Mer Scott
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PHCY320 (Neurology) Quiz on NE5 Anti-epileptic drugs, created by Mer Scott on 10/10/2019.

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Mer Scott
Created by Mer Scott about 5 years ago
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NE5 Anti-epileptic drugs

Question 1 of 16

1

Lamotrigine and zonisamide affect both Na+ and Ca++ channels.

Select one of the following:

  • True
  • False

Explanation

Question 2 of 16

1

Ethosuximide and pregabalin affect calcium channels.

Select one of the following:

  • True
  • False

Explanation

Question 3 of 16

1

Vigabatrin is used as an adjuct therapy for infantile seizures.

Select one of the following:

  • True
  • False

Explanation

Question 4 of 16

1

Sodium valproate increases GABA levels by decreasing breakdown.

Select one of the following:

  • True
  • False

Explanation

Question 5 of 16

1

GABA receptor upregulators: .
- Examples:
- Action: Enhances GABA neurotransmission, GABA neurotransmission, suppresses transmission throughout the CNS
- Use: all forms of epilepsy EXCEPT epilepsy; status epilepticus, phenobarbitol 1st -line therapy for
- Pros: Oldest prescribed AED; WHO list; CHEAP; long
- Cons: CNS ; phenobarbitol - relatively- therapeutic window; substance issues; CYP inducer

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    Barbiturates
    Phenobarbital, Primidone
    mimics
    motor and polysynaptic
    absence
    infantile seizures
    half-life
    sedation
    narrow
    abuse

Explanation

Question 6 of 16

1

Zonisamide:
Action: Blocks ion channels; binds and activates GABA receptor
Use: mono- and adjunctive therapy for focal epilepsy; Lennox-Gastaut syndrome; Parkinson disease
Powerful antiepileptic, costly, available in NZ.

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    Na+ VG and T-type Ca++
    not

Explanation

Question 7 of 16

1

Topiramate
- Action: Blocks channels; potentiates GABA and effect; inhibits carbonic anhydrase
- Use: mono- and adjunctive therapy for multiple forms of epilepsy; migraine prophylaxis, idiopathic intracranial
hypertension
- Pros: No serum monitoring; relatively
- Cons: 20+yrs of use; CNS ; renal and ophthalmologic complications; side effects; unclear regarding pregnancy/lactation risk

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    Na+ VG
    receptors
    cheap
    sedation

Explanation

Question 8 of 16

1

Retigabine (Onelink)
Action: Activates ion channel to return depolarised neurons to state and reducing neuronal excitability
Use: management of focal epilepsy
Pros: Quick ; unique of activity
Cons: cardiac and ophthalmologic complications; side effects; costly

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    K+
    resting
    adjunctive
    absorption
    mechanism

Explanation

Question 9 of 16

1

Racetams
- Examples: Levetiracetam (Keppra), Piracetam (Nootropil)
- Action: Block ion channels; modulate AMPA receptors
- Use: focal epilepsy (mono- and adjunctive therapeutic uses); generalised GTC and myoclonic epilepsy
- Pros: Wide therapeutic use in epilepsy (L); limited effects

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    N-type Ca++
    side

Explanation

Question 10 of 16

1

DA agonists - -ergot derivatives:
e.g. Pramipexole, Ropinirole
tolerated (but still nausea, hypotension, constipation)
• Dyskinesias
• Sudden onset of - caution re: driving
• Adjunct:

(specialist supervision)
• Good for unpredictable ‘off’ periods, administration
• 2 days pre-treatment with

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    Non
    Better
    sleep
    confusion, hallucinations
    Apomorphine
    s.c.
    domperidone

Explanation

Question 11 of 16

1

Amantadine:
DA agonist
• Modest anti-PD effect
• Tolerance
• Confusion/
• Useful for in late disease
Unwanted Effects: (decrease dose in renal impairment)

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    Weak
    hallucinations
    insomnia, peripheral oedema
    L-DOPA induced dyskinesia

Explanation

Question 12 of 16

1

Selective MAO- inhibitors: E.g. and rasagiline
• Decrease of DA in
• Prolong of action
• First used as adjunct to L-DOPA, to decrease dose requirement (1/3)
• ‘L-DOPA sparing’
• Mow also used with DA agonists
• Decreases end-of-dose
• UEs: Nausea, mouth, dyspepsia, constipation, (common)

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    B
    Selegiline
    breakdown
    striatum
    duration
    deterioration
    dry
    transient dizziness

Explanation

Question 13 of 16

1

Inhibition of cholinergic activity -
Anti drugs e.g. Benztropine (benatropine),
• Decrease relative
• Little effect on
• Modest effect - (excessive salivation)
Unwanted effects:
- (peripheral) worsen PD-related mouth. Also vision, urinary .
- (Central) restlessness (elderly)

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    muscarinic
    procyclidine
    central cholinergic excess
    bradykinesia
    tremor and rigidity, sialorrhea
    constipation, dry
    blurred
    retention
    confusion, memory impairment,

Explanation

Question 14 of 16

1

Drug-induced Parkinsonism - % of PD. >men.

HIGH RISK
1. Dopamine :

Antipsychotics -
Typicals e.g.
Atypicals ((lower incidence): e.g.

- e.g. metoclopromide

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    7
    Women
    D2 receptor blockers
    haloperidol
    risperidone, olanzapine
    Antiemetics

Explanation

Question 15 of 16

1

Methyldopa (centrally acting antihypertensive) is a dopamine depleter.

Select one of the following:

  • True
  • False

Explanation

Question 16 of 16

1

Which of these drug classes is not an intermediate risk for drug induced PD?

Select one of the following:

  • Calcium channel blockers eg verapamil, diltiazem

  • Mood stabilisers e.g. sodium valproate, lithium

  • Selective serotonin reuptake inhibitors e.g. fluoxetine, escitalopram

Explanation