Science Quiz / Anti-Seizure Drugs

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Can you name the Anti-Seizure Drugs ?

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1st line for partial seizures. Toxicities include: Vertigo, drowsiness, diplopia and ataxia
Current 1st Choice for most partial. Used for generalized tonic-clonic seizures (either primary or secondary), but not absence seizures.
Inhibits the reuptake of GABA.
Inhibits GABA transaminase and results in more GABA release.
Sudden loss of postural tone (1-2 s); sudden fall. Wear helmets to prevent head injured
Shocklike muscle contractions also exists as major seizure type. Associated with metabolic disorders, degenerative CNS diseases, or anoxic brain injury.
Characteristic EEG 2-3 Hz spike-and-wave Begin in childhood (y 4-8)
Rigidity (15-30 sec), then tremor, clonic jerking (60-120 sec), stupor Main seizure in epileptic patients (10%) Therapy similar to partial
30-120 sec, weakness for hours localized onset (mostly from temporal lobes), becoming widespread (bilateral, limbic system) patient impaired consciousness after brief “warning”
minimal spread, 60-90 sec, then 15 min weakness consciousness preserved (sometimes aura precedes)
Involvement of both cortical hemispheres and thalamus Biochemical, cellular, structural different drugs for individual types
Localized foci in cerebral cortex Structural brain abnormalities same drugs for the whole class
transient behavioral alterations caused by hypersynchronous and rhythmic neuronal firing in the CNS
name for brain disorder that is characterized by episodic and unpredictable recurrent seizure activity
seizure fail to cease spontaneously or recur before consciousness is restored
Drug: at low doses: 1st order (proportional to dose) at therapeutic doses
Toxicities of this drug: Nystagmus, early Ataxia, diplopia (adjust dose!) Sedation at high plasma level Gingival hyperplasia, hirsutism (very common-- 20%)
Effective in bipolar depression trigeminal neuralgia (original use)
Very effective for absence seizures, (but because of its hepatotoxicity, ethosuximide is preferred)
First line for most, alternative for absence Also used for Bipolar depression Significant toxicity issue, hypersensitivity, SJS in children 0.8% - low starting doses help
First line for generalized tonic-clonic and atypical absence, myoclonic, and atonic. Also used for preventative therapy for migraine headaches
Sulfonamide derivative marketed in Japan: Febrile seizures
Reduces low-threshold (T-type) Ca++ currents (pacemaker currents in thalamic neurons, responsible for generating rhythmic cortical discharge in absence attack)
I.V. for status epilepticus; can be more effective and durable than diazepam.
Teratogenicity: spina bifida in 1-2%

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