Anti-epileptics Flashcard Supplement

Beschreibung

WEEK 10 Quiz am Anti-epileptics Flashcard Supplement, erstellt von Victoria Wright am 22/03/2017.
Victoria Wright
Quiz von Victoria Wright, aktualisiert more than 1 year ago
Victoria Wright
Erstellt von Victoria Wright vor mehr als 7 Jahre
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Zusammenfassung der Ressource

Frage 1

Frage
Which of the following are First Generation anti-epileptics?
Antworten
  • Phenytoin
  • Carbamazepine
  • Ethosuximide
  • Pregabalin
  • Phenobarbital
  • Levetiracetam
  • Valproic acid
  • Felbamate
  • Clonazepam

Frage 2

Frage
Which of the following are Second Generation anti-epileptics?
Antworten
  • Topiramate
  • Oxcarbazepine
  • Phenytoin
  • Pregabalin
  • Ethosuximide
  • Valproic acid
  • Felbamate
  • Lamotrigine
  • Gabapentin
  • Levetiracetam

Frage 3

Frage
[blank_start]Epilepsy[blank_end] is chronic disorder characterized by recurring seizures.
Antworten
  • Epilepsy

Frage 4

Frage
Pharmacological treatment can control but not cure epilepsy.
Antworten
  • True
  • False

Frage 5

Frage
Status epilepticus is a medical [blank_start]emergency[blank_end].
Antworten
  • emergency

Frage 6

Frage
[blank_start]Generalized[blank_end] – no evidence of localized onset  [blank_start]Absence[blank_end] – sudden onset, abrupt cessation; 10-45 sec duration; may occur >100 times per day; characterized by a spike and wave pattern on EEG; patient may simply stare (daydream) or show postural changes, autonomic phenomena, automatisms  [blank_start]Tonic-clonic[blank_end] – tonic rigidity of all extremities, followed by relaxation, then by massive jerking of the body; patient is groggy/disoriented afterwards, urinary incontinence is common, 1-2 min duration  [blank_start]Tonic[blank_end] – increased tone of all muscles  [blank_start]Atonic[blank_end] – sudden loss of postural tone  [blank_start]Myoclonic[blank_end] – muscles spasm and limbs jerk; contractions and relaxations repeat rapidly
Antworten
  • Generalized
  • Absence
  • Tonic-clonic
  • Tonic
  • Atonic
  • Myoclonic
  • Simple
  • Complex
  • Secondarily generalized
  • Focal

Frage 7

Frage
[blank_start]Focal (partial)[blank_end] – seizure initiates in a specific site  [blank_start]Secondarily generalized[blank_end] – focal seizure precedes a generalized tonic-clonic seizure  [blank_start]Simple[blank_end] – minimal spread within brain; often clonic jerking, no diminished awareness, 20-60 sec duration  [blank_start]Complex[blank_end] – localized onset but discharge spreads; alteration of consciousness (but not unconscious), automatisms (integrated motor behavior, e.g. lip smacking, button picking)
Antworten
  • Focal (partial)
  • Secondarily generalized
  • Simple
  • Complex
  • Tonic-clonic
  • Absence
  • Tonic
  • Atonic
  • Clonic and myoclonic

Frage 8

Frage
Classify the following seizures:  [blank_start]Generalized Tonic-Clonic Seizure[blank_end]: “When it starts, she suddenly shrieks with this unnatural cry, then she falls, and every muscle in her body seems to be activated. Her teeth clench. Shortly after she falls, her arms and upper body start to jerk while her legs are more or less still stiff. This is the longest part of the seizure. Then it finally stops and she passes into a deep sleep.”  [blank_start]Generalized Absence Seizure[blank_end] "He is a 7 year old boy. He often “blanks out” for a few seconds. His teacher calls his name, but he doesn’t seem to hear her. He usually blinks a few times, and his eyes may roll up a bit. Then he is right back where he left off. Some days he has more than 50 of these spells.”  [blank_start]Secondary Generalization Focal Seizure[blank_end] "They start with a tingling in the right thumb. Then the thumb starts jerking. In a few seconds, the whole right hand is jerking. The jerking spreads up my arm. When it reaches the shoulder, I pass out and people tell me that my whole body starts to jerk.”
Antworten
  • Secondary Generalization Focal Seizure
  • Generalized Absence Seizure
  • Generalized Tonic-Clonic Seizure
  • Generalized Tonic Seizure
  • Generalized Atonic Seizure
  • Complex Focal Seizure
  • Simple Focal Seizure

Frage 9

Frage
What are the goals of therapy with anti-epileptics? Improve [blank_start]quality of life[blank_end] by:  Controlling [blank_start]seizures[blank_end]  Rarely are seizures eliminated; even occasional seizures are still a concern for patients  Minimizing [blank_start]adverse effects[blank_end]  Usually lifelong treatment
Antworten
  • quality of life
  • seizures
  • adverse effects

Frage 10

Frage
Which anti-epileptic drugs have the following mechanism of action? Inhibit voltage dependent Na+ channels
Antworten
  • oxcarbazepine
  • phenytoin
  • valproate
  • topiramate
  • felbamate
  • gabapentin
  • carbamazepine
  • clonazepam
  • lamotrigine
  • ethosuximide

Frage 11

Frage
Which anti-epileptic drugs have the following mechanism of action? Inhibit glutamate receptors
Antworten
  • valproate
  • felbamate
  • phenobarbital
  • oxcarbazepine
  • pregabalin
  • topiramate

Frage 12

Frage
Which anti-epileptic drugs have the following mechanism of action? Modulate glutamate release (putative)
Antworten
  • levetiracetam
  • pregabalin
  • topiramate
  • ethosuximide
  • felbamate
  • gabapentin

Frage 13

Frage
Which anti-epileptic drugs have the following mechanism of action? Increase inhibitory neurotransmission  Enhance GABA-A activity (positive allosteric modulation)
Antworten
  • ethosuximide
  • clonazepam
  • lamotrigine
  • phenobarbital
  • valproate
  • topiramate

Frage 14

Frage
Which anti-epileptic drugs have the following mechanism of action? Inhibit T-type Ca2+ channels  Depolarization of thalamic neurons activates cortical neurons
Antworten
  • topiramate
  • carbamazepine
  • clonazepam
  • valproate
  • ethosuximide
  • phenytoin

Frage 15

Frage
In a normal neuron (A), excitation and inhibition are [blank_start]balanced[blank_end] Neurons susceptible to seizure activity show [blank_start]decreased[blank_end] inhibition (B) or [blank_start]increased[blank_end] excitation (C) (D) [blank_start]Increasing[blank_end] GABA activity can [blank_start]decrease[blank_end] seizure activity in both situations (D) Similarly, [blank_start]decreasing[blank_end] Glutamate activity can also [blank_start]decrease[blank_end] seizure activity
Antworten
  • balanced
  • unbalanced
  • increased
  • decreased
  • increased
  • decreased
  • Increasing
  • Decreasing
  • increase
  • decrease
  • increasing
  • decreasing
  • increase
  • decrease

Frage 16

Frage
Block voltage-activated calcium channels − Neurons in thalamus are dependent on calcium channel [blank_start]pacemaker[blank_end] currents for depolarization − Blocking these channels slows the [blank_start]pacemaker[blank_end] − Depolarization of [blank_start]thalamic[blank_end] neurons activates [blank_start]cortical[blank_end] neurons
Antworten
  • pacemaker
  • pacemaker
  • thalamic
  • cortical

Frage 17

Frage
Which four of the following are drugs of choice for Focal Epileptic Seizures?
Antworten
  • Valproate
  • Gabapentin
  • Oxcarbazepine
  • Pregabalin
  • Carbamazepine
  • Ethosuximide
  • Topiramate
  • Phenytoin
  • Lamotrigine
  • Levetiracetam

Frage 18

Frage
Which five of the following are alternative drugs for Focal Epileptic Seizures?
Antworten
  • Valproate
  • Topiramate
  • Gabapentin
  • Oxcarbazepine
  • Phenytoin
  • Clonazepam
  • Carbamazepine
  • Levetiracetam
  • Pregabalin
  • Lamotrigine

Frage 19

Frage
Which three of the following are drugs of choice for Primary GTC Seizures?
Antworten
  • Topiramate
  • Valproate
  • Lamotrigine
  • Levetiracetam
  • Phenytoin
  • Pregabalin

Frage 20

Frage
Which two of the following are alternative drugs for Primary GTC Seizures?
Antworten
  • Topiramate
  • Phenytoin
  • Levetiracetam
  • Gabapentin
  • Valproate
  • Lamotrigine

Frage 21

Frage
Which two of the following are drugs of choice for Absence Seizures?
Antworten
  • Topiramate
  • Clonazepam
  • Ethosuximide
  • Lamotrigine
  • Valproate
  • Levetiracetam

Frage 22

Frage
Which two of the following are alternative drugs for Absence Seizures?
Antworten
  • Topiramate
  • Ethosuximide
  • Lamotrigine
  • Clonazepam
  • Valproate
  • Levetiracetam

Frage 23

Frage
Which five of the following are some of the adverse effects of Phenytoin?
Antworten
  • Hiccups
  • Hepatic failure
  • Nystagmus
  • Depression
  • Diplopia
  • Gingival hyperplasia
  • Mild parasthesias
  • Acne / Hirsuitism / Coarsening of facial features
  • Anorexia
  • Concern with HLA-B*1502 allele and skin reactions

Frage 24

Frage
Which six of the following are some of the adverse effects of Phenytoin?
Antworten
  • May interfere with learning
  • Sedation
  • Ataxia
  • Rare serious blood dyscrasias
  • Fulminant hepatitis
  • Folate and Vitamin D deficiencies (megaloblastic anemia, osteomalacia)
  • Transient diplopia
  • Dizziness
  • Involuntary movements
  • Mild parasthesias

Frage 25

Frage
Which five of the following are some of the adverse effects of Carbamazepine and Oxcarbazepine?
Antworten
  • Ataxia
  • Hyperammonemia
  • Hyponatremia
  • Hallucinations
  • Alopecia
  • Transient diplopia
  • Dizziness
  • Rare serious blood dyscrasias
  • Weight gain
  • Menstrual abnormalities

Frage 26

Frage
Which five of the following are some of the adverse effects of Carbamazepine and Oxcarbazepine?
Antworten
  • Anorexia
  • Nausea
  • Mild parasthesias
  • Dependence
  • Drowsiness
  • Acute pancreatitis
  • Difficulty with speech
  • Insomnia
  • Skin rash
  • Stevens-Johnson syndrome

Frage 27

Frage
Which six of the following are some of the adverse effects of Valproate?
Antworten
  • Menstrual abnormalities
  • Hyperammonemia
  • Aggression
  • Ataxia
  • Fulminant hepatitis
  • Dizziness
  • Alopecia
  • Rare serious blood dyscrasias
  • Hyponatremia
  • Acute pancreatitis

Frage 28

Frage
Which six of the following are some of the adverse effects of Valproate?
Antworten
  • Nervousness
  • GI discomfort (tolerance)
  • Stevens-Johnson syndrome
  • Tremor
  • Diplopia
  • Somnolence
  • Weight gain
  • Thrombocytopenia
  • Polycystic ovaries
  • Folate and Vitamin D deficiencies (Megaloblastic anemia, Osteomalacia)

Frage 29

Frage
Which four of the following are the adverse effects of Ethosuximide?
Antworten
  • Fulminant hepatitis
  • Hiccups
  • Vomiting
  • Difficulty with speech
  • Behavioral changes
  • Weight gain
  • Tolerance
  • Dependance
  • Stevens-Johnson syndrome
  • Nausea

Frage 30

Frage
Which four of the following are the adverse effects of Phenobarbital?
Antworten
  • Hepatic failure
  • Sedation
  • Respiratory depression
  • Impaired concentration and memory
  • Difficulty with speech
  • Lower extremity edema
  • Tolerance
  • Dependance
  • Hyperammonemia
  • Hyponatremia

Frage 31

Frage
Which three of the following are the adverse effects of Clonazepam?
Antworten
  • Diplopia
  • Dependance
  • Anorexia
  • Sedation
  • Respiratory depression
  • Gingival hyperplasia
  • Weight gain
  • Tolerance
  • Involuntary movements
  • Polycystic ovaries

Frage 32

Frage
Which six of the following are the adverse effects of Lamotrigine?
Antworten
  • Dizziness
  • Skin rash
  • Hallucinations
  • Confusion
  • Stevens-Johnson syndrome
  • Insomnia
  • Aggression
  • Headache
  • Hiccups
  • Nausea

Frage 33

Frage
Which six of the following are the adverse effects of Topiramate?
Antworten
  • Mild parasthesias
  • Difficulty with speech
  • Confusion
  • Depression
  • Nervousness
  • Insomnia
  • Impaired concentration and memory
  • Hallucinations
  • Aggression
  • Somnolence

Frage 34

Frage
Which three of the following are the adverse effects of Gabapentin and Pregabalin?
Antworten
  • Lower extremity edema
  • Hyperammonemia
  • Acne, Hirsuitism, Coarsening of facial features
  • Stevens-Johnson syndrome
  • Mild parasthesias
  • Drowsiness
  • Insomnia
  • Weight Gain
  • Tolerance
  • Dependence

Frage 35

Frage
Which four of the following are the adverse effects of Levetiracetam?
Antworten
  • Irritability
  • Vomiting
  • Transient diplopia
  • Ataxia
  • Headache
  • Depression
  • Nausea
  • Hallucinations
  • Acute pancreatitis
  • Aggression

Frage 36

Frage
Which two of the following are the adverse effects of Felbamate?
Antworten
  • Respiratory depression
  • Hyponatremia
  • Confusion
  • Tremor
  • Aplastic anemia
  • Tolerance
  • Rare serious blood dyscrasias
  • Dependance
  • Lower extremity edema
  • Hepatic failure

Frage 37

Frage
Which of the following are the drug-drug interactions of Phenytoin?
Antworten
  • Can reduce blood levels of contraceptive hormones
  • Enzyme inducers can increase clearance
  • Metabolism inhibited by valproate
  • Significant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
  • Warfarin: can decrease anticoagulant effect
  • No significant drug interactions
  • Significant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
  • Interactions due to plasma protein binding

Frage 38

Frage
Which of the following are the drug-drug interactions of Valproate?
Antworten
  • Significant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
  • Interactions due to plasma protein binding
  • Can reduce blood levels of contraceptive hormones
  • Enzyme inducers can increase clearance
  • Significant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
  • No significant drug interactions
  • Can increase plasma levels of carbamazepine metabolite, phenytoin, phenobarbital, ethosuximide, lamotrigine and tricyclic antidepressants

Frage 39

Frage
Which of the following are the drug-drug interactions of Ethosuximide?
Antworten
  • Affected by CYP3A4 inducers
  • Significant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
  • Enzyme inducers can increase clearance
  • Metabolism inhibited by valproate
  • Can reduce blood levels of contraceptive hormones
  • Significant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
  • No significant drug interactions

Frage 40

Frage
Which of the following are the drug-drug interactions of Phenobarbital?
Antworten
  • Reduces blood levels of contraceptive hormones
  • Warfarin: can decrease anticoagulant effect
  • Significant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
  • Metabolism inhibited by valproate
  • Can increase plasma levels of carbamazepine metabolite, phenytoin, phenobarbital, ethosuximide, lamotrigine and tricyclic antidepressants
  • Significant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
  • Enzyme inducers can increase clearance

Frage 41

Frage
Which of the following are the drug-drug interactions of Clonazepam?
Antworten
  • Interactions due to plasma protein binding
  • Metabolized by CYP3A4
  • Significant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
  • Can reduce blood levels of contraceptive hormones
  • Metabolism inhibited by valproate
  • Significant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
  • No significant drug interactions

Frage 42

Frage
Which of the following are the drug-drug interactions of Lamotrigine?
Antworten
  • Enzyme inducers can increase clearance
  • Significant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
  • Metabolism induced by carbamazepine, phenobarbital, phenytoin
  • Metabolism inhibited by valproate
  • Oral contraceptives can reduce levels
  • Interactions due to plasma protein binding
  • No significant drug interactions

Frage 43

Frage
Which of the following are the drug-drug interactions of Lamotrigine?
Antworten
  • Can reduce blood levels of contraceptive hormones
  • Affected by CYP3A4 inducers
  • Warfarin: can decrease anticoagulant effect
  • Significant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
  • Significant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
  • Interactions due to plasma protein binding
  • No significant drug interactions

Frage 44

Frage
Which of the following are the drug-drug interactions of Gabapentin, Levetiracetam, and Pregabalin?
Antworten
  • Significant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
  • Significant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
  • Warfarin: can decrease anticoagulant effect
  • Enzyme inducers can increase clearance
  • Can increase plasma levels of carbamazepine metabolite, phenytoin, phenobarbital, ethosuximide, lamotrigine and tricyclic antidepressants
  • Reduces blood levels of contraceptive hormones
  • No significant drug interactions

Frage 45

Frage
Which of the following are the drug-drug interactions of Carbamazepine?
Antworten
  • Induces metabolism of phenytoin, ethosuximide, valproate, clonazepam
  • Enzyme inducers can increase clearance
  • Reduces blood levels of contraceptive hormones
  • Drug level affected by CYP3A4 inducers (phenytoin, phenobarbital), inhibitors
  • Can increase plasma levels of carbamazepine metabolite, phenytoin, phenobarbital, ethosuximide, lamotrigine and tricyclic antidepressants
  • Significant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
  • No significant drug interactions

Frage 46

Frage
Which of the following statements are true for Phenytoin?
Antworten
  • Many PO formulations available – IR / ER formulations
  • 10-20 mg/L is common therapeutic range
  • Metabolism: dose-dependent capacity-limited pharmacokinetics (zero order metabolism)
  • Oldest non-sedating, anti-seizure drug
  • MUST MONITOR SERUM LEVELS
  • Used in bipolar disorder
  • 90% in vascular space is bound to albumin
  • At steady-state, 10% in vascular space, 90% tissue
  • Weight loss common (80% patients; 3-4% bodyweight loss)
  • Takes up to 6 weeks to achieve steady state, depending on dose

Frage 47

Frage
Which of the following statements are true for Carbamazepine?
Antworten
  • Oldest non-sedating, anti-seizure drug
  • Also used for migraine prophylaxis and bipolar disorder
  • Used in children more than adults
  • Adjunctive therapy in children with focal seizures and generalized tonic clonic seizures
  • Induces its own metabolism; t1/2 ~36 hr ~20 hr
  • Used for migraine prophylaxis
  • Used for neuropathic pain
  • Is often Drug of Choice for focal seizures
  • 100% renal elimination
  • Monotherapy in >16 yr old for focal seizures

Frage 48

Frage
Which of the following statements are true for Valproate?
Antworten
  • Used in children more than adults
  • Effective and well tolerated so used for many seizure types
  • No longer a drug of 1st choice for women of childbearing potential
  • Many PO formulations available – IR / ER formulations
  • 90% protein bound – can be significant
  • Many enzymes responsible for its metabolism (2A6, 2B6, 2C9, UGT, etc.)
  • Weight loss common (80% patients; 3-4% bodyweight loss)
  • Used for migraine prophylaxis
  • Used for neuropathic pain
  • Used for bipolar disorder

Frage 49

Frage
Which of the following statements are true for Phenobarbital?
Antworten
  • Used for febrile seizures
  • 100% renal elimination
  • Used for weight management
  • Used in children more than adults
  • Weight loss common (80% patients; 3-4% bodyweight loss)
  • Infrequently used for seizures due to adverse effects and risks
  • Off label use for bipolar disorder
  • Induces its own metabolism; t1/2 ~36 hr ~20 hr
  • Oldest non-sedating, anti-seizure drug
  • Commonly used in monotherapy

Frage 50

Frage
Which of the following statements are true for Lamotrigine?
Antworten
  • Monotherapy in >16 yr old for focal seizures
  • 90% in vascular space is bound to albumin
  • Used for migraine prophylaxis
  • Adjunctive therapy in children with focal seizures and generalized tonic clonic seizures
  • Used for weight management
  • Used in children more than adults
  • Used in absence (better tolerated than ethosuximide, valproate)
  • Used in bipolar disorder
  • Used for neuropathic pain
  • Does not induce or inhibit CYP enzymes

Frage 51

Frage
Which of the following statements are true for Topiramate?
Antworten
  • At steady-state, 10% in vascular space, 90% tissue
  • Weight loss common (80% patients; 3-4% bodyweight loss)
  • Used for bipolar disorder
  • Oldest non-sedating, anti-seizure drug
  • Used for migraine prophylaxis
  • Used for weight management
  • Induces its own metabolism; t1/2 ~36 hr ~20 hr
  • Used for neuropathic pain
  • 100% renal elimination
  • Adjunctive therapy in children with focal seizures and generalized tonic clonic seizures

Frage 52

Frage
Which of the following statements are true for Levetiracetam?
Antworten
  • 90% in vascular space is bound to albumin
  • Used in bipolar disorder
  • Oldest non-sedating, anti-seizure drug
  • Adjunct for Focal and generalized tonic-clonic seizures
  • Not an inhibitor or inducer of CYP enzymes
  • Commonly used for monotherapy
  • Used for migraine prophylaxis
  • Renal elimination (>70%)
  • Used for weight management
  • Used in children more than adults

Frage 53

Frage
Principles of AED Therapy  Choose monotherapy agent on basis of seizure [blank_start]type[blank_end] (or epilepsy syndrome if known) & patient-specific considerations (usually [blank_start]adverse effect[blank_end] profile)  Increase to [blank_start]usual[blank_end] effective dose or to a serum level within the therapeutic range  If seizures not controlled - increase gradually to [blank_start]maximal[blank_end] tolerated dose (MTD) = highest dose a patient can tolerate without bothersome adverse effects  If monotherapy fails, choose alternate monotherapy agent and repeat process  If monotherapy fails with several drugs, try [blank_start]adjuvant therapy[blank_end]  Concern is management of [blank_start]adverse effects[blank_end] of two drugs
Antworten
  • type
  • adverse effect
  • maximal
  • usual
  • adjuvant therapy
  • adverse effects

Frage 54

Frage
Which of the following drugs reduce blood levels of contraceptive hormone?
Antworten
  • Carbamazepine
  • Phenobarbital
  • Phenytoin
  • Felbamate
  • Lamotrigine
  • Oxcarbazepine
  • Topiramate

Frage 55

Frage
Antiepileptics are [blank_start]gradually[blank_end] increased to therapeutic concentrations to minimize [blank_start]adverse effects[blank_end] and are withdrawn [blank_start]gradually[blank_end] to reduce the risk of inducing [blank_start]seizures[blank_end].
Antworten
  • gradually
  • adverse effects
  • gradually
  • seizures

Frage 56

Frage
 Enhanced vitamin [blank_start]D[blank_end] metabolism can cause osteomalacia (phenytoin, phenobarbital)  Enhanced vitamin [blank_start]K[blank_end] metabolism can cause bleeding disorders (phenytoin, phenobarbital)  Many anti-epileptics enhance [blank_start]metabolism[blank_end] of other anti-epileptics (phenytoin, carbamazepine, phenobarbital)  [blank_start]Valproate[blank_end] inhibits metabolism of some anti-epileptics
Antworten
  • D
  • K
  • metabolism
  • Valproate

Frage 57

Frage
Pregnancy  Teratogenicity: Valproate, phenobarbital, phenytoin, carbamazepine  Prefer [blank_start]lamotrigine[blank_end] (or levetiracetam, oxcarbazepine)  Can increase drug metabolism, which can [blank_start]reduce[blank_end] seizure control  Need to switch drugs or increase dose?
Antworten
  • lamotrigine
  • reduce

Frage 58

Frage
Hepatic disease  Avoid [blank_start]hepatotoxic[blank_end] antiepileptic drugs (e.g., valproate) when possible  Monitor free (unbound) levels of phenytoin, valproate when [blank_start]albumin[blank_end] low
Antworten
  • hepatotoxic
  • albumin

Frage 59

Frage
Which of the following are contraindications / precautions for Phenytoin?
Antworten
  • IV use for patients with sinus bradycardia, sinoatrial block, second- and third-degree heart block
  • Risk of dependence is high
  • Black box warning on rate of IV administration (<50mg/min)
  • Teratogenic risk

Frage 60

Frage
Which of the following are contraindications / precautions for Carbamazepine?
Antworten
  • HLA-B*1502, common in Asians, linked to 10X increased incidence of Stevens-Johnson syndrome
  • Teratogenic risk
  • Black box warning on rate of IV administration (<50mg/min)
  • Caution in patients with history of sedative dependence

Frage 61

Frage
Which of the following are contraindications / precautions for Valproate?
Antworten
  • Not used in children <3 yrs because of risk of liver failure
  • IV use for patients with sinus bradycardia, sinoatrial block, second- and third-degree heart block
  • Do not use in patients with history of sedative addiction
  • Teratogenic risk

Frage 62

Frage
Which of the following are contraindications / precautions for Phenobarbital?
Antworten
  • Risk of dependence is high
  • Do not use in patients with history of sedative addiction
  • Teratogenic risk
  • Black box warning on rate of IV administration (<50mg/min)

Frage 63

Frage
Which of the following are contraindications / precautions for Clonazepam?
Antworten
  • Caution in patients with history of sedative dependence
  • Teratogenic risk
  • IV use for patients with sinus bradycardia, sinoatrial block, second- and third-degree heart block
  • HLA-B*1502, common in Asians, linked to 10X increased incidence of Stevens-Johnson syndrome
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