1Antiepileptic medications attempt to do what in relation to seizures?
Prevent seizures (decreasing the number, severity, and/or duration)
2Do antiepileptic medications cure epilepsy?
No, they do not cure epilepsy or alter the underlying problem predisposing to seizures
3What are the two main ways antiepileptic medications work to prevent seizures?
Decreasing excitation or enhancing inhibition
4Name some common mild side effects when starting antiepileptic medications
Nausea, abdominal pain, dizziness, sleepiness, irritability, anxiety or mood changes
5Side effects similar to being "drunk" (e.g., unsteadiness, poor concentration) are common when antiepileptic medications are prescribed at what dose?
Too great a dose
6What side effect is associated with chronic administration of Phenytoin?
Gingival (gum) hyperplasia or Hirsuitism
7Which antiepileptic drug is indicated for generalized non-motor (absence) seizures?
Ethosuximide
8Which class of antiepileptic drugs carries an FDA black box warning for suicidality?
As a class, antiepileptic drugs (AEDs)
9Approximately what percentage of patients with epilepsy is resistant to current AEDs?
30%
10Which drug is effective in terminating status epilepticus?
Diazepam (Also Valproate, but Diazepam is often the first-line benzodiazepine mentioned)
11What are the three major classes of mechanism for antiepileptic drugs (AEDs)?
Modulation of voltage-gated ion channels; enhancement of GABA-mediated inhibitory neurotransmission; and attenuation of glutamate-mediated excitatory neurotransmission
12What is the most common mechanism of action among currently available AEDs?
Blockade of voltage-gated sodium channels
13Which neurotransmitter is the predominant inhibitory neurotransmitter in the mammalian central nervous system?
Gamma-aminobutyric acid (GABA)
14Which AEDs act by blocking voltage-operated sodium channels?
Lamotrigine, Phenytoin, or Carbamazepine (among others)
15Which drug is mentioned as blocking voltage-operated calcium channels, especially those that mediate calcium currents in thalamic neurons?
Ethosuximide
16What is one way AEDs enhance GABAergic neurotransmission?
Modulate transmission through chloride channels (e.g., Barbiturates and Benzodiazepines)
17What is the effect of blocking voltage-gated sodium channels by AEDs?
Decreased electrical activity and probably a subsequent reduction in glutamate release
18Which AED irreversibly inhibits GABA transaminase, the enzyme that degrades GABA?
Vigabatrin
19How do benzodiazepines and barbiturates enhance GABA-mediated inhibition?
Benzodiazepines increase the frequency, and Barbiturates prolong the duration of GABA-mediated chloride channel openings
20What are the three ionotropic receptor subtypes that glutamate exerts its effects on?
AMPA, kainate, and NMDA
21What is the general class of adverse effects that includes dizziness, nystagmus, diplopia, and drowsiness?
Neurotoxic side effects (due to suppression of the nervous system)
22What is a common characteristic of many neurotoxic side effects of AEDs?
They are dose-dependent
23What three anti-epileptic drugs (AEDs) are specifically mentioned as enzyme inducers that pose a risk factor for osteoporosis?
Phenytoin, Carbamazepine, and Phenobarbital (also Primidone)
24Which long-term side effect is specifically associated with Phenytoin?
Gingival hyperplasia or Hypertrichosis (increased body hair)
25What dangerous side effect is common to Carbamazepine and Lamotrigine, which involves a skin rash, eosinophilia, and organ involvement?
DRESS syndrome (Drug Reaction with Systemic Symptoms)
26What condition is a common side effect of Topiramate due to its mechanism causing metabolic acidosis?
Nephrolithiasis (kidney stones)
27What are the three symptoms that commonly present in a triad for anticonvulsant toxicity?
Central nervous system (CNS) depression, Ataxia, and Nystagmus
28What long-term side effect of Valproate can also cause increased ammonia levels?
Liver injury (hepatotoxicity) or Pancreatitis
29What two conditions are Phenytoin, Carbamazepine, Phenobarbital, and Primidone risk factors for with long-term use?
Osteoporosis and Folic acid depletion (leading to megaloblastic anemia)
30What common side effect is often seen with Carbamazepine and Oxcarbazepine due to its effect on antidiuretic hormone receptors?
Hyponatremia (low blood sodium)
31Which broad-spectrum AED is known to cause weight gain, tremor, and hair loss?
Valproate (Valproic Acid)
32The FDA issued a warning for all antiseizure medications regarding an increased risk of what serious side effect?
Suicidal ideation and suicidal behavior
33What mechanism of action, when blocked by certain AEDs (like Carbamazepine), can lead to cardiac conduction abnormalities?
Sodium channels