ANTICONVULSANTS/EPILEPSY

Question 1

GABA - glutamine seesaw

Answer 1

GABA acts as an inhibitor on the GABA receptor and glutamine is excitatory
Must stay in balance like a seesaw

Question 2

estrogen vs progesterone - R/T seizures

Answer 2

estrogen is proconvulsant

progesterone is anticonvulsant

Question 3

Which 3 anti epileptics can worsen absence seizures?

Answer 3

Phenytoin
Carbamezepam
Phenobarb

Question 4

Phenytoin reference range

Answer 4

10-20mg/L

Question 5

Phenytoin toxic effects - what levels do you see what?

Answer 5

> 20 mg/L - nystagmus
30 mg/L - ataxia/increased seizures
40 mg/L - lethargy, altered LOC, coma

Question 6

Phenytoin - Pregnancy risk

Answer 6

D

Fetal hydantoin syndrome (cleft palate, congenital heart disease and mental retardation)

Question 7

Valproate - Reference range

Answer 7

50-120 mg/L or mcq/mL

Question 8

Carbamazepine - Reference range

Answer 8

4-12 mg/L (for seizures)

6-12 mg/L (for BPD)

Question 9

Phenytoin - Reference range

Answer 9

10-20 mg/L

Question 10

Phenobarbital - Reference range

Answer 10

15-40 mg/L

Question 11

Anticonvulsant - pregnancy (possibly, depends on manufacturer)

Answer 11

Phenobarbital

Question 12

Pregabalin (Lyrica) - use and ADE

Answer 12

peripheral neuropathy
adjunt partial seizure
pain r/t diabetic neuropathy
postherpetic neuralgia
SE: sedation, dizziness, blurred vision

Question 13

Felbamate (Felbatol) - use and ADE

Answer 13

adjunct for Lennox-Gastaut

SE: aplastic anemia, N/V/C

Question 14

Which anti epileptic is contraindicated if Sulfa allergy?

Answer 14

Zonisamide (Zonegran)

Question 15

Levetiracetam AKA

Answer 15

Keppra

Question 16

Topiramate AKA

Answer 16

Topamax

Question 17

Oxcarbazepine AKA

Answer 17

Trileptal

Question 18

Pregabalin AKA

Answer 18

Lyrica

Question 19

Ethosuximide AKA

Answer 19

Zarontin

Question 20

Gabapentin AKA

Answer 20

Neurontin

Question 21

Lamotrigine AKA

Answer 21

Lamictal

Question 22

Felbamate AKA

Answer 22

Felbatol

Question 23

Tonic clinic seizures - DOC (3)

Answer 23

Phenytoin
Carbamazepine
Valproate

Question 23

Primidone - reference range

Answer 23

8-12 mcg/mL

Question 23

Partial and secondarily generalized seizure - DOC (4)

Answer 23

Carbamazepine Phenytoin Lamotrigine Oxcarbazepine

Question 23

Partial and secondarily generalized seizures - alternatives

Answer 23

``` Pretty much everything else... Preferred - Valproate Primidone Phenobarbital Levitiracetam, etc. ```

Question 23

Absence (petit mal) - DOC

Answer 23

Ethosuximide (zarontin) | Preferred - Valproate

Question 23

Ethosuximude - reference range

Answer 23

60-100 mcg/mL

Question 23

Absence (petit mal) - alternatives

Answer 23

Levetiracetam Lamotrigine Zonisamide Clonazepam

Question 23

Atypical absence, myoclonic seizure - DOC

Answer 23

Preferred - Valproate | Lamictal

Question 23

Atypical absence, myoclonic seizure - alternatives (5)

Answer 23

``` Levetiracetam Topiramate Felbamate Zonisamide Clonazepam ```

Question 23

Lennox-gastaut - DOC

Answer 23

Lamotrigine Levetiracetam Topiramate

Question 33

Antibiotics that can cause seizures

Answer 33

Cefepime FQs Imipenem, Meropenem Metronidazole

Question 34

Antipsychotic that can cause seizures

Answer 34

Clozapine

Question 35

Antiviral that can cause seizures

Answer 35

Foscarnet

Question 36

Antidepressant that can cause seizures

Answer 36

Bupropion

Question 37

Analgesic that can cause seizures

Answer 37

Meperidine | Tramadol

Question 38

Bronchodilator that can cause seizures

Answer 38

Theophylline

Question 39

Stimulants that can cause seizures

Answer 39

Amphetamine derivative Dexmethylphenidate Methylphenidate

Question 40

Drug withdrawal that can cause seizures

Answer 40

Beclofen, Barbiturates, Benzos, ETOH

Question 41

Trigeminal neuralgia - DOC

Answer 41

Carbemazepine

Question 42

Phenytoin and Carbemazepine - MOA

Answer 42

blocks Na channels so prevents repetitive firing