Katzung Chapter 22: Sedative-Hypnotic Drugs, Chapter 23: The Alcohols and Chapter 24: Antiseizure Drugs

Atonic

Sudden loss of postural tone

Phenytoin

Anticonvulsant, binds to sodium channels and prolongs the inactive state after opening, may cause gingival hyperplasia, hirsutism, coarsening of facial features, mild peripheral neuropathy, osteomalacia, agranulocytosis, exfoliative lesions and megaloblastic anemia

Carbamazapine

Anticonvulsant, binds to sodium channels and prolongs the inactive state after opening

Phenobarbital

Anticonvulsant, barbiturate binds to GABA channels and increases duration of chloride channel opening

Vigabatrin

Anticonvulsant, irreversible inhibitor of GABA aminotransferase (degrades GABA)

Lamotrigine

Anticonvulsant, binds to voltage-dependent sodium and calcium channels

Felbamate

Anticonvulsant- use dependent blockade of NMDA receptors, adverse effects- aplastic anemia and severe hepatitis

Gabapentin and Pregabalin

Anticonvulsant- binds to voltage gated calcium channels

Topiramate

Anticonvulsant- blocks voltage dependent sodium channels

Tiagabine

Anticonvulsant- inhibitor of GABA reuptake in neurons and glia

Lacosamide

Anticonvulsant- enhances slow inactivation of voltage-gated sodium channels

Levetiracetam

Anticonvulsant- binds to a synaptic vesicular protein may modify the synaptic release of glutamate and GABA

Rufinamide

Anticonvulsant- prolongs the inactive state of voltage-gated sodium channels

Zonisamide

Anticonvulsant- primary site of action appears to be the Na+ channel; it also acts on T-type voltage-gated Ca2+ channels

Ethosuximide

Anticonvulsant- reduces low-threshold calcium currents, inhibits sodium/potassium ATPase and inhibits GABA aminotransferase

Valproic acid and sodium valproate

Anticonvulsant- increased availability of GABA or may enhance the action of GABA, hepatotoxicity limits its use because it can be fatal

Sedative

Reduces anxiety and exerts a calming effect with little or no effect on motor or mental function

Hypnotic

Produces drowsiness and encourages the onset and maintenance of sleep (usually these effects can be produced with sedatives by increasing the dose)

Zolpidem

BZ1 selective agonists at the alpha 1 subunit, approved for insomnia

Eszopiclone

BZ1 selective agonists at the alpha 1 subunit, approved for insomnia

Zaleplon

BZ1 selective agonists at the alpha 1 subunit, apporved for insomnia

Flumazenil

Benzodiazepone antagonist, approved for use in reversing CNS depression effects after overdose and to hasten recovery from anesthesia and diagnostic procedures

Anterograde amnesia

Inability to remember events occurring during the drug's actions

Tolerance

Decreased responsiveness to a drug following repeated exposure

Lorazepam

Benzodiazepine, long-acting

Flurazepam

Benzodiazepine, long-acting

Chlordiazepoxide

Benzodiazepine, long-acting

Diazepm

Benzodiazepine, long-acting

Alprazolam

Benzodiazepine, long-acting

Clonazepam

Benzodiazepine, long-acting

Triazolam

Benzodiazepine, short-acting

Midazolam

Benzodiazepine, short-acting

Disulfiram

Inhibits aldehyde dehydrogenase

Ethanol

Small water soluble molecule that is rapidly absorbed from GI tract, readily crosses membranes including blood-brain barrier, 90% metabolized in the liver

Alcohol dehydrogenase

Catalyzes the conversion of ethanol to acetaldehyde

Aldehyde dehydrogenase

Catalyzes the conversion of acetaldehyde to acetate

Methanol

Wood alcohol

Ethylene glycol

Anti-freeze

Epilepsy

Finite episodes of brain dysfunction resulting from abnormal discharge of cerebral neurons

Focal aware seizures

Minimal spread of abnormal discharge and patient remains conscious and aware (can describe the attack in detail)

Focal impaired awareness seizures

Localized onset but becomes more widespread (usually bilateral) and involves the limbic system, lost start in the temporal lobe

Generalized onset tonic-clonic seizure

Characterized by tonic rigidity of all extremities followed by a tremor 15-30 seconds later that is actually an interruption of the tonus by relaxation

Generalized onset absence seizure

Characterized by sudden onset and brief duration (10-45 seconds), consciousness is altered and may be accompanied by mild clonic jerking of eyelids or extremities with postural tone changes and automatisms, begin in childhood or adolescence and may occur hundreds of times a day

Nystagmus

Involuntary movement of eyeball

Hirsutism

Abnormal growth of hair on a person's face and body, especially on a woman