AEDs

Question 1

Mechanism of Topiramate

Answer 1

• Na+ and Ca++ channel blockade
• increase GABAergic tone
• decrease AMPA (glutamate) activity

“topomax”

Question 2

What are the two narrow spectrum AEDs?

Answer 2

Carbamazepine and Phenytoin (Dilantin)

Question 3

Which two AEDs require slow uptitration

Answer 3

• Topiramate

- Lamotrigine

Question 4

Which two AEDs can be used for headache prophylaxis

Answer 4

• Topiramate (Topomax)

- Vaproate (Depakote)

Question 5

Which AED can be used as a treatment for trigeminal neuralgia?

Answer 5

Carbamazepine

Question 6

Which AED increases risk of nephrolithiasis?

Answer 6

Topiramate (Topomax) increases risk for nephrolithiasis (kidney stones)

Question 7

Which AED can cause weight loss?

Answer 7

Topiramate (Topomax)

Question 8

Which AED can cause weight gain

Answer 8

Valproate (Depakote)

Question 9

Which AED has the highest risk of causing Steven-Johnson syndrome?

Answer 9

Lamotrigine (Lamictal)

-Steven-Johnson syndrome = death of skin cells leading to splitting of the dermis and epidermis

Question 10

Which AED carries a risk of hyponatremia?

Answer 10

Carbamazepine

Question 11

Which AED carries a risk of neurobehavioral effects?

Answer 11

1/6 of pts on Levetiracetam (Keppra) experience neurobehavioral effects- can range from irritability to psychosis to homicidal ideation

Question 12

Which AEDs work as mood stabilizers/

Answer 12

Lamotrigene (lamictal)
Carbamazepine (tegreton)
Vaproate (depicote)

Question 13

Which AEDs may worsen mood?

Answer 13

Topiramate (topamax)

Levetriacetam (Keppra)

Question 14

Which AEDs are associated w/ osteoporosis?

Answer 14

Carbamazepine (tegreton)

Phenytoin (dilantin)

Question 15

Which AEDs are the two worst teratogens?

Answer 15

Worst = valproate (depakote)

Second worst = topiramate (topomax)

Question 16

Which AED has an association w/ PCOS?

Answer 16

Valproate (depakote)

Question 17

What are three dose dependent side effects of lamotrigine?

Answer 17

Headache, tremor, insomnia

Question 18

Which AED is second line therapy for bipolar disorder?

Answer 18

Carbamazepine (tegretol)

Question 19

Mechanism of lamotrigine

Answer 19

-Na+ and Ca++ channel blockade

Question 20

Mechanism of carbamazepine

Answer 20

-Na+ channel blockade

Question 21

Mechanism of phenytoil

Answer 21

-Na+ channel blockade

Question 22

Mechanism of Levetiracetam

Answer 22

(Keppra)

-mechanism unclear, possibly binds to SV2A to inhibit neurotransmitter release

Question 23

Mechanism of Vaproate

Answer 23

• Na+ and Ca++ channel blockade

- increase GABAergic tone

Question 24

Which AED has a huge range of variation in metabolism depending on pt’s genetics?

Answer 24

Phenytoin (dilantin)- some pts have difficulty metabolizinG

Question 25

Which AED may impact cognitive/processing speed?

Answer 25

Topiramate (topamax)

Question 26

Which AED may improve compulsion control?

Answer 26

Topiramate (topomax)

Question 27

Describe how vagal nerve stimulation may be helpful in treating seizures

Answer 27

Constant impulse pacing of the thalamus to teach the thalamus how to not get overexcited

Question 28

Describe how a corpus callostomy may be helpful in seizure control

Answer 28

Separate the two hemispheres to prevent seizures from easily spreading

Question 29

Which AEDs interact w/ OCPs and warfarin

Answer 29

Tons... - Carbamazepine (CBZ) - Phenytoin (dilantin) - Phenobarb)

Question 30

Mechanism of phenobarbital

Answer 30

Prolongs GABA-A activation (it's a barbituate)

Question 31

What is the main side effect of phenobarb?

Answer 31

- sedation! - potential withdrawal - drug interactions (OC, warfarin, statins)

Question 32

What AEDs most common cause hypersensitivity?

Answer 32

Phenytoin, lamotragine, CBZ

Question 33

Which AED has tremor/parkinsonism as a potential side effect?

Answer 33

Valproate (depakote)