizures?
Staring into space or subtle body movements like eye blinking or lip smacking.
p.4
Epilepsy: Definition and Diagnosis
Does having a single seizure mean you have epilepsy?
No, having a single seizure does not mean you have epilepsy.
p.51
Side Effects and Drug Interactions
What are some common side effects of Carbamazepine?
Sedation, agranulocytosis, aplastic anemia, leukopenia, hyponatremia, nausea, and visual disturbances.
p.62
Status Epilepticus: Management and Treatment
What are the most common situations where these medications are used?
In acute convulsions and status epilepticus.
p.52
Pharmacology of Antiepileptic Drugs
Which drugs affect the metabolism of Lamotrigine?
Valproate, Carbamazepine, Phenobarbital, Phenytoin.
p.46
Side Effects and Drug Interactions
What risk is associated with the use of Phenobarbital?
Tolerance may arise and there is a risk of dependence.
p.46
Treatment Options for Epilepsy
Why are Primidone and Phenobarbital seldom used in initial therapy?
Due to their side effects.
p.70
Side Effects and Drug Interactions
What is a key side effect of Phenobarbital?
Sedation and potential for dependence.
p.24
Overview of CNS Drugs
What is the primary function of nerve axons?
To transmit electrical impulses away from the neuron's cell body.
p.57
Pharmacology of Antiepileptic Drugs
What is a notable characteristic of Valproate's pharmacological profile?
It is highly pleiotropic.
p.37
Treatment Options for Epilepsy
Why are newer antiepileptic drugs important?
Because partial seizures are often resistant to treatment.
p.31
Mechanisms of Action of AEDs
What happens when there is a decline in the equilibrium between excitatory and inhibitory effects?
It can lead to a convulsion.
p.4
Epilepsy: Definition and Diagnosis
Can anyone develop epilepsy?
Yes, anyone can develop epilepsy.
p.10
Common CNS Conditions
What is narcolepsy?
A chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep.
p.39
Mechanisms of Action of AEDs
How do AEDs increase inhibitory neurotransmitter activity?
By enhancing the GABA system.
p.32
Pharmacology of Antiepileptic Drugs
What do antiepileptic drugs treat?
They treat the symptom of seizures, not the underlying epileptic condition.
What is another type of seizure symptom?
Others may repeatedly twitch their arms or legs.
p.29
Treatment Options for Epilepsy
How does the cost of medication impact the choice of drugs for epilepsy?
It affects accessibility and adherence to treatment.
How may absence seizures manifest in terms of awareness?
They may cause a brief loss of awareness.
What happens during an atonic seizure?
Loss of muscle control, leading to sudden collapse or fall.
p.47
Pharmacology of Antiepileptic Drugs
What is the mechanism of action of Vigabatrin?
It elevates GABA levels by irreversibly inhibiting its main catabolic enzyme, GABA-transaminase.
p.64
Treatment Options for Epilepsy
What are other considerations in the treatment of epilepsy besides efficacy?
Potential long-term side effects, pharmacokinetics, and cost.
p.37
Pharmacology of Antiepileptic Drugs
What are Gabapentin and Pregabalin primarily used for?
They are used as antiepileptic drugs and for neuropathic pain.
p.70
Mechanisms of Action of AEDs
What is the mechanism of action of Lorazepam?
Increases GABA-A receptor activity, leading to enhanced inhibitory effects.
What is a common drug interaction with Valproate?
Can increase the levels of other antiepileptic drugs like Lamotrigine.
p.38
Side Effects and Drug Interactions
Which medications are associated with weight gain?
Valproic acid and gabapentin.
p.50
Pharmacology of Antiepileptic Drugs
How does Phenytoin affect its own metabolism?
It induces P450, resulting in an increase in its own metabolism.
p.49
Mechanisms of Action of AEDs
What is the mechanism of action for Topiramate regarding Na+ channels?
It exhibits use-dependent blockade.
p.54
Pharmacology of Antiepileptic Drugs
What type of channels does Ethosuximide act on?
T-type channels in the thalamus.
p.67
Status Epilepticus: Management and Treatment
What is the purpose of using diazepam and lorazepam in Status Epilepticus?
They are fast-acting medications to quickly control seizures.
p.67
Status Epilepticus: Management and Treatment
When are preventer medications administered in the treatment of Status Epilepticus?
When control is established after initial treatment.
What are CNS drugs used for?
To treat conditions of the central nervous system.
p.62
Status Epilepticus: Management and Treatment
How can IV preparations of medications be used in emergencies?
IV preparations can be used rectally in emergencies.
p.39
Mechanisms of Action of AEDs
What is the role of K+ in the action of AEDs?
Increased outward positive current causes repolarization.
p.64
Treatment Options for Epilepsy
What is the first consideration in the treatment of epilepsy?
Efficacy in stopping seizures.
p.34
Treatment Options for Epilepsy
Why is seizure type important in selecting antiepileptic drugs?
Different seizure types may respond better to specific medications.
p.69
Pharmacology of Antiepileptic Drugs
What are the commonly used antiepileptic drugs?
Commonly used AEDs include phenytoin, carbamazepine, valproate, and lamotrigine.
p.69
Status Epilepticus: Management and Treatment
What AEDs can be used to treat status epilepticus?
Benzodiazepines (like lorazepam and diazepam) and phenytoin are commonly used for status epilepticus.
p.57
Treatment Options for Epilepsy
What is Valproate primarily used for?
First-line treatment for generalized seizures and also used for partial seizures.
p.72
Pharmacology of Antiepileptic Drugs
What does Vigabatrin inhibit?
Inhibits GABA transaminase.
p.50
Treatment Options for Epilepsy
What is Phenytoin primarily used for?
First-line treatment for partial seizures and some use for tonic-clonic seizures.
p.50
Pharmacology of Antiepileptic Drugs
What is Fosphenytoin?
A prodrug for Phenytoin, used for IM injection.
What is the relationship between seizure classifications and epilepsy?
Most classifications are associated with specific forms of the disorder.
p.35
Pharmacology of Antiepileptic Drugs
How are some AEDs excreted from the body?
Unchanged in the kidneys.
p.39
Mechanisms of Action of AEDs
What effect do AEDs have on excitatory neurotransmitter systems?
They decrease the activity of glutamate.
p.55
Mechanisms of Action of AEDs
What is unclear about the action of Gabapentin and Pregabalin?
How their action on calcium channels leads to antiepileptic effects.
Do individuals with epilepsy experience the same type of seizure each time?
Yes, most individuals tend to have the same type of seizure each time, leading to similar symptoms.
What characterizes atypical febrile seizures?
Prolonged seizure, associated atypical features, neurological or developmental abnormalities.
p.52
Treatment Options for Epilepsy
What is Lamotrigine used for?
Add-on therapy or monotherapy for refractory partial seizures.
p.65
Treatment Options for Epilepsy
What does 'refractory' seizures refer to?
Seizures that are resistant to treatment.
p.52
Side Effects and Drug Interactions
How does Lamotrigine compare in terms of sedation to other AEDs?
It is less sedating than other AEDs.
p.36
Pharmacology of Antiepileptic Drugs
What is Primidone classified as?
A classical antiepileptic drug.
p.70
Pharmacology of Antiepileptic Drugs
What is the pharmacokinetic property of Ethosuximide?
Primarily metabolized in the liver and has a long half-life.
p.34
Treatment Options for Epilepsy
Why are age and gender relevant in the selection of antiepileptic drugs?
They can affect drug metabolism and response to treatment.
p.24
Overview of CNS Drugs
What is saltatory conduction?
The process by which action potentials jump from one node of Ranvier to another, speeding up transmission.
p.38
Side Effects and Drug Interactions
What are some allergic side effects that can occur with many medications?
Hypertrophy of the gums and hirsutism.
How do symptoms vary in epilepsy?
Symptoms vary depending on the type of seizure.
What happens to the impulse during a seizure?
It spreads to other areas of the brain.
p.16
Status Epilepticus: Management and Treatment
What characterizes the seizures in status epilepticus?
Frequent recurrent seizures without regaining full consciousness in between.
p.62
Status Epilepticus: Management and Treatment
Which medications are available as IV preparations for emergency use?
Phenytoin, phenobarbital, diazepam, lorazepam, and valproate.
What are some symptoms associated with febrile seizures?
Drowsiness and emptying of the bladder.
p.64
Pharmacology of Antiepileptic Drugs
What is a characteristic of newer antiepileptic drugs?
They tend to have less CNS depressant effects.
p.34
Side Effects and Drug Interactions
What role do interactions with other medical conditions play in choosing antiepileptic drugs?
They can affect the safety and efficacy of the treatment.
p.37
Pharmacology of Antiepileptic Drugs
What is the role of Tiagabine in epilepsy therapy?
It is used to treat partial seizures.
p.37
Pharmacology of Antiepileptic Drugs
What is Oxycarbazepine used for?
It is used to treat partial seizures.
p.37
Pharmacology of Antiepileptic Drugs
What is Fosphenytoin used for?
It is a prodrug of phenytoin used for seizure control.
p.50
Pharmacology of Antiepileptic Drugs
What effect does Valproate have on Phenytoin?
Valproate can displace Phenytoin from plasma proteins.
p.35
Pharmacology of Antiepileptic Drugs
What should be considered when choosing the best AED?
Minimizing side effects in addition to efficacy.
p.65
Treatment Options for Epilepsy
What are 'breakthrough' seizures?
Seizures that occur despite treatment.
What is a notable feature of the occurrence of absence seizures?
They may occur in clusters.
p.36
Pharmacology of Antiepileptic Drugs
What are the classical antiepileptic drugs (AEDs)?
Phenytoin, Phenobarbital, Primidone, Carbamazepine, Ethosuximide, Valproate (valproic acid).
p.46
Pharmacology of Antiepileptic Drugs
What is the half-life of Phenobarbital?
It can be up to approximately 5 days.
p.47
Pharmacology of Antiepileptic Drugs
What does Vigabatrin do to the action of GABA?
It prolongs the action of GABA.
p.70
Treatment Options for Epilepsy
What type of seizures is Phenytoin primarily used for?
Focal and generalized tonic-clonic seizures.
p.36
Pharmacology of Antiepileptic Drugs
Which classical AED is commonly used for generalized seizures?
Valproate (valproic acid).
p.34
Treatment Options for Epilepsy
How do cost considerations affect the choice of antiepileptic drugs?
Cost can influence accessibility and adherence to treatment.
p.38
Side Effects and Drug Interactions
What reproductive function issue is associated with valproic acid?
It can affect reproductive function.
p.50
Side Effects and Drug Interactions
What syndrome is associated with fetal exposure to Phenytoin?
Fetal hydantoin syndrome.
p.46
Status Epilepticus: Management and Treatment
What are Lorazepam and Diazepam used for?
They are benzodiazepines used as first-line treatment for status epilepticus.
p.4
Epilepsy: Definition and Diagnosis
How many unprovoked seizures are generally required for an epilepsy diagnosis?
At least two unprovoked seizures.
p.46
Side Effects and Drug Interactions
What are some side effects of Phenobarbital?
Very strong sedation, cognitive impairment, and behavioral changes.
p.37
Pharmacology of Antiepileptic Drugs
What is Lamotrigine used for?
It is used as an antiepileptic drug.
p.52
Side Effects and Drug Interactions
What is a potential severe side effect of Lamotrigine in pediatric patients?
Severe dermatitis in 1-2% of pediatric patients.
p.72
Pharmacology of Antiepileptic Drugs
What is the mechanism of action of Clonazepam?
Inhibits glutamate action.
p.24
Overview of CNS Drugs
What is the role of synapses in nerve impulse transmission?
To facilitate communication between neurons by allowing the transfer of neurotransmitters.
p.70
Treatment Options for Epilepsy
What are the indications for Valproate?
Used for various types of seizures, including generalized and focal seizures.
p.70
Mechanisms of Action of AEDs
What is the mechanism of action of Diazepam?
Enhances the effect of the neurotransmitter GABA at the GABA-A receptor.
p.72
Pharmacology of Antiepileptic Drugs
What is the action of Lorazepam?
Potentiates GABA receptors.
p.69
Common CNS Conditions
What needs to be considered when a patient with a history of epilepsy comes for dental treatment?
Consideration should be given to potential drug interactions, seizure triggers, and the patient's current AED regimen.
p.57
Mechanisms of Action of AEDs
How does Valproate affect GABAergic transmission?
It enhances GABAergic transmission.
p.70
Treatment Options for Epilepsy
What are some newer drugs used for epilepsy?
Examples include Lacosamide, Levetiracetam, and Rufinamide.
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Overview of CNS Drugs
How do neurotransmitters affect the postsynaptic neuron?
They bind to receptors, leading to changes in the postsynaptic neuron's membrane potential.
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Side Effects and Drug Interactions
What effect can some medications have on bone marrow function?
They can affect bone marrow function.
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Pharmacology of Antiepileptic Drugs
What type of seizures is Felbamate particularly important for?
Partial seizures that are resistant to treatment.
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Treatment Options for Epilepsy
Why is the efficacy of an antiepileptic drug important?
It determines how well the drug controls seizures.
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Alternative Uses for Antiepileptic Drugs
What AEDs are used in the treatment of trigeminal neuralgia?
Carbamazepine and oxcarbazepine are commonly used for trigeminal neuralgia.
p.37
Mechanisms of Action of AEDs
What is Vigabatrin's mechanism of action?
It inhibits the enzyme that breaks down GABA, increasing its levels.
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Pharmacology of Antiepileptic Drugs
What is Levetiracetam known for in epilepsy treatment?
It is effective for a broad range of seizure types.
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Treatment Options for Epilepsy
What AEDs are used for long-term prevention of seizures?
AEDs such as valproate, lamotrigine, and levetiracetam are used for long-term seizure prevention.
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Side Effects and Drug Interactions
What should be considered regarding expected adverse effects when selecting antiepileptic drugs?
Potential side effects can impact patient compliance and quality of life.
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Pharmacology of Antiepileptic Drugs
What is Valproate's interaction with plasma proteins?
It is highly bound to plasma proteins.
p.57
Side Effects and Drug Interactions
What are some common side effects of Valproate?
CNS depression, GI disturbances, hair loss, weight gain, and teratogenic effects.
p.57
Mechanisms of Action of AEDs
What action does Valproate inhibit besides blocking Na+ channels?
Inhibits glutamate action.
