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level: DRUGS - Generalized Seizures

Questions and Answers List

level questions: DRUGS - Generalized Seizures

Question	Answer
• introduced as a "PURE PETIT MAL" drug • MOA: has an important effect on Ca2+ currents, reducing the lowthreshold current DOC for ABSENCE SEIZURE	ETHOSUXIMIDE • Zarontin®
• are phenylsuccimides that were developed and marketed before ethosuximide • used as ANTI-ABSENCE DRUG	Phensuximide & Methsuximide - has been used for partial seizures
• also used as the free acid, Valproic Acid • MOA: blocks high-frequency firing of neurons, modifies amino acid metabolism • Very effective against ABSENCE SEIZURE and is often PREFERRED when the patient has CONCOMITANT GENERALIZED TONIC-CLONIC ATTACKS Myoclonic seizures Generalized Tonic-Clonic Seizures MANAGEMENT OF BIPOLAR DISORDER MIGRAINE PROPHYLAXIS	SODIUM VALPROATE • Depakene®
Therapeutic Level SODIUM VALPROATE	• 50-100mcg/mL
First Oxazolidinedione former DOC for ABSENCE SEIZURE Toxicity: Sedation	Trimethadione
Other Drugs Used in Management of Epilepsy	BENZODIAZEPINES
• given IV or rectally for STOPPING CONTINUOUS SEIZURE ACTIVITY, especially GENERALIZED TONIC-CLONIC STATUS EPILEPTICUS •BENZODIAZEPINE	DIAZEPAM • Valium®
•MORE EFFECTIVE AND LONGER ACTING THAN DIAZEPAM for STATUS EPILEPTICUS •BENZODIAZEPINE	LORAZEPAM • Ativan®
• a long acting drug with DOCUMENTED EFFICACY against ABSENCE SEIZURE, MYOCLONIC SEIZURES and INFANTILE SPASM	CLONAZEPAM • Klonopin®
used for INFANTILE SPASM AND MYOCLONIC SEIZURES	NITRAZEPAM
• approved in USA as an adjunct treatment of complex partial seizures in adults • Toxicities: drowsiness and lethargy	CLORAZEPATE • Tranxene®
Limitations for BZD Use	• Pronounced sedative effect • Tolerance
• a DIURETIC whose main action is the INHIBITION OF CARBONIC ANHYDRASE • MOA: mild acidosis in the brain	ACETAZOLAMIDE • Diamox®