Central Nervous System - Antiepileptic Drugs
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Questions and Answers

Which of the following is a common adverse effect of Valproate?

  • Weight loss
  • Dizziness (correct)
  • Hypertension
  • Neural tube defects (correct)

What is the drug of choice for treating absence seizures?

  • Carbamazepine
  • Valproate
  • Phenytoin
  • Ethosuximide (correct)

Which adverse effect may occur with long-term use of anticonvulsants?

  • Cleft palate (correct)
  • Hirsutism (correct)
  • Euphoria
  • Insomnia

Which condition is contraindicated when prescribing certain anticonvulsants?

<p>Liver disease (C)</p> Signup and view all the answers

What is a recognized effect of Phenytoin on neurotransmitters?

<p>Blocks sodium channels (B)</p> Signup and view all the answers

Which of the following is NOT an adverse effect associated with Ethosuximide?

<p>Hallucinations (C)</p> Signup and view all the answers

Which condition is NOT effectively treated by Valproate?

<p>Status epilepticus (C)</p> Signup and view all the answers

What is a potential idiosyncratic adverse effect of Valproate?

<p>Pancreatitis (D)</p> Signup and view all the answers

What characterizes a seizure?

<p>Transient alteration of behavior due to disordered neuron firing (A)</p> Signup and view all the answers

Which type of seizure is classified as absence seizures?

<p>Generalized seizures (A)</p> Signup and view all the answers

What is the first step in the management of epilepsy?

<p>Start with a single drug adjusted to patient response (C)</p> Signup and view all the answers

Which drug is considered the drug of choice for status epilepticus?

<p>Diazepam I.V. (B)</p> Signup and view all the answers

What type of seizures does phenytoin effectively treat?

<p>Partial and generalized tonic-clonic seizures (C)</p> Signup and view all the answers

Which action do drugs like phenytoin and carbamazepine perform?

<p>Blocking sodium channels (B)</p> Signup and view all the answers

What is a known adverse effect of phenytoin?

<p>Confusion and nystagmus (A)</p> Signup and view all the answers

What is the recommended duration for full drug therapy after the last seizure?

<p>2-3 years (A)</p> Signup and view all the answers

Flashcards

Epilepsy

A chronic disorder characterized by recurrent unprovoked seizures.

Seizure

A transient alteration of behavior due to disordered synchronous and rhythmic firing of brain neurons.

Partial (focal) seizure

Seizures that affect a localized area of the brain.

Generalized seizure

Seizures that affect both sides of the brain.

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Status epilepticus

Prolonged seizures lasting more than 20 minutes.

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Anti-epileptic drug (AED)

Medication used to prevent and control seizures.

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Diazepam (IV)

First-line drug for treating status epilepticus (IV = intravenous).

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Phenytoin (IV)

A second-line drug option for treating status epilepticus (IV = intravenous).

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Sodium channel blocker

A type of anti-epileptic drug that prevents sodium ions from entering neurons, stopping the misfiring of neurons.

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GABA potentiator

Type of anti-epileptic drug that enhances the effects of GABA, a neurotransmitter that calms brain activity.

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Calcium channel blocker

Type of anti-epileptic drug that prevents calcium ions from entering neurons.

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Epilepsy treatment approach

Treatment starts with a single drug, increasing if needed, and continuing for 2-3 years after seizure ends.

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Drug monitoring

Continuous monitoring of drug effects and blood levels is crucial in epilepsy treatment.

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Gingival hyperplasia

Excessive growth of gum tissue.

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Coarsening of facial features

Changes in facial structure becoming more prominent and less refined.

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Hirsutism

Excessive hair growth, especially in areas where it's typically uncommon for women.

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Hypotension

Low blood pressure.

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Bradycardia

Slow heart rate.

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Toxic Hepatitis

Liver damage caused by a toxin or poison.

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Teratogenic

Causing birth defects.

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Osteomalacia

Softening of the bones.

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Megaloblastic Anemia

A type of anemia caused by the production of unusually large red blood cells.

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Hyperglycemia

High blood sugar.

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Lymphadenopathy

Swollen lymph nodes.

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Anti-convulsant

A drug that reduces seizures or convulsions.

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Sodium Channels

Proteins that regulate the flow of sodium ions across cell membranes.

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GABA

Gamma-aminobutyric acid; an inhibitory neurotransmitter in the brain.

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Generalized tonic-clonic seizures

Severe seizures that affect the whole body.

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Partial seizures

Seizures that affect only one part of the brain.

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Trigeminal neuralgia

Facial pain caused by irritation of the trigeminal nerve.

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Bipolar disorder

A mental disorder characterized by extreme shifts in mood.

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Drowsiness

A state of feeling sleepy.

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Diplopia

Double vision.

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Blood dyscrasias

Blood disorders.

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Agranulocytosis

A potentially dangerous blood disorder involving insufficient white blood cells.

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Absence seizures

Brief loss of awareness with staring spells.

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Myoclonic seizures

Jerky muscle contractions or spasms.

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Status epilepticus

A prolonged and dangerous seizure.

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Migraine

A common headache disorder.

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Hallucination

A sensory experience that isn't real.

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Ataxia

Lack of muscle control.

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Tremors

Involuntary shaking of body parts.

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Nystagmus

Involuntary eye movements.

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Sedation

A state of being calm and sleepy.

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GI disturbances

Problems in the gastrointestinal system.

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Idiosyncratic pancreatitis

Pancreatitis (inflammation of the pancreas) that is not typical for the treatment.

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Idiosyncratic hepatotoxicity

Liver damage not typical or expected with a particular drug or substance.

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Neural tube defects

Birth defects that occur when the neural tube doesn't fully close.

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Alopecia

Hair loss.

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Weight gain

Increase in body weight.

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Ethosuximide (Zarontin)

An anti-epileptic medication that blocks calcium channels.

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Study Notes

Central Nervous System - Antiepileptic Drugs

  • Epilepsy is a chronic disorder characterized by recurrent unprovoked seizures.
  • A seizure is a temporary disruption of brain function due to abnormal, synchronous firing of brain neurons.

Classification of Epileptic Seizures

  • Partial (Focal):
    • Simple partial seizures
    • Complex partial seizures
    • Partial seizures with secondary generalization
  • Generalized:
    • Absence seizures
    • Myoclonic seizures
    • Tonic seizures
    • Clonic seizures
    • Tonic-clonic seizures
    • Atonic seizures

Tonic-Clonic Seizures

  • Involves two phases:
    • Tonic phase (muscle stiffness)
    • Clonic phase (jerking movements)

Absence Seizures

  • Characterized by brief, sudden lapses of awareness.
  • During a seizure, the person may stare blankly, with eyes rolling upward.
  • There's a lack of response to stimuli.

Partial Seizures (Detailed)

  • Visual:
    • Flashes of light or visual disturbances (flickering, blurring).
  • Somatosensory:
    • Tingling or unusual sensations (numbness, pins and needles) on one side of the body.
  • Auditory:
    • Ringing, hissing, or other noises.
  • Focal Motor:
    • Jerking or muscle contractions
  • Contraversive:
    • Head and eyes moving to the opposite side of the seizure focus.
  • Autonomic:
    • Sweating, flushing, or pallor.

Complex Partial Seizures

  • Characteristic features include impaired consciousness.
  • Vacant expressions, staring, and confusion.
  • Other features such as olfactory or gustatory hallucinations.

General Principles of Drug Therapy

  • Evaluate the type of epilepsy.
  • Start with a single drug, adjusting the dose to plasma concentration if necessary.
  • Add another drug if the initial drug is not effective.
  • Gradually withdraw the drug after 2-3 years.
  • Monitor the drug throughout treatment.

Choice of Drug Therapy (Table)

  • A table showing different seizure types and their corresponding treatments.

Status Epilepticus

  • Prolonged seizures lasting more than 20 minutes.
  • Considered a life-threatening emergency.
  • Diazepam is often the drug of choice.

Classification of Antiepileptic Drugs

  • Drugs that block sodium channels
  • Drugs that potentiate GABA (gamma-aminobutyric acid)
  • Drugs that block calcium channels
  • Drugs that inhibit glutamate activity

Mechanisms of Action of Antiepileptic Drugs

  • Detailed explanation of how various drugs work at a cellular level, affecting sodium channels, GABA, and glutamate.

Specific Drug Details: Phenytoin

  • Antiepileptic actions: blocks sodium channels, effective for partial and generalized tonic-clonic seizures.
  • Not effective for absence seizures.
  • Antidysrhythmic properties in relation to cardiac action potentials.

Uses of Antiepileptic Drugs

  • Treatment of generalized and partial tonic-clonic seizures.
  • Treatment of status epilepticus.
  • Treatment of trigeminal neuralgia.
  • Treatment of ventricular arrhythmias.

Adverse Effects of Antiepileptic Drugs

  • Confusion, nystagmus, ataxia, slurred speech.
  • Gingival hyperplasia, facial coarsening.
  • Hypotension, bradycardia.
  • Nausea, vomiting, constipation, toxic hepatitis.
  • Teratogenic effects (cleft palate).
  • Osteomalacia and megaloblastic anemia.
  • Hyperglycemia, agranulocytosis.

Contraindications for Antiepileptic Drugs

  • Liver disease.
  • Pregnancy.
  • Hypersensitivity.
  • Agranulocytosis.

Specific Drug Details (Carbamazepine, Valproate, Ethosuximide, etc.)

  • Detailed information on mechanisms of action, uses, and adverse effects for various antiepileptic drugs, including Carbamazepine, Valproate, Ethosuximide, and others.

New Antiepileptic Drugs

  • Descriptions of Lamotrigine, Topiramate, Felbamate, Vigabatrin, Gabapentin, and Tiagabine, and their specific mechanisms of action.

Uses of New Antiepileptic Drugs

  • Information on use for different types of seizures.

Adverse Effects of New Drugs (Summary)

  • Summarized information regarding adverse effects. (Detailed list from the slides)

Specific Detailed information on newer classes of antiepileptic drugs (e.g., specific uses for each drug in treatment of certain seizure types).

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Related Documents

Antiepileptic Lecture 2 PDF

Description

This quiz covers the classification and characteristics of various types of seizures associated with epilepsy. Test your knowledge on partial and generalized seizures, including tonic-clonic and absence seizures. Understand their phases and symptoms better to enhance your learning about antiepileptic drugs.

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