Anti seizure

Question 1

Etiology of seizures includes:

Answer 1

Idiopathic causes, infectious diseases (e.g., meningitis, brain abscess), metabolic disorders, vascular diseases, neoplastic diseases, congenital defects, head injuries, trauma, hypoxia, and drug-related factors such as local anesthetic overdose, drug abuse, and withdrawal from alcohol or sedative-hypnotics.

Question 2

What is a febrile convulsion?

Answer 2

A seizure triggered by fever, commonly occurring in children.

Question 3

What determines coordinated activity among neurons?

Answer 3

A controlled balance between excitation (via glutamate-mediated neurotransmission) and inhibition (via GABA-mediated neurotransmission).

Question 4

What can cause seizures due to abnormal electrical discharge in the brain?

Answer 4

Local imbalances between excitation and inhibition in neuronal activity.

Question 5

What are the mechanisms of action of seizure medications?

Answer 5

Enhancement of GABA-mediated inhibition, inhibition of voltage-gated Na channels, inhibition of T-type Ca channels, and reduction of glutamate-mediated excitation.

Question 6

First-line drug used for tonic-clonic seizures?

Answer 6

Valproic acid.

Question 7

The therapeutic aim in drug therapy for seizure disorders is to:

Answer 7

Reduce the frequency of seizures and minimize adverse reactions.

Question 8

Over what period should AEDs be tapered during withdrawal?

Answer 8

Over at least 6 months.

Question 9

What class of drugs enhance GABA-mediated synaptic inhibition?

Answer 9

Benzodiazepines, phenobarbital, vigabatrin, and tiagabine.

Question 10

What is the classification of Phenytoin?

Answer 10

It is a first-generation seizure medication.

Question 11

What is a common side effect of Phenytoin?

Answer 11

CNS effects like nystagmus and diplopia, along with gingival hyperplasia and teratogenic effects.

Question 12

Neonates and patients with which condition may experience increased free Phenytoin levels?

Answer 12

Hypoproteinemia.

Question 13

Key drug interactions with Phenytoin include:

Answer 13

Cimetidine, isoniazid, phenylbutazone, and warfarin which inhibit phenytoin metabolism.

Question 14

What is Carbamazepine primarily used for?

Answer 14

Focal seizures and as a second-line agent for tonic-clonic seizures.

Question 15

What should be monitored in patients on Valproic acid due to its teratogenic risk?

Answer 15

Risk of major congenital malformations in pregnancy.

Question 16

Which drug is considered first-line treatment for absence seizures?

Answer 16

Ethosuximide.

Question 17

What is the side effect profile for Valproic acid?

Answer 17

CNS effects like nystagmus, liver enzyme induction, and the risk of teratogenic effects.

Question 18

What is the MOA (Mechanism of Action) for Ethosuximide?

Answer 18

It blocks T-type Ca channels.

Question 19

What type of seizure is Phenobarbital primarily used for?

Answer 19

Status epilepticus and febrile convulsions.

Question 20

What are common side effects of Phenobarbital?

Answer 20

Sedation, tolerance, and physical dependence.

Question 21

Drug that irreversibly inhibits GABA aminotransferase?

Answer 21

Vigabatrin.

Question 22

What is the role of Lamotrigine in seizure management?

Answer 22

It is used for all types of seizures and migraine prophylaxis.

Question 23

What condition is related to high doses of local anesthetics?

Answer 23

Seizure activity.

Question 24

Seizures caused by metabolic disorders are categorized under which etiology?

Answer 24

Etiology of seizures.

Question 25

What class of drugs is used for withdrawal seizures?

Answer 25

Benzodiazepines, such as Diazepam or Lorazepam.

Question 26

What factors can lead to drug resistance in seizure therapy?

Answer 26

Impaired access of drugs to target sites or insensitivity of target molecules.

Question 27

What is the mechanism of action for Gabapentin?

Answer 27

It binds to voltage-gated Ca channels, decreasing glutamate release, and increases GABA activity.

Question 28

Second-line treatment for generalized tonic-clonic seizures?

Answer 28

Phenytoin and Carbamazepine.

Question 29

What is the effect of combining Phenytoin with C P450 inhibitors?

Answer 29

It can increase Phenytoin metabolism, potentially leading to toxicity.

Question 30

What is the common adverse effect of Lacosamide?

Answer 30

Dizziness and nausea.

Question 31

The recommended folic acid intake for women with a history of seizures during pregnancy is:

Answer 31

To decrease teratogenic risk.

Question 32

Focal seizures can be effectively managed with which drugs?

Answer 32

Carbamazepine and Lamotrigine.

Question 33

What are the key symptoms of status epilepticus?

Answer 33

Life-threatening seizures requiring immediate resuscitation and pharmacologic therapy.

Question 34

Which drug causes irreversible visual loss in a percentage of patients?

Answer 34

Vigabatrin.

Question 35

What is an important consideration when using Topiramate?

Answer 35

It may cause cognitive impairment.

Question 36

What should be done if a patient is taking two AEDs?

Answer 36

One drug should be slowly withdrawn before tapering the second.

Question 37

What is the mechanism of action of Tiagabine?

Answer 37

Enhances GABA uptake and increases synaptic GABA concentrations.

Question 38

Which antiepileptic drug is most widely prescribed for focal seizures?

Answer 38

Lamotrigine.

Question 39

What category of seizure is Valproic acid effective for?

Answer 39

Tonic-clonic seizures and all types.

Question 40

What are common side effects of Topiramate?

Answer 40

Cognitive impairment and weight loss.

Question 41

What is the important point regarding drug therapy for seizures in pregnancy?

Answer 41

Monotherapy is usually preferred to minimize risks.

Question 42

What should be ensured during the treatment of status epilepticus?

Answer 42

Facilities for resuscitation must be available due to the risk of respiratory and cardiovascular suppression.

Question 43

Withdrawal of AED after seizure control requires:

Answer 43

Intensive follow-up and a slow taper over 6 months.

Question 44

What is the therapeutic use of Levetiracetam?

Answer 44

Adjunctive treatment for focal seizures.

Question 45

Which drug should be avoided in women who are pregnant?

Answer 45

Phenytoin and valproic acid.

Question 46

What is a key safety point regarding the dosing of Phenytoin?

Answer 46

It has a very narrow therapeutic index and should be increased slowly.

Question 47

What are potential side effects of Gabapentin?

Answer 47

Sedation and physical dependence.

Question 48

What type of patients may become toxic with therapeutic Phenytoin levels?

Answer 48

Neonates, patients with uremia or hypoproteinemia.

Question 49

The major risk associated with the use of Phenobarbital includes:

Answer 49

Tolerance and physical dependence.