Anti-convulsants

Question 1

What are the two mechanisms of action of anti-convulsants?

Answer 1

Reduce excitation
Promote inhibition

Question 2

List five goals of epilepsy management

Answer 2

Reduce seizure frequency
Reduce severity
Acceptable side effects
Acceptable costs
Practical

Question 3

List three situations in which monitoring before starting treatment is appropriate in seizure cases

Answer 3

Known toxic trigger
Long interictal period (>3 months)
Single seizure

Question 4

What is the first choice drug in epilepsy management for cats and dogs?

Answer 4

Phenobarbitone

Question 5

When is imepitoin indicated as an anti-epileptic drug?

Answer 5

Dogs without cluster seizures and with long inter-ictal periods

Question 6

What are the three main side effects of anti-epileptic drugs?

Answer 6

PUPD
Sedation
Ataxia

Question 7

List four idiosyncratic reactions to phenobarbitone use as an anti-epileptic

Answer 7

Dermatitis
Liver failure
Cytopaenias
Pseudolymphoma

Question 8

List three situations when you should use a second anti-epileptic drug

Answer 8

Improper seizure control despite appropriate use of first line drug
If increasing the first line drug leads to unacceptable side effects
If reaching the first line drug means reaching a possible toxic blood level

Question 9

List five steps in the management of acute seizures

Answer 9

Check vital parameters
Protect patient
Try to get IV access
Check blood glucose
Give anticonvulsant

Question 10

Which three drugs can you use in first line seizure management?

Answer 10

Diazepam
Midazolam
Propofol