Neurological

Question 1

Levodopa (Co-beneldopa, Co-careldopa, Sinemet, Madopar)

Answer 1

Dopamine precursor

Question 2

Mechanism of Levodopa

Answer 2

Levodopa crosses blood-brain barrier to basal ganglia and is converted to dopamine by dopa carboxylase

Question 3

Indications of Levodopa

Answer 3

Parkinsons Disease

Question 4

Contraindications of Levodopa

Answer 4

Closed-angle glaucoma
Drug-induced parkinsonism 
Psychiatric disease or dementia 
Cardiac or cerebrovascular disease
Diabetes
Pregnancy

Question 5

Side-effects of Levodopa

Answer 5

Nausea, palpitations, anorexia, vomiting, abdominal pain, insomnia, agitation, postural hypotension

Question 6

Interactions of Levodopa

Answer 6

MAOIs: risk of HT (withdraw L-dopa 2 weeks before starting MAOIs)
Iron: reduced absorption of L-dopa
Antipsychotic drugs: reduce effect of L-dopa

Question 7

What is Levodapa prescribed with and why

Answer 7

Carbidopa. Prevents levodopa from being converted into dopamine prematurely in the bloodstream, allowing more of it to get to the brain

Question 8

Phenytoin (Fosphenytoin, Epantuin)

Answer 8

Anti-seizure

Question 9

Mechanism of Phenytoin

Answer 9

Inhibits initiation of action potentials in the brain resulting in seizure control

Question 10

Indications for Phenytoin

Answer 10

Epilepsy
Migraine
Trigeminal Neuralgia
Abnormal heart rhythms

Question 11

Contraindications for Phenytoin

Answer 11

Pregnancy- Drug is teratogenic
Diabetes
Porphyria
Hepatic Impairment

Question 12

Side effects of Phenytoin

Answer 12

Nausea and vomiting, confusion, insomnia, hirsutism

Rare: rash, gum hypertrophy, Stevens-Johnson syndrome

Question 13

Interactions of Phenytoin

Answer 13

OCP: Phenytoin reduces effectiveness
Rifampicin: decrease concentration of Phenytoin
Warfarin: increase metabolism of warfarin
Antidepressants, antipsychotics, mefloquine, chloroquine and St. John’s Wort

Question 14

Carbamazepine (Carbagen, Epimaz, Tegretol)

Answer 14

Anti-convulsant

Question 15

Mechanism of Carbamazepine

Answer 15

Increases GABA-mediated inhibitory transmission

Question 16

Indications of Carbamazepine

Answer 16

Generalised tonic-clonic seizures
Partial seizures
Trigeminal neuralgia
Bipolar prophylaxis
Reduce urine output in diabetes insipidus
Relieve pain in diabetic neuropathy

Question 17

Contraindications of Carbamazepine

Answer 17

Bone marrow depression
AV node conduction abnormalities
Porphyria

Question 18

Side effects of Carbamazepine

Answer 18

Drowsiness, ataxia, blurred vision, confusion

Question 19

Interactions of Carbamazepine

Answer 19

Cimetidine, erythromycin: inhibit metabolism of carbamazepine
Corticosteroirds, cyclosporine, phenytoin: decrease effect of Carbamazepine
Diltiazem, Isoniazid, Verapamil: increase plasma concentration
OCP
Warfarin

Question 20

Sodium Valporate

Answer 20

Anti-convulsant

Question 21

Mechanism of Sodium Valporate

Answer 21

Increase GABA content of the brain by inhibiting GABA transaminase enzyme, preventing GABA re-uptake

Question 22

Indications of Sodium Valporate

Answer 22

Epilepsy (all types)
Manic episodes
Bipolar Disorder

Question 23

Contraindications of Sodium Valporate

Answer 23

Hepatic dysfunction
Porphyria
Blood disorders
Pregnancy

Question 24

Side effects of Sodium Valporate

Answer 24

Hair loss, weight gain, Nausea and vomiting

Question 25

Interactions of Sodium Valporate

Answer 25

Anticonvulsants, Zidovudine, Lamotrigine, Carbapenems, Antidepressants, antipsychotics, clarithromycin and erythromycin

Question 26

Lamotrigine (Lamictal)

Answer 26

Anti-convulsant

Question 27

Indications of Lamotrigine

Answer 27

Epilepsy Lennon-Gastaut syndrome seizures Trigeminal neuralgia

Question 28

Side effects of Lamotrigine

Answer 28

Skin rash, nausea, headache, dizziness and poor muscle coordination

Question 29

Interactions of Lamotrigine

Answer 29

Sodium Valporate Antidepressants, antipsychotics, rifampicin, mefloquine and chloroquine Carbamazepine Phenytoin and phenobarbital

Question 30

Levetiracetam (Keppra)

Answer 30

Anticonvulsants

Question 31

Indications of Levetiracetam

Answer 31

Focal Seizure Epilepsy

Question 32

Contraindication of Levetiracetam

Answer 32

Anaemia Psychotic disorder Depression Liver or kidney disease

Question 33

Side effects of Levetiracetam

Answer 33

Headache, dizziness, drowsiness, GI problems, anxiety, asthenia

Question 34

Interactions of Levetiracetam

Answer 34

MAOIs, TCA, SSRIs and Mefloquine | St John's Wort

Question 35

Mefloquine

Answer 35

Anti-malarial drug. Effective against malaria parasites resistant to chloroquine