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PHM231 CH 8
Central Nervous System Disorders and Drugs
| Question | Answer |
|---|---|
| seizure | caused by abnormal electrical discharge in the cerebral cortex, resulting in a change of behavior. conscious periods may or may not be accompanied by loss of control over movements or distortion of the senses |
| types of CNS disorders | epilepsy, Parkinson's, myasthenia gravis, attention deficit disorders, amyotrophic lateral sclerosis, multiple sclerosis, Alzheimer's, restless leg syndrome, fibromyalgia, Huntington's |
| convulsion | involuntary contraction or series of contractions, of the voluntary muscles |
| epilepsy | paroxysmal (sudden and recurring) seizures. involves disturbances of neuronal electrical activity that interfere with normal brain function; all epilepsy patients have seizures, but not all patients with seizures have epilepsy |
| 3 states of neurons | resting, firing, returning to rest |
| what determines when a neuron fires | the balance between excitatory and inhibitory impulses |
| negatively charged ions | inhibit neuron firing |
| positively charged ions | excite neuron and make it more likely to fire |
| ion channels | the flow of ions, or molecules in the cell membrane, controlled by neurotransmitters |
| glutamate | an excitatory amino acid neurotransmitter, increases firing |
| GABA | an inhibitory neurotransmitter, gamma-aminobutyric acid, decreases firing |
| causes of seizures | alcohol or drug withdrawal, epilepsy, high fever, hypoglycemia or hyperglycemia, infection, brain tumors, trauma or head injury |
| partial seizure | localized in a specific hemisphere of the brain |
| generalized seizure | involve malfunction in both hemispheres of the brain |
| simple partial seizure | twitching and sensory hallucinations with no loss of consciousness |
| complex partial seizure | blank stare, postseizure amnesia with impaired consciousness |
| tonic-clonic seizure FKA: grand mal | generalized, muscle rigidity followed by muscle jerks with shallow breathing, loss of bladder control, excess salivation |
| status epilepticus | generalized, tonic-clonic convulsions, high fever, lack of oxygen, with or without loss of consciousness |
| absence seizure FKA: petit mal | generalized, blank stare, rotating eyes, uncontrolled facial movements but no generalized convulsions |
| myoclonic seizure | generalized, sudden, massive, brief muscle jerks or non massive, quick jerks of the arms, hands, legs or feet; consciousness not lost |
| atonic seizure | generalized, sudden loss of muscle tone and consciousness |
| sodium channel blockers | block sodium in the fast sodium channels, lowers inappropriate firing of neurons; most common MOA of existing anticonvulsants |
| calcium channel blockers | block calcium channels, lowers inappropriate firing of neurons |
| GABA enhancers | an inhibitory neurotransmitter, inhibits neuron firing, higher GABA = anticonvulsant lower GABA = proconvulsant |
| Glutamate inhibitors | excitatory neurotransmitter, increases neuron firing, lower glutamate = anticonvulsant, higher glutamate = proconvulsant |
| gabapentin | Neurontin |
| phenobarbital | Luminal |
| pregabalin | Lyrica |
| felbamate | Felbatol |
| lamotrigine | Lamictal |
| topiramate | Topamax |
| GABA enhancers for partial seizures | gabapentin (Neurontin), pregabalin (Lyrica), felbamate (Felbatol), lamotrigine (Lamictal), topiramate (Topamax) |
| GABA enhancers for tonic-clonic seizures | phenobarbital (Luminal), felbamate (Felbatol), lamotrigine (Lamictal), topiramate (Topamax) |
| GABA enhancer for status epilepticus seizures | phenobarbital (Luminal) |
| phenobarbital | Schedule IV controlled substance, monitor drug levels |
| pregabalin | Schedule V controlled substance |
| enzymes | biological molecules that catalyze chemical reactions in the body |
| aura | premonition of the seizure attack through unusual sensations of light, sound, and taste |
| monotherapy | single-drug therapy, preferred to combo therapy as less expensive and less side effects |
| combination therapy of polytherapy | using two or more drugs from different classes, common among patients with severs forms of epilepsy |
| seizure drugs | are specific to different seizure types, may help one type of seizure but exacerbate another type |
| Sodium Channel Blockers | carbamazepine (Carbatrol, Epitol, Tegretol, Teril), fosphenytoin (Cerebyx), lacosamide (Vimpat), oxcarbazepine (Trileptal), phenytoin (Dilantin), vigabatrin (Sabril) |
| Calcium Channel Blockers | ethosuximide (Zaronin), valproic acid (Depakene, Depakote), zonisamide (Zonegran) |
| GABA Enhancers | gabapentin (Neurontin), phenobarbital (Luminal), pregabalin (Lyrica), primidone (Mysoline), tiagabine (Gabitril) |
| Glutamate Inhibitors | felbamate (Felbatol), lamotrigine (Lamictal), topiramate (Topamax) |
| unknown mechanism for anticonvulsants | levetiracetam (Keppra) |
Created by:
ChemeketaPHM2021
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