CNS Question

Question 1

Which antiepileptics cause antiepileptic hypersensitivity syndrome?
What are the symptoms?

Answer 1

Carbamazepine, Lamotrigine, lacosamide, phenobarbital. Phenytoin, primidone and fufinamide
- causes fever, rash and lymphadenopathy
Drug should be immediately withdrawn

Question 2

How long should someone not drive for following changes or withdrawral from their antiepileptic medication?

Answer 2

6 months after their last dose

Question 3

How long should someone not drive for if they have a seizure due to changed or withdrawn anti-epileptic medication

Answer 3

1 year
- may be considered at 6 months if no further seizure has occured

Question 4

Main side effect of dopamine agonist (non-ergot derived) in parkinsons disease?
What is done to treat this?

Answer 4

Impulse control disorders
- gambling
- binge eating
- smoking
Gradually withdrawn dopamine agonist (rotigotine)

Question 5

What condition is being described? (Asscoiated with antipsychotics)
- high fever
- muscle rigidity
- confusion
- sweating
- high blood pressure

Answer 5

Neuroleptic malignant syndrome
- discontinue antipsychotic for 5 days

Question 6

What is the treatment for neuroleptic malignant syndrome?

Answer 6

Bromocriptine

Question 7

Antipsychotics most likely to cause hyperprolactinaemia

Answer 7

Risperidone and amisulpride and 1st generation (haloperidol)

Question 8

Which antipsychotic causes less hyperprolactinaemia?

Answer 8

Aripriprazole clozapine, and quetiapine

Question 9

What is can be hashed for hypersalivation associated with clozapine therapy?

Answer 9

Hyoscine hydroBROmide

Question 10

How many days can you take metoclopramide for?
What age is it licensed in?

Answer 10

5 days max
18+

Question 11

What electrolyte imbalance is associated with sertraline and carbamazepine/

Answer 11

Hyponatreamia

Question 12

what is the main side effect associated with pramipexole?

Answer 12

• hypotension
• sudden onset of sleep
• compulsive behaviour

Question 13

what vitamin is deficient in wernicke’s encephalopathy?

Answer 13

Vitamin B1 (thiamine)

Question 14

symptoms of benzo overdose
benzo reversal agent

Answer 14

Anxiety, aggression and agitation (paradoxical side effects)
- talkative
- excitement
- excessive movement
reversal agent: flumazenil

Question 15

When should blood tests for clozapine be done after treatment initiation?

Answer 15

Weekly for 18 weeks
2 weeks until 1 year
4 weekly after

Question 16

which antiepileptics are in group 1? What does this mean?

Answer 16

Carbamepine
Primidone
Phenytoin
Phenobarbital
- they MUST be prescribed by brand

Question 17

which antiepileptics are in group 2? What does this mean?

Answer 17

Clobazam, clonazepam, eslicarbazepine acetate, lamotrigine, oxcarbazepine, perampanel, rufinamide, topiramate, valproate, zonisamide.
- brand prescribing should be based on clinical judgement

Question 18

which antiepileptics are in group 3? What does this mean?

Answer 18

Brivaracetam, ethosuximide, gabapentin, lacosamide, levetiracetam, pregabalin, tiagabine, vigabatrin
- unnecessary to ensure same brand prescribing

Question 19

Legal age restriction for codeine (and co-codamol)

Answer 19

12+

Question 20

Antipsychotic most commonly associated with weight gain?

Answer 20

Olanzapine and clozapine

Question 21

What type of headache is this describing?
‘Sudden severe pain with a stiff neck, light sensitivity and double vision’

Answer 21

Subarachnoid Haemorrhage

Question 22

treatment for myoclonic seizures

Answer 22

Sodium valporate
Levetiracetam- if they are on child bearing potential

Question 23

Patient is taking 60mg morphine BD, but experiencing breakthrough pain- what is the max amount of morphine that patient can take in 24 hours?

Answer 23

1/6th-1/10th of total daily dose every 2-4 hours
- 120mg in 24 hours
- 1/6th of 120 = 20
- max = 20mg ever 2-4 hours

Question 24

Pinpoint pupils is a tell tail sign of what overdose?

Answer 24

Opioid