Introduction to Seizures and Epilepsy
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Questions and Answers

Which of the following statements about benzodiazepines is true?

  • Benzodiazepines have a favorable teratogenic potential for pregnant women. (correct)
  • Benzodiazepines are first-line treatments for all types of seizures.
  • Benzodiazepines are preferred over barbiturates for managing seizures. (correct)
  • Benzodiazepines can cause medullary depression and coma at high doses.

    • What is a key characteristic of the drug Perampanel?

  • It causes significant medullary depression.
  • It is a type of benzodiazepine.
  • It is a first-line treatment for generalized seizures.
  • It is primarily an AMPA antagonist. (correct)

    • What might be a consequence of barbiturate overdose?

  • Lesser risk of respiratory depression compared to benzodiazepines.
  • Agitation and anxiety.
  • Medullary depression leading to respiratory arrest. (correct)
  • Increased activity level and hyperactivity.

    • Which drug is noted for having no significant drug interactions?

    <p>Levetiracetam</p> Signup and view all the answers

    Which medications are categorized under the 'L medicines' suitable for pregnant women?

    <p>Levetiracetam and Lacosamide</p> Signup and view all the answers

    What is the effect of AMPA/Kainate receptor antagonists on neurotransmission?

    <p>Decrease fast excitatory neurotransmission</p> Signup and view all the answers

    How do NMDA receptor antagonists primarily affect excitatory neurotransmission?

    <p>They decrease slow excitatory neurotransmission</p> Signup and view all the answers

    What is the role of SV2A protein ligands regarding neurotransmitter release?

    <p>Decrease neurotransmitter release</p> Signup and view all the answers

    Which of the following drugs is associated with a suppressive effect on burst action potentials?

    <p>Cenobamate (CNB)</p> Signup and view all the answers

    Which drug is classified as a calcium channel inhibitor?

    <p>Gabapentin (GBP)</p> Signup and view all the answers

    Which effect is characteristic of positive modulation of potassium channels?

    <p>Hyperpolarizes membrane potentials</p> Signup and view all the answers

    Which of the following is NOT an effect associated with Felbamate (FBM)?

    <p>Activation of AMPA receptors</p> Signup and view all the answers

    What is a common side effect associated with the use of oxcarbazepine?

    <p>Weight gain</p> Signup and view all the answers

    Which pharmacokinetic property is unique to lacosamide compared to other anti-seizure medications?

    <p>Renal excretion</p> Signup and view all the answers

    In patients with cardiac conditions, which medication should be avoided due to the risk of prolonging the PR interval?

    <p>Lacosamide</p> Signup and view all the answers

    What is the mechanism of action of oxcarbazepine?

    <p>Fast sodium channel inhibitor</p> Signup and view all the answers

    What dosage is typically recommended for children using lacosamide?

    <p>6-8 mg/kg</p> Signup and view all the answers

    Which of the following best describes the half-life of oxcarbazepine?

    <p>1-5 hours</p> Signup and view all the answers

    What is a notable advantage of oxcarbazepine in terms of dosing compared to carbamazepine?

    <p>Can be titrated upward at a more rapid rate</p> Signup and view all the answers

    Which metabolite is produced from oxcarbazepine?

    <p>Eslicarbazepine</p> Signup and view all the answers

    Which condition can oxcarbazepine exacerbate in patients?

    <p>Myoclonic seizures</p> Signup and view all the answers

    What is the favorable teratogenic profile of oxcarbazepine?

    <p>Safe for use in pregnancy</p> Signup and view all the answers

    What is a characteristic of Gabapentin's absorption?

    <p>It displays a dose-related absorption.</p> Signup and view all the answers

    Which anticonvulsants are known to be ionized in serum?

    <p>Valproate, Gabapentin, Pregabalin</p> Signup and view all the answers

    How does protein binding influence drug distribution?

    <p>Low protein binding allows for more free drug distribution.</p> Signup and view all the answers

    Which drugs are exceptions that undergo extensive metabolism?

    <p>Gabapentin, Pregabalin, and Levetiracetam</p> Signup and view all the answers

    What is a primary characteristic of therapeutic drug monitoring?

    <p>It takes into account factors such as sex, age, and comorbidities.</p> Signup and view all the answers

    Which anticonvulsants have >90% protein binding?

    <p>Valproate, Phenytoin, and Carbamazepine</p> Signup and view all the answers

    Which drug is recognized as an inhibitor in the context of enzyme induction?

    <p>Valproic acid</p> Signup and view all the answers

    What general rule is followed regarding the dosing of anticonvulsants?

    <p>Initiate treatment at lower doses and titrate slowly.</p> Signup and view all the answers

    Which drug acts as a Slow Sodium Channel Inhibitor?

    <p>Lamotrigine</p> Signup and view all the answers

    What common adverse drug reaction is associated with Gabapentin and Pregabalin?

    <p>Somnolence</p> Signup and view all the answers

    Which drug is recommended as first-line for focal seizures?

    <p>Lamotrigine</p> Signup and view all the answers

    What is the half-life of Pregabalin?

    <p>15-60 hours</p> Signup and view all the answers

    What is the maximum daily dose for adults taking Gabapentin?

    <p>3,600 mg</p> Signup and view all the answers

    Which condition is NOT indicated for Gabapentin as first-line treatment?

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

    What is an important risk factor associated with Pregabalin use?

    <p>HLA-B*1502 Haplotype</p> Signup and view all the answers

    Which symptom is a potential side effect of Gabapentin and Pregabalin?

    <p>Ataxia</p> Signup and view all the answers

    What characterizes the pharmacokinetics of the medication linked to Glu release and SV2A?

    <p>Nonlinear pharmacokinetics with a narrow therapeutic index</p> Signup and view all the answers

    Which of the following is a potential adverse drug reaction associated with Carbamazepine?

    <p>Severe rash indicating risk of SJS-TEN</p> Signup and view all the answers

    Which condition is Carbamazepine primarily indicated for?

    <p>First-line treatment for focal seizures</p> Signup and view all the answers

    Which factor primarily influences the pharmacokinetics of the medication related to GABA?

    <p>Formulation and binding to albumin</p> Signup and view all the answers

    For pediatric patients, what is the recommended dosing range of the GABA-enhancing medication?

    <p>20-30 mg/kg</p> Signup and view all the answers

    What is a significant side effect of Phenytoin that necessitates careful monitoring?

    <p>Hyponatremia due to water retention</p> Signup and view all the answers

    Which mechanism underlies the action of Barbiturates and Benzodiazepines in relation to GABA?

    <p>Activating GABA receptors</p> Signup and view all the answers

    What should be done if a patient develops a rash while taking Carbamazepine?

    <p>Immediately stop the medication</p> Signup and view all the answers

    Study Notes

    Introduction to Seizures and Epilepsy

    • Seizures are transient symptoms caused by excessive or synchronous neuronal activity, potentially due to infections, conditions like
      • An imbalance in electrolytes - WEIRD transmitting electrical signals in the nervous system. Other underlying conditions that may lead to seizures include metabolic disorders, head injuries, or brain tumors.
    • Epilepsy is characterized by at least two unprovoked seizures occurring more than 24 hours apart. Unprovoked indicates the seizure wasn't triggered by a known cause like fever.

    Anti-Seizure Medications

    • Anti-seizure medications (ASMs) function through various mechanisms, including inhibition of voltage-gated channels, enhancement of GABA synaptic transmission, and modulation of glutamate release. Specific ASMs influence GABA-A receptors, glutamate release, or sodium channels.
    • Several drugs are listed and categorized in this study resource.

    Epilepsy Types

    • Focal seizures affect only one brain hemisphere.
    • Generalized seizures involve both hemispheres.
    • Myoclonic seizures involve sudden, jerking, involuntary movements.
    • Absence seizures cause brief loss of awareness and consciousness.

    Seizure Generation

    • Excitatory neurotransmitter glutamate plays a critical role.
    • Inhibitory neurotransmitter GABA helps control neuronal activity

    Neurotransmitter Flow

    • Glutamate is the primary excitatory neurotransmitter.
    • GABA is the primary inhibitory neurotransmitter.
    • Astrocytes are important in regulating glutamate levels in the synapse.

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    Description

    This quiz covers the basics of seizures and epilepsy, including definitions, types of seizures, and classifications. It also explores anti-seizure medications and their mechanisms of action. Test your knowledge on this important neurological topic.

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