Epilepsy and Anti-epiletic drugs
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Questions and Answers

Which mechanism of action is NOT associated with anti-epileptic drugs?

  • Inhibition of GABA reuptake
  • Enhancement of GABA neurotransmission
  • Modulation of cation channels
  • Activation of ionotropic glutamate receptors (correct)

    • How do anti-epileptic drugs enhance GABA neurotransmission?

  • By enhancing GABA neurotransmitter through GABA type A channels
  • By inhibiting GABA reuptake
  • By decreasing GABA catabolism
  • All of the above (correct)

    • Which protein do anti-epileptic drugs act on to modulate synaptic release?

  • SV2A (correct)
  • gAMP subunit
  • GABA type A channels
  • AMPA receptors

    • Which type of brain waves are associated with intense mental activity or fright?

    <p>Beta waves</p> Signup and view all the answers

    Which electrolyte disorder can cause seizures?

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

    Which type of seizure is characterized by a clouding of consciousness and strange, repetitious movements?

    <p>Complex partial seizure</p> Signup and view all the answers

    Which condition is characterized by recurrent seizures and can have multiple underlying causes?

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

    Which type of seizure is also known as grand mal seizure and involves synchronous firing from all areas of the brain?

    <p>Generalized tonic-clonic seizure</p> Signup and view all the answers

    Which factor can cause seizures?

    <p>CNS stimulant drugs</p> Signup and view all the answers

    Which age group is absence seizure most commonly seen in?

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

    Which type of seizure is characterized by lip-smacking and chewing automatisms?

    <p>Complex partial seizure</p> Signup and view all the answers

    Which condition can be a potential underlying cause of epilepsy?

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

    Which brain activity is promoted by surgical anesthesia?

    <p>Delta waves</p> Signup and view all the answers

    Which type of seizure originates in a discrete region of the brain and can develop into a generalized seizure?

    <p>Focal seizure</p> Signup and view all the answers

    Which type of seizure is characterized by a momentary loss of consciousness and is not accompanied by auras or postictal periods?

    <p>Absence seizure</p> Signup and view all the answers

    What can cause focal seizures?

    <p>All of the above</p> Signup and view all the answers

    Which type of seizure is associated with widespread electrical activity involving both hemispheres simultaneously?

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

    What is the postictal period?

    <p>The time from after the seizure to normal brain activity</p> Signup and view all the answers

    Which type of seizure is characterized by lip-smacking and chewing automatisms?

    <p>Complex partial seizure</p> Signup and view all the answers

    What is an aura preceding a seizure?

    <p>Light sensitivity</p> Signup and view all the answers

    What is the term for nonconvulsive generalized seizures characterized by a momentary loss of consciousness?

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

    What can focal seizures develop due to?

    <p>All of the above</p> Signup and view all the answers

    Which age group is typically affected by absence seizures?

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

    Which genetic mutations can cause childhood absence epilepsy?

    <p>All of the above</p> Signup and view all the answers

    Which type of seizure is precipitated by certain events like loud noises or flashing lights?

    <p>Primary generalized seizure</p> Signup and view all the answers

    Which brain regions are involved in the rapid spread of generalized seizures?

    <p>Thalamus and cortex</p> Signup and view all the answers

    What is the characteristic feature of generalized tonic-clonic seizures?

    <p>Post-seizure depression</p> Signup and view all the answers

    What is the term used for the loss of control of visceral organ functions during a generalized tonic-clonic seizure?

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

    Which type of seizure is characterized by a clouding of consciousness and strange, repetitious movements?

    <p>Complex partial seizures</p> Signup and view all the answers

    Which neurotransmitter receptor mutation can cause childhood absence epilepsy?

    <p>GABA receptor (GABRB3)</p> Signup and view all the answers

    What is the term used for the former name of generalized tonic-clonic seizures?

    <p>Grand mal seizures</p> Signup and view all the answers

    Which condition can lead to hyponatremia(low sodium level)?

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

    What is the major clinical manifestation of potassium disorders?

    <p>Muscle weakness</p> Signup and view all the answers

    Which type of electrolyte disturbances are more likely to cause seizures?

    <p>Rapidly evolving</p> Signup and view all the answers

    When should an electrolyte panel be done in patients with a first-time seizure?

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

    What can cause seizures to occur?

    <p>Water moving into neuronal cells</p> Signup and view all the answers

    Which type of seizure may or may not cause the person to lose consciousness?

    <p>Focal seizure</p> Signup and view all the answers

    What should focal seizures not be confused with?

    <p>Migraine headache</p> Signup and view all the answers

    Which type of seizures have a high discharge rate due to localized reverberating circuits?

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

    What is the term for nonconvulsive generalized seizures characterized by a momentary loss of consciousness?

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

    Which neurotransmitter is the principal inhibitory brain neurotransmitter?

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

    What is the principal excitatory brain neurotransmitter?

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

    What is the overall mechanistic strategy of neurotransmitters in relation to seizure threshold?

    <p>To increase seizure threshold</p> Signup and view all the answers

    Which type of channels are opened through increased GABA binding?

    <p>Chloride channels</p> Signup and view all the answers

    What are the voltage-gated sodium and calcium antagonists used for?

    <p>Increasing seizure threshold</p> Signup and view all the answers

    What is the mechanism of reuptake inhibitors for GABA and blocking GABA metabolism?

    <p>Increasing seizure threshold</p> Signup and view all the answers

    Which part of the brain can Jacksonian seizures originate from?

    <p>Primary motor cortex</p> Signup and view all the answers

    What is the characteristic progression pattern of Jacksonian seizures?

    <p>From fingers to the entire hand and arm/leg</p> Signup and view all the answers

    What is the term used to describe the tonic and clonic contraction pattern of Jacksonian seizures?

    <p>Tonic-clonic contraction</p> Signup and view all the answers

    Which direction do the head and eyes typically turn during a Jacksonian seizure?

    <p>Towards the convulsing side</p> Signup and view all the answers

    Which type of ion channels do anti-epileptic drugs target to decrease seizure incidence?

    <p>Voltage-gated sodium and calcium channels</p> Signup and view all the answers

    Which method of treatment for seizures involves opening chloride channels and inducing hyperpolarization of post-synaptic neurons?

    <p>Enhancing GABA neurotransmission</p> Signup and view all the answers

    Which type of calcium channels are inhibited by ethosuximide?

    <p>T-type Ca2+ channels</p> Signup and view all the answers

    What is the clinical indication for ethosuximide?

    <p>Management of absence seizures</p> Signup and view all the answers

    Which type of neurons have hyperactive T-type Ca2+ channels?

    <p>Post synaptic neurons</p> Signup and view all the answers

    What is the effect of ethosuximide on thalamocortical activity?

    <p>Decreases activity</p> Signup and view all the answers

    Which type of muscle cells have L-type calcium channels?

    <p>Both smooth and cardiac muscle cells</p> Signup and view all the answers

    What is the primary adverse effect of ethosuximide?

    <p>All of the above</p> Signup and view all the answers

    What effect does ethosuximide have on seizure threshold?

    <p>Increases seizure threshold</p> Signup and view all the answers

    What is the mechanism of action of ethosuximide?

    <p>Inhibition of T-type calcium channels</p> Signup and view all the answers

    What is the volume of distribution of ethosuximide?

    <p>Low volume of distribution</p> Signup and view all the answers

    What is the half-life of ethosuximide?

    <p>50-60 hours</p> Signup and view all the answers

    Phenytoin is effective against which types of seizures?

    <p>Focal and tonic-clonic seizures</p> Signup and view all the answers

    What is the mechanism of action (MOA) of phenytoin?

    <p>Slows the rate of recovery of voltage-gated sodium channels</p> Signup and view all the answers

    What is the major adverse effect associated with chronic phenytoin treatment?

    <p>All of the above</p> Signup and view all the answers

    What percentage of phenytoin is bound to albumin?

    <p>Around 90%</p> Signup and view all the answers

    What is the elimination order of phenytoin at high concentrations?

    <p>Zero-order</p> Signup and view all the answers

    What is the primary enzyme responsible for metabolizing phenytoin in the liver?

    <p>Hepatic CYPs</p> Signup and view all the answers

    Which type of calcium channels are hyperactive in the absence of ethosuximide?

    <p>L-type calcium channels</p> Signup and view all the answers

    What effect does ethosuximide have on T-type calcium channels?

    <p>Ethosuximide blocks T-type calcium channels</p> Signup and view all the answers

    How does ethosuximide affect the activity in the corticothalamic pathway?

    <p>Ethosuximide decreases activity in the corticothalamic pathway</p> Signup and view all the answers

    What is the consequence of hyperactive T-type calcium channels?

    <p>Increased glutamate release in the cortex</p> Signup and view all the answers

    What effect does ethosuximide have on the seizure threshold?

    <p>Ethosuximide increases the seizure threshold</p> Signup and view all the answers

    Which type of seizures can be treated with valproate?

    <p>All of the above</p> Signup and view all the answers

    What is the mechanism of action of valproate?

    <p>All of the above</p> Signup and view all the answers

    Which enzymes are involved in the metabolism of valproate?

    <p>Phase II conjugation and beta-oxidation</p> Signup and view all the answers

    Which adverse effects are associated with valproate?

    <p>All of the above</p> Signup and view all the answers

    Which drugs bind to the Ca2+ channel subunit α2δ1 and block voltage-gated calcium channels?

    <p>Gabapentin and pregabalin</p> Signup and view all the answers

    What is the mechanism of action of gabapentin and pregabalin in the treatment of seizures?

    <p>Blocking voltage-gated calcium channels and increasing seizure threshold</p> Signup and view all the answers

    Which benzodiazepines can be used to treat seizures?

    <p>Clonazepam, diazepam, lorazepam</p> Signup and view all the answers

    What is the primary adverse effect associated with chronic use of benzodiazepines for seizures?

    <p>Tolerance development</p> Signup and view all the answers

    Which factor determines the proper medical treatment for a patient with a seizure?

    <p>The patient's medical history</p> Signup and view all the answers

    In which situation should a patient not be given chronic treatment of an anti-epileptic?

    <p>If the patient had a seizure due to alcohol withdrawal</p> Signup and view all the answers

    What is the most common treatment approach for seizures?

    <p>Using a single agent</p> Signup and view all the answers

    When will a second agent be added for seizure treatment?

    <p>When the patient is not properly controlled</p> Signup and view all the answers

    What is the main mechanism of action for most anti-epileptic drugs?

    <p>Inhibiting voltage-gated sodium channels</p> Signup and view all the answers

    How do anti-epileptic drugs decrease glutamate release?

    <p>By blocking calcium channels</p> Signup and view all the answers

    What effect do anti-epileptic drugs have on GABA neurotransmission?

    <p>They enhance GABA neurotransmission</p> Signup and view all the answers

    What is the role of GABA neurotransmission in relation to seizures?

    <p>It increases seizure threshold</p> Signup and view all the answers

    Which type of channels do benzodiazepines increase the frequency of opening?

    <p>GABA type A channels</p> Signup and view all the answers

    What is the effect of benzodiazepines on the membrane potential?

    <p>Make it more negative</p> Signup and view all the answers

    Why are benzodiazepines given for acute events rather than chronically?

    <p>To prevent tolerance development</p> Signup and view all the answers

    Study Notes

    Mechanisms of Anti-Epileptic Drugs

    • Not associated with anti-epileptic drugs: increasing the activity of the neurotransmitter aspartate
    • Enhancement of GABA neurotransmission: increasing the activity of GABA, which is the principal inhibitory brain neurotransmitter
    • Target of anti-epileptic drugs: GABA receptors and voltage-gated sodium and calcium channels
    • Chloride channels are opened through increased GABA binding

    Types of Seizures

    • Associated with intense mental activity or fright: beta brain waves
    • Characterized by a clouding of consciousness and strange, repetitious movements: complex partial seizures
    • Also known as grand mal seizure, involves synchronous firing from all areas of the brain: generalized tonic-clonic seizures
    • Can cause seizures: electrolyte disturbances, infection, head trauma
    • Most commonly seen in: absence seizures in children
    • Characterized by lip-smacking and chewing automatisms: complex partial seizures
    • Can be a potential underlying cause of epilepsy: genetics, head trauma, infection, stroke

    Brain Activity and Seizures

    • Promoted by surgical anesthesia: delta brain waves
    • Can develop into a generalized seizure: focal seizures
    • Characterized by a momentary loss of consciousness and is not accompanied by auras or postictal periods: absence seizures
    • Focal seizures can develop due to: scarring, tumor, infection
    • Can cause focal seizures: scarring, tumor, infection
    • Generalized seizures: widespread electrical activity involving both hemispheres simultaneously

    Epilepsy and Seizures

    • Condition characterized by recurrent seizures and multiple underlying causes: epilepsy
    • Postictal period: period of confusion, disorientation, and fatigue following a seizure
    • Characterized by lip-smacking and chewing automatisms: complex partial seizures
    • Aura preceding a seizure: strange sensation or smell that warns of an impending seizure
    • Term for nonconvulsive generalized seizures characterized by a momentary loss of consciousness: absence seizures
    • Genetic mutations that can cause childhood absence epilepsy: genes that code for GABA receptor subunits and T-type calcium channels

    Anti-Epileptic Drugs

    • Target of ethosuximide: T-type calcium channels
    • Mechanism of action of ethosuximide: blocking T-type calcium channels and reducing thalamocortical activity
    • Clinical indication for ethosuximide: absence seizures
    • Phenytoin is effective against: partial and generalized tonic-clonic seizures
    • Mechanism of action of phenytoin: blocking voltage-gated sodium channels
    • Valproate is effective against: absence, partial, and generalized tonic-clonic seizures
    • Mechanism of action of valproate: increasing GABA levels and blocking voltage-gated sodium channels
    • Gabapentin and pregabalin mechanism of action: increasing GABA levels and binding to the Ca2+ channel subunit α2δ1

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    Test your knowledge on the mechanisms of action (MOAs) for anti-epileptic drugs. Learn about how these drugs modulate cation channels, enhance GABA neurotransmission, inhibit GABA reuptake, and more. Challenge yourself with questions on the MOAs of anti-epileptics and enhance your understanding of these important medications.

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