Pharm - Exam 1

Question 1

1. What is the med that is indicated for the absence seizures only?

Answer 1

Ethosuximide

Question 2

2. Which drug has a side effect of weight loss?

Answer 2

Felbamate

Also : Ethosuximide, Topiramate, Zonisumide

Question 3

3. What drug does not cause diplopia?

Answer 3

Zonsiumide

Lacosamide, Lamotrigine, Phenytoin, Pregabalin, Tiagabine, Vigabatrin

Question 4

4. What are 2 drugs that are pan CYP inducers?

Answer 4

Phenobarb and CBZ

Question 5

5. What was false regarding gabapentin?

Answer 5

Not a pan inducer of hepatic enzymes

a. it is needed in high dose, is excreted unchanged, and has no known DIs

Question 6

6. How much active drug in phenytoin sodium?

Answer 6

0.92

Question 7

7. Calculate the loading dose

Answer 7

DL = (Vd)(Css)/(S)(F)

Vd = .65 x Wgt (Kg)

Css = 18!!!!

S (Sodium) Capsule & Injec = .92
S (Acid) Tablet & suspension = 1.0

F = 1

Question 8

8. Calculate the loading dose

Answer 8

(convert pounds to kg)

Question 9

9. What is the VPA dose range?

Answer 9

50-150

Question 10

10. What drug do you have to serum monitor?

Answer 10

Phenytoin (Also CBZ & VPA)

Question 11

11. What drug causes gingival hyperplasia?

Answer 11

Phenytoin

Question 12

12. What are the symptoms of acute intoxication of phenobarbitol?

Answer 12

Slurred speech,
Nystagmus,
Ataxia (unsteady gate)

Question 13

13. What is converted to phenobarb via hepatic oxidation?

Answer 13

Primidone

Question 14

14. What has to be tapered slowly to prevent rebound convulsions?

Answer 14

Phenobarb

Also Delirium

Question 15

15. Why do you have to start topirimate slowly?

Answer 15

Cognitive impairment

Used for migraines

Question 16

16. What’s not first line for early established stat epi?`

Answer 16

IV Valproate

Question 17

17. If you are on valproic acid and want to start lamotrigine why slowly?

Answer 17

SJS

Decrease Lamotragine by 50% if used in combo w/ VPA

Question 18

18. Typical first line for Parkinsons?

Answer 18

Rasagiline

Question 19

19. What is true about Diastat?

Answer 19

all of the above

• Used for breakthrough seizures,
• When on established AED,
• Gel formulation w/ rectal admin,
• Can’t give more than 5x a month

Question 20

20. Which of the following drugs has significant drug interaction?

Answer 20

Valproic acid

NOT
Gabapentin
Levitiracetem
Pregabalin

Question 21

21. Which drugs are used for general anesthesia in the treatment of stat epi?

Answer 21

Midazolam & Propofol

Question 22

22. What is true?

Answer 22

All of the above

• Lamotrigine level is inc during the placebo week,
• CBZ interferes w estrogen and makes OCP ineffective,
• Lamotrigine decreases the bioavailability of progesterone & makes OCP ineffective

Question 23

23. What is true about Capylidene in the tx of Alzheimer’s?

Answer 23

Not 1st line

• It is a medical food
• Watch for risk of ketoacidosis
• Increases triglyceride levels

Question 24

24. Pt with a h/o Alzheimer’s now has aggression w no other Sx?

Answer 24

Anticonvulsants

Question 25

25. Pt dx w new Alzheimer’s w h/o IBS, what should the initia tx be?

Answer 25

Donepezil

Question 26

26. What drug causes memory loss?

Answer 26

NSAIDs

Question 27

27. MOA of donepezil?

Answer 27

Ach inhibitor only

Question 28

28. What cholinesterase inhibitor comes in a patch?

Answer 28

Rivastigmine

Question 29

29. After 6 months what would the pts MMSE score would be if they started at 23?

Answer 29

24 (Inc 1-1.5)

Question 30

30. Why do you use aspirin in the tx of AD?

Answer 30

Improve perfusion & helps w vascular dz

Question 31

31. Alzheimer’s is now moderate, was on low dose donepezil, how should tx change?

Answer 31

Memantine Donepezil in high doses can be used for moderate to severe but the dose is 23 mg – question option suggested increases

Question 32

32. MOA of memantine?

Answer 32

NMDA antagonist

Question 33

33. Young Parkinson’s patient preventing w/ tremors, what should initial tx be?

Answer 33

Amantadine

Question 34

34. What do you add to CD/LD to extend?

Answer 34

COMT inhibitor (Entecapone)

Question 35

35. 70 yo w/ not otherwise specified Parkinson’s?

Answer 35

CD/LD

Question 36

36. Delayed on/no-on?

Answer 36

Add apomorphine plus trimethomenzamine

Question 37

37. Clinical predictor of disease in PD?

Answer 37

Decrease response to dopamine

Question 38

38. Who will most benefit from starting CD/LD initially?

Answer 38

Older pt w/ cog and functional impairment

Question 39

39. What is the rationale for using Selegeline in tx of PD?

Answer 39

Delay need for LD by 9 months

Question 40

40. ADR of amantadine?

Answer 40

Tachyphylaxis in 1- 2 months

Question 41

41. MOA of Rotigotine?

Answer 41

Dopamine antagonist

Question 42

42. Which of the dopamine agonists need to be renally dose adjusted?

Answer 42

Pramipexole

Question 43

43. What class has the ADR brown-orange urine?

Answer 43

COMT inhibitor

Question 44

44. What are the side effects of Galantamine?

Answer 44

N/V/D

Question 45

45. What drugs don’t you give to pregnant people?

Answer 45

all of the above Phenytoin, Valproic acid, Phenobarb