Epilepsy

Question 0

Seizure in which a large population of neurons in both hemispheres is involved immediately at the start of the seizure

Answer 0

generalized seizure

Question 1

Seizure in which abnormal firing is limited to a specific area in 1 hemisphere

Answer 1

partial seizure

Question 2

AED that has a weak effect on Na+ channels, increases GABA and decreases Ca2+ channel activity

Answer 2

Valproic Acid

Question 3

AED that acts on Na+ channels as well as decreases glutamate release

Answer 3

Lamotrigine

Question 4

AED that acts on Na+ channels as well as is a GABA agonist and a glutamate antagonist

Answer 4

Topiramate

Question 5

Drug that acts on Na+ channels as well as Ca2+ channels

Answer 5

Zonisamide

Question 6

6 AEDs that mainly act on Na+ channels

Answer 6

1. Carbamazepine
2. Oxcarbazepine
3. Eslicarbazepine
4. Phenytoin
5. Lacosamide
6. Rufinamide

Question 7

Enzyme that synthesizes GABA from glutamate

Answer 7

glutamate decarboxylase

Question 8

Inotropic GABA receptor that is a Cl- channel that is inhibitory of synaptic transmission

Answer 8

GABA-A

Question 9

Metabotropic GABA receptor that inhibits neurotransmitter release

Answer 9

GABA-B

Question 10

AED that is a product of rational drug design and decreases GABA reuptake through GABA transporters into neurons and glial cells

Answer 10

Tiagabine

Question 11

AED that is an irreversible inhibitor of GABA transaminase, which is responsible for GABA metabolism

Answer 11

Vigabatrin

Question 12

Black box warning on vigabatrin

Answer 12

irreversible concentric focal field loss

Question 13

AED that also has sedative properties that binds to GABA-A receptor and increases its response to GABA

Answer 13

Phenobarbital

Question 14

Class of AEDs that enhance the inhibitory action of GABA

Answer 14

Benzodiazepines

Question 15

AED that is a Ca2+ channel inhibitor and is mainly used in absence seizures

Answer 15

Ethosuximide

Question 16

2 AEDs that have a high affinity for the alpha2-delta binding site on voltage-gated Ca2+ channels and decrease the Ca2+-dependant release of neurotransmitters, including glutamate and NE

Answer 16

Gabapebtin and pregabalin

Question 17

AED that binds with high affinity to synaptic vesicle protein (SV2A)

Answer 17

Levetiracetam

Question 18

AED that is a K+ channel opener or stabilizer, stabilizing the resting membrane potential

Answer 18

Ezogabine

Question 19

AED that is a non-competitive AMPA receptor antagonist

Answer 19

Perampanel

Question 20

The hormonal influence on seizures in women who are menstrating

Answer 20

catamenial influence

Question 21

Sudden, uncontrollable electrical discharges in normal brain activity

Answer 21

seizure

Question 22

Recurrent, unprovoked seizures

Answer 22

Epilepsy

Question 23

The most prevalent form of epilepsy

Answer 23

complex partial seizures

Question 24

Seizure that involves loss of consciousness and tonic-clonic movements and often involves tongue bitting or incontinence

Answer 24

Grand mal seizure

Question 25

Seizure that involves a brief episode (2-15 sec.) of staring, unable to respond

Answer 25

Absence seizure

Question 26

Seizure that involves brief, bilateral jerk of neck, shoulders and legs

Answer 26

myoclonic seizure

Question 27

Seizure that involves brief, bilateral stiffening of the body

Answer 27

tonic seizure

Question 28

Seizure that involves sudden loss of muscle tone and people tend to drop things

Answer 28

atonic seizure

Question 29

A seizure lasting for >30 min or with no recovery

Answer 29

status epilepticus

Question 30

Treatment options for status epilepticus

Answer 30

IV benzodiazepines, phenytoin or phenobarbital

Question 31

AED that has saturable metabolism, meaning a small increase in dose may cause a greater than expected increase in drug conc.

Answer 31

Phenytoin

Question 32

Toxicities in phenytoin

Answer 32

nystagmus, ataxia, gingival hyperpasia, osteomalacia

Question 33

AED in which the liver has auto-induction to and becomes more efficient at clearing the drug over time

Answer 33

Carbamazepine

Question 34

Toxicities with carbamazepine

Answer 34

dizziness, diplopia, leukopenia, osteomalacia

Question 35

Toxicities with oxcarbazepine

Answer 35

dizziness, diplopia, ataxia, hyponatremia

Question 36

Toxicities in lacosamide

Answer 36

diplopia, HA, dizziness, nausea

Question 37

AED that is metabolized by CYP3A4 but still has no clinically significant drug interactions

Answer 37

lacosamide

Question 38

Uses of carbamazepine outside of epilepsy

Answer 38

bipolar disorder, pain

Question 39

Use of lamotrigine outside of epilepsy

Answer 39

bipolar disorder

Question 40

Toxicities with lamotrigine

Answer 40

sedation, diplopia, ataxia, nausea, rash

Question 41

AED in which estrogen increases its clearance

Answer 41

lamotrigine

Question 42

Toxicities in topiramate

Answer 42

difficulty concentrating, kidney stones, weight loss

Question 43

Uses of topiramate outside of epilepsy

Answer 43

migraine prophylaxis, weight loss

Question 44

AED that is a sulfonamide

Answer 44

Zonisamide

Question 45

Toxicities with zonisamide

Answer 45

somnolence, dizziness, kidney stones, weight loss

Question 46

Toxicities with phenobarbital

Answer 46

sedation, paradoxical hyperactivity, osteomalacia

Question 47

Toxicities with ethosuximide

Answer 47

sedation, GI

Question 48

Toxicities with valproic acid

Answer 48

sedation, N/V, weight gain, hair loss, tremor, thrombocytopenia (check for bruising)

Question 49

Uses of valproic acid outside of epilepsy

Answer 49

migraine prophylaxis, bipolar disorder

Question 50

AED that has saturable absorption

Answer 50

Gabapentin

Question 51

Toxicities with gabapentin

Answer 51

fatigue, dizziness, ataxia

Question 52

Uses of gabapentin outside of epilepsy

Answer 52

post-herpetic neuralgia, diabetic peripheral neuropathy, restless leg syndrome

Question 53

Toxicities with pregabalin

Answer 53

dizziness, ataxia, weight gain

Question 54

Uses of pregabalin outside of epilepsy

Answer 54

post-herpetic neuralgia, diabetic peripheral neuropathy, firomyalgia, anxiety (off-label)

Question 55

Toxicities with levetiracetam

Answer 55

somnolence, dizziness, behavioral changes

Question 56

Toxicities in ezogabine

Answer 56

dizziness, fatigue, diplopia, ataxia, urinary retention

Question 57

Black box warning for ezogabine

Answer 57

bluish discoloration of skin and ocular toxicity

Question 58

Toxicities with perampanel

Answer 58

dizziness, somnolence, irritability, ataxia, weight gain

Question 59

Black box warning for perampanel

Answer 59

suicidality and homocidality

Question 60

4 AEDs that are 1st generation

Answer 60

1. Phenobarbital 2. Phenytoin 3. Carbamazepine 4. Valproic acid

Question 61

1st generation AEDs that are enzyme inducers

Answer 61

phenobarbital phenytoin carbamazepine

Question 62

1st generation AED that is an enzyme inhibitor

Answer 62

vaproic acid