neuro drugs

Question 1

What is kepra? what is the most common side effect of kepra?

Answer 1

An anti-epileptic drug- leviteracetam. Can cause emotional distress and irritability.

Question 2

what are some side effects of phenytoin?

Answer 2

Phenytoin= anti-convulsant. Some side effects include nausea, vomiting, allergy, induction of enzymes, pseudo leukaemia and drowsiness. MAIN ONE- GUM HYPERTROPHY AND HIRSUTISM

Question 3

what are the pharmokinetics of phenytoin?

Answer 3

zero order kinetics

Question 4

what are some side effects of valproate?

Answer 4

teratogenicity. so should be warned to patients who are considering pregnancy. Mostly associated with spina bifida

Question 5

what are some drug interactions of anti epileptic drugs that you should know about?

Answer 5

enzyme induction by barbitutates, carbamezapine and phenytoin. They increase the elimination of most other anti epileptic drugs, the OCP and most other drugs metabolised by the liver (e.g. warfarin, cyclosporin and antiretrovirals)

Question 6

which anti epileptic LEAST interferes with the OCP?

Answer 6

sodium valproate. However, has severe teratogenic effects

Question 7

what is first line therapy for MAINTENANCE management of tonic clonic seizures?

Answer 7

sodium valproate or carbamezapine

Question 8

what is a consideration of the dosage amount of carbamezapine?

Answer 8

The drug induces its own metabolism and therefore the maintenance dose must be higher simply to maintain the same concentrations as were achieved with the starting dose.

Question 9

What is first line therapy in the ACUTE management of seizure?

Answer 9

clonazepam/diazepam (benzodiazepines)

Question 10

What type of seizure is carbamezapine preferred drug of choice?

Answer 10

partial seizures, however it can also be used for generalised tonic clonic seizures

Question 11

what type of drug is carbamezapine?

Answer 11

sodium channel blocker drug/anticonvulsant

Question 12

Name some dopamine agonists, and list some adverse side effects. What are these dopamine agonists used for?

Answer 12

Bromocriptine, Cabergoline, Apomorphine are dopamine agonists. They are used in PD, acromegaly and PRL secreting pituitary tumours. They can cause erythromelagia (adverse rare event), impulsive behaviour e.g. gambling, confusion, pulmonary fibrosis (rare event)

Question 13

what are the 3 mechanisms of actions for anti-epileptics?

Answer 13

1. enhance GABA
2. Inhibit Sodium channels
3. Inhibit calcium channels

Question 14

what is interesting about clonazepam in the use for seizures?

Answer 14

Both GABA agonist and calcium channel blocker

Question 15

first line therapy for trigeminal neuralgia?

Answer 15

carbamazepine