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NAPLEX 2022 > EPILEPSY > Flashcards

EPILEPSY Flashcards

1
Q

WHICH KEY DRUGS CAN LOWER SEIZURE THRESHOLDS

A

BUPROPION
CLOZAPINE
THEOPHYLLINE
VARENICLINE
CARBAPENEMS
LITHIUM
MEPERIDINE
PENICILLIN
QUINOLONES
TRAMADOL

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2
Q

SEIZURE EPILEPTICUS

A

SEZURES LASTING BEYOND 5 MINUTES
MEDICAL EMERGENCY

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3
Q

STATUS EPILEPTICUS TREATMENT: PHASES AND TIMING

A

STABILIZATION: 0-5 MINUTES
INITIAL TREATMENT: 5-20 MINUTES
SECOND TREATMENT: 20-40 MINUTES

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4
Q

STAUS EPILEPTICUS STABILIZATION PHASE

A

START TIMING SEIZURE
SUPPORT: OXYGEN
MONITOR: ECG, AED LEVELS, ELECTROLYTES, BG

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5
Q

STATUS EPILEPTICUS: INITIAL TREATMENT PHASE

A

BENZO INJECTION, THEN ALTERNATIVES
- IV LORAZEPAM
- IM MIDAZOLAM
- RECTAL DIAZEPAM
- BUCCAL, NASAL MIDAZOLAM

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6
Q

STATUS EPILEPTICUS: SECOND TREATMENT PHASE

A

GIVE REGULAR AED: FOSPHENYTOIN, VALPROIC ACID, KEPPRA, PHENOBARBITAL

IF SEIZURE CONTINUES, NO CLEAR TREATMENT

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7
Q

KETOGENIC DIET HELPS WITH WHAT KIND OF SEIZURES

A

REFRACTORY SEIZURES

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8
Q

A KETOGENIC DIET CONSISTS OF…

A

4:1 RATIO OF FTS TO COMPINED PROTEIN AND CARBS
PUTS BODY IN KETOSIS, REDUCING SEIZURE FREQUENCY

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9
Q

WHICH AED IS SPECIFICALLY INDICATED FOR ABSENCE SEIZURES

A

ETHOSUXAMIDE

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10
Q

WHICH AED CAN CAUSE VISION LOSS

A

VIGABATRIN

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11
Q

AED MOA: BEZODIAZEPINE

A

↑ GABA

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12
Q

AED MOA: VALPROIC ACID

A

↑ GABA

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13
Q

AED MOA: ETHOSUXAMIDE

A

T-TYPE CA CHANNEL BLOCKER
SLOWS TRANSMISSION OF ELECTRICAL SIGNAL

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14
Q

AED MOA: CARBAMAZEPINE

A

NA CHANNEL BLOCKER

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15
Q

AED MOA: PHENYTOIN

A

NA CHANNEL BLOCKER

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16
Q

CARBAMAZEPINE IS “COUSIN” TO WHICH AGENTS AND HAVE WHICH SHARED ADR?

A

OXCARBAZEPINE AND ESLICARBAZEPINE
↓NA, RASH, ENZYME INDUCTION

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17
Q

GABAPENTIN AND PREGABALIN ADR

A

WEIGHT GAIN, PERIPHERAL EDEMA, MILD EUPHORIA

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18
Q

PHENOBARBITAL IS “COUSIN” TO WHICH AGENTS AND HAVE WHAT SHARED ADR?

A

PRIMIDONE
SEDATION,
DEPENDENCE/TOLERANCE/OVERDOSE RISK
ENZYME INDUCTION

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19
Q

TOPIRAMATE IS “COUSIN” WITH WHAT AGENT AND HAS WHAT SHARED ADR?

A

ZONISAMIDE
WEIGHT LOSS, METABOLIC ACIDOSIS
NEPHROLITHIASIS AND OLIGOHIDROSIS/HYPERTHERMIA

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20
Q

WHAT VITAMINS/SUPPLEMENTS SHOULD BE TAKEN WITH AEDS

A

ALL: CA, VIT D
WOMEN OF CHILD BEARING AGE: FOLATE
VALPROIC ACID: CARNITINE
LAMOTRIGINE & VALPROATE: SELENIUM AND ZINC IF ALOPECIA

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21
Q

LAMOTRIGINE INITIAL DOSING

A

WEEKS 1 AND 2: 25 MG DAILY

22
Q

LAMOTRIGINE BOXED WARNING

A

SJS/TENS, DRESS

23
Q

LAMOTRIGINE SIDE EFFECTS

A

ALOPECIA - CAN SUPPLEMENT WITH SELENIUM AND ZINC

24
Q

LAMOTRIGINE STARTER KIT COLOR DOSES

A

ORANGE = STANDARD STARTING DOSE
BLUE = LOWER STARTING DOSE (USED IF TAKING ENZYME INHIBITOR)
GREEN = HIGHER STARTING DOSE (USED IF TAKING ENZYME INDUCER)

25
Q

WHICH AEDs ARE ENZYME INHIBITOR

A

VALPROIC ACID

26
Q

WHICH AEDs ARE ENZYME INDUCERS

A

CARBAMAZEPINE
PHENYTOIN
PHENOBARBITAL/PRIMIDONE

27
Q

WHICH AEDS ARE BROAD SPECTRUM

A

LAMOTRIGINE
KEPPRA
TOPIRAMATE
VALPROATE

28
Q

WHICH AEDS ARE NARROW SPECTRUM

A

CARBAMAZEPINE
LACOSAMIDE
OXCARBAZEPINE
PHENOBARBITAL
PHENYTOIN

29
Q

CARBAMAZEPINE THERAPEUTIC RANGE

A

4 - 12 MCG/ML

30
Q

CARBAMAZEPINE BOXED WARNING

A

SJS/TEN, HLA-B*1502
APLASTIC ANEMIA AND AGRANULOCYTOSIS

31
Q

CARBAMAZEPINE CONTRAINDICATION

A

MYELOSUPPRESSION

32
Q

CARBAMAZEPINE WARNING

A

SIADH (↓ NA)
FETAL HARM

33
Q

WHICH AED IS AN AUTOINDUCER

A

CARBAMAZEPINE

34
Q

LACOSAMIDE WARNIGN

A

EXTENDS PR INTERVAL AND ↑RISK OF ARRHYTHMIAS

35
Q

OXCARBAZEPINE CONTRAINDICATION AND WARNINGS

A

HYPERSENSITIVITY TO CARBAMAZEPINE
SJS/TEN, HLA-B*1502

36
Q

PHENOBARBITAL THERAPEUTIC RANGE

A

20 - 40 MCG/ML IN ADULTS
15 - 40 IN CHILDREN

37
Q

PHENOBARBITAL WARNINGS

A

HABIT FORMING,
RESPIRATORY DEPRESSION
FETAL HARM

38
Q

PHENOBARBITAL SIDE EFFECTS

A

PHYSIOLOGICAL DEPENDENCE
TOLERANCE
HANGOVER EFFECT

39
Q

PHENOBARBITAL CONTRAINDICATION

A

HEPATIC IMPAIRMENT

40
Q

PHENYTOIN/FOSPHENYTOIN THERAPEUTIC RANGE

A

10 - 20 MCG/ML TOTAL LEVEL
1 - 2.5 MCG/ML FREE LEVEL

41
Q

PHENYTOIN/FOSPHENYTOIN BOXED WARNING

A

PHENYTOIN IV RATE SHOULD NOT EXCEED 50 MG/MINUTE
FOSPHENYTOIN IV SHOULD NOT EXCEED 150 MG PE/MINUTE
IF FASTER, RISK OF CARDIAC ARRHYTHMIAS

42
Q

PHENYTOIN/FOSPHENYTOIN WARNINGS

A

EXTRAVASATION LEADING TO PURPLE GLOVE SYNDROME
HLA-B*1502, SJS/TEN, DRESS
FETAL HARM

43
Q

PHENYTOIN/FOSPHENYTOIN DOSE RELATED SIDE EFFECT

A

NYSTAGMUS
ATAXIA
DIPLOPIA

44
Q

PHENYTOIN/FOSPHENYTOIN CHRONIC USE SIDE EFFECT

A

GINGIVAL HYPERPLASIA
HAIR GROWTH
HEPATOTOXICITY

45
Q

GIVING PHENYTOIN WHILE ON NG-TUBE

A

ENETERAL FFEDING ↓ PHENYTOIN ABSORPTION
HOLD FEEDING 1-2 HOURS BEFORE AND AFTER ADMIN

46
Q

ETHOSUXIMIDE WARNING

A

SJS/TEN
BLOODS DYSCRASIAS

47
Q

FELBAMATE BOXED WARNING

A

HEPATIC FAILURE
APLASTIC ANEMIA

48
Q

FENFLURAMINE BOXED WARNING

A

VALVULAR HEART DISEASE
PULMONARY HTN
↓ APPETITE/WEIGHT LOSS

49
Q

ZONISAMIDE CONTRAINDICATION

A

HYPERSENSITIVITY TO SULFONAMIDES

50
Q

ZONISAMIDE SIDE EFFECTS

A

OLIGOHIDROSIS/HYPERTHERMIA
NEPHROLITHIASIS

51
Q

ADJUSTING PHENYTOIN DOSES

A

(TOTAL PHENYTOIN MEASURED) / ( [0.2 X ALBUMIN] + 0.1)

ADJUST IF ALBUMIN IS LOW <3.5 AND CRCL ≥ 10

NAPLEX 2022 (37 decks)

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