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Exam 3
Lecture 2- Seizure treatment Part 1
40
Architecture
7th Grade
10/15/2013

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Term
all new AEDs are less terotegenic except
Definition
topiramate
Term
the new AEDS have what improved things comapred to the 1st gen? -4
Definition
PK
less CYP
less EPS
less sedation
Term
this drug can be used in neonates and older
Definition
phenytoin
Term
these drugs are approved for children >10 yrs old-2
Definition
valproate
Lamotrigine
Term
which drug has risk of liver tox in children <2
Definition
Valproate
Term
this drug can be used for absence seizure with children >2
Definition
lamotrigine
Term
what are the 2 meds for absence seizures
Definition
valproate
lamotrigine
Term
what meds cna be used for lennox gastaut-2
Definition
lamotrigine
topiramte
Term
topiramate can be used as monotherapy in what age
Definition
>10
Term
oxcarbamezapine is adjunst for what age?
monotherapy?
Definition
>2
>4
Term
Levetiracetam shoudl be used in what age
Definition
>4
Term
which drug isnt approved for use in children
Definition
zonisamide
Term
factors that imrpove successful AED withdrawl-
Definition
seizure free 2 yrs
complete control in 1 yr
age>2, <35
only 1 type of seizure
normal EEG while on therapy
Term
withdrawl should be done over _ months-
Definition
6
Term
the acute dose depednt ADEs-2
Definition
neutoxic- sedation, dizzy
cognition impairment
Term
what classic drug is greater impair of cognition? which is least
Definition
phenytoin
valproate
Term
which new AED causes most cognitive impair?
Definition
topiramate
Term
the idiosyncratic AEDs-2
Definition
allergy, hepatitis
Term
long term osteoporis is assoc with
what is the treatment?
Definition
the classical AEDS
Ca + Vit D
Term
for ppl with epilepsy- is ther an increased risk of suice?
Definition
no
Term
which hormone increases seizure effect
why?
Definition
estrogen
inhibits GABA
Term
which hormone is seizure protective
Definition
progesterone (increases GABA)
Term
why do seizures occur rihgt before/during menstration?
Definition
bc estrogen >>> progesterone
Term
AEDs that are hepatic inducers do what-2
Definition
increase steroid hormone
decrease fee sex hormones
Term
AEDs that decrease oral contraceptives-4
Definition
all classicla but valproate
topiramate, oxacarbamezapine, lamotrigine,
Term
valproate is associ with what disease
Definition
PCOS
Term
during pregnancy what happens to seizures
Definition
1/3 increase but 1/3 decrease
Term
what 2 drugs cause cleft palate and heart malform if used in preggos
Definition
phenobarbital
phenytoin
Term
what 2 drugs cauase spina bifida if sued in preggos
Definition
valproate and carbamezapine
Term
many birth defects can be prevented by supplementaiton of
Definition
folic acid
Term
if using 1st gen AEDS, to reduce hemmorhage need to give in last month
Definition
Vitmain K
Term
*higher protein binding = less in breast milk
Definition
Term
status epilepticus is when seizure lasts?
what else cna be defined as it?
Definition
30 minutes
reccurrent seizures without period of conciousness
Term
what is the more common SE?
Definition
generalized convulsive (almost msot severe)
Term
incidence of generalized SE is higher for what ages
Definition
<1 yo
>60
Term
nonconvulsive SE has what continuous state
Definition
twilight/altered conciousness
Term
drug of choice for SE
why?
Definition
lorazepam (is IV)
higher affinity for BDZ recpt than diazepam
Term
for the SE drugs which gets to brain first?
which stays longer tho?
Definition
diazepam
lorazepam
Term
second line treatment for SE
Definition
phenytoin
fosphenytoin (will have less phlebitis)and cna infuse faster
Term
3rd line treatmen for SE
Definition
phenobarbital
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