ott seizures

Question 1

status epilepticus defined as

Answer 1

seizure lasting greater than 5 mins, or 2 + seizures without complete recovery between

Question 2

drug therapy for status epilepticus

Answer 2

5-20 mins: lorazepam / midazolam IV
20-40 mins: IV phosphenytoin, valproic acid or keppra

Question 3

why cant we give phenytoin quickly?

Answer 3

hypotension

Question 4

fosphenytoin dose

Answer 4

20 mg PE/kg IV

Question 5

what can fosphenytoin cause?

Answer 5

purple glove syndrome

Question 6

phenytoin therapeutic serum concentration

Answer 6

10-20 mcg/mL

Question 7

what must we obtain for phenytoin loading dose?

Answer 7

serum albumin and serum phenytoin concentration

Question 8

valproate IV to PO conversion

Answer 8

1:1

Question 9

desired serum concentration of valproate

Answer 9

80 mcg/mL
range 50-125

Question 10

1A2 inducers

Answer 10

carbamazepine
phenytoin
phenobarbital

Question 11

2C9 inducers

Answer 11

carbamazepine
phenytoin
phenobarbital

Question 12

3A4 inducers

Answer 12

carbamazepine
phenytoin
phenobarbital
lamotrigine
oxcarbazepine
topiramate
CPP LOT

Question 13

UGT inhibitor

Answer 13

valproate

Question 14

lamotrigine box warning se

Answer 14

Stevens Johnson Syndrome

Question 15

lamotrigine dosing without UGT inhibitor or inducer

Answer 15

25 mg qd x 14 days
50 mg qd x 14 days
100 mg qd x 7 days
200 mg daily

Question 16

lamotrigine dosing with UGT inhibitor (valproate)

Answer 16

25 mg qOD x 14 days
25 mg qd x 14 days
50 mg qd x 7 days
100 mg qd

Question 17

lamotrigine dosing with UGT inducer

Answer 17

50 mg qd x 14 deays
100 mg qd x 14 days
200 mg qd x 7 days
400 mg qd

Question 18

what must you do before getting carbamazepine or oxcarbazepine

Answer 18

HLA-B 1502 allele screening

Question 19

Asian patients at high risk of what

Answer 19

HLAB1502 and anticonvul hypersensitivity syndrome

Question 20

positive ____ in northern european and asian descent may confer similar risk for DRESS

Answer 20

HLA 3101

Question 21

DRESS syndrome mortality

Answer 21

10%

Question 22

when does DRESS occur

Answer 22

2-6 weeks after starting drug therapy

Question 23

DRESS can happen from what drugs

Answer 23

carbamezapine
cenobamate
lamotrigine
phenytoin
phenobarbital
valproate
zonisamide

Question 24

drug concentrations in pregnancy may be increased due to

Answer 24

changes in VD

Question 25

teratogenic risk drugs

Answer 25

carbamezapine clonazepam fosphenytoin phenobarbital phenytoin primidone topiramate

Question 26

which drug can cause neural tube defects and decreased IQ

Answer 26

valproate

Question 27

infant should receive what at birth

Answer 27

vitamin K 1 mg IM to decrease risk of hemorragew

Question 28

estrogen and ____ interact and decrease eachother concentration

Answer 28

lamotrigine

Question 29

birth control recomended forms

Answer 29

high dose estrogen progestin only - IUDs good

Question 30

which drug has risk of arrythmia

Answer 30

lamotrigine phenytoin / fosphenytoin

Question 31

which drug has PR interval changes

Answer 31

lacosamide, pregabalin

Question 32

which drug has heart block

Answer 32

lacosamide

Question 33

which drug increase risk valvular heart disease

Answer 33

fenfluramine

Question 34

which drugs lead to SIADH, hyponatremia

Answer 34

carbemazepine, oxcarbemazepine

Question 35

which drug mess with vitamin d so increase risk osteoporosis

Answer 35

phenytoin

Question 36

which drug lead to kidney stones, metabolic acidosis, heat intolerance

Answer 36

topirimate

Question 37

which drug psychosis, suicidal thoughs, worsening depression

Answer 37

lamotrigine

Question 38

which drug life threatening neuro events

Answer 38

perampanel

Question 39

which drug hypermmonemia, acute mental status changes

Answer 39

valproate, give at night

Question 40

which drug cognitive dysfunction and visual abnormalities

Answer 40

topiramate

Question 41

which drug contraindicated if you have vision risk factors

Answer 41

vigabitran

Question 42

drug with risk of respiratory depression

Answer 42

gabapentin and pregabalin

Question 43

which drug could cause thrombocytopenia, PCOS, weight gain

Answer 43

valproate

Question 44

which drug gingival hyperplasia and hirsutism

Answer 44

phenytoin

Question 45

zonisamide contraindicated i

Answer 45

sulfa allergy

Question 46

Epidiolex is what

Answer 46

cannabidoil oral solution

Question 47

Epidiolex used for what conditions

Answer 47

Dravet Syndrome Lennox Gastaut Syndrome

Question 48

keotgenic diet

Answer 48

3-4:1 fats to protein/carb risk kidney stones hyperlipidemia, weight loss, constipation, decreased bone mass only works in adults