phcl 444 test#4 antiseizure
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29 terms
Terms | Definitions |
|---|---|
 true (generalized) | type of seizure that is idiopathic with no known cause |
| partial simple | type of seizure where consciousness is conserved and jerking is of short duration |
| partial complex | type of seizure that involves automatisms (lip smacking, scratching, fumbling); may have brief warning, generally no post episode memory; impaired at onset |
| partial | seizure classification type that responds well to ASDs |
| absence (petit mal) | type of seizure with sudden onset, altered consciousness; abrupt cessation |
| generalized tonic-clonic (grand mal) | type of seizure that is the most dramatic and life threatening, pt left in stupor |
| atonic | type of seizure characterized by complete loss of postural tone; often wear helmets to avoid head injury |
| phenytoin | prolongs the inactivated state of the Na+ channel; used against partial seizures and gen. tonic clonic seizures |
| phenytoin | small changes in dose can lead to erratic steady state levels |
| nystagmus | toxicity effect from phenytoin that doesn't req. dose modification |
| diplopia and ataxia | toxicity effects from phenytoin that do req. dose modification |
| fosphenytoin | phenytoin prodrug; freely soluble; pKa 8-8.3 |
| carbemazepine, oxcarbazepine | iminostilbenes |
| carbemazepine | can lead to blood dyscrasias incl. fatal anemias |
| induces, inhibits | oxcarbazepine adverse effects ___ CYP3A4/5 and ___ CYP2C19; lots of D/D interactions |
| phenobarbital, mephobarbital, primidone | barbiturates that act as ASDs |
| phenobarbital | 1/2 life 80-120 hrs (really long half life, probably longest in barbiturates) |
| topiramate | only glutamate receptor antagonist that does not have an uride backbone |
| topiramate | Adverse effects: speech & language dysfunction (wernicke's & broca's area depression); may decrease efficacy of birth control pills |
| gabapentin | less glutamate release and increased GABA release; also promoted for neuropathic pain |
| felbamate | blocks glutamate excitation; use-dependent block of NMDA-R |
| felbamate | 1/2 life of 20hr (shortened when combined with phenytoin or carbamazepine); in combination, increases plasma levels of phenytoin & valproic acid, but decreases carbamazepine |
| felbamate | very high rates of severe hepatitis and aplastic anemia (severely toxic) |
| valproic acid | clinically used in all seizure types |
| valproic acid | HDAC inhibitor; transcriptional modulator |
| 4-ene-valproic acid | reactive, hepatotoxic metabolite of valproic acid |
| clonazepam | one of the most potent anti-seizure medications; long acting; acts on GABAa-R; BZD |
| ethosuximide | MOA: primarily Ca2+ currents, decreasing the low-threshold (T-type) current; responsible for some absence attacks, but efficacious in absence seizures |
| ethosuximide, valproic acid | toxicity leads to gastric distress |
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