00 Epilepsy Study Questions Flashcards

1
Q

Generic name of: Luminal

A

Phenobarbital

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2
Q

Generic name of: Dilantin

A

Phenytoin

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3
Q

Generic name of: Valium

A

Diazepam

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4
Q

Generic name of: Diastat

A

Diazepam (Rectal Gel)

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5
Q

Generic name of: Klonopin

A

Clonazepam

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6
Q

Generic name of: Tegretol

A

Carbamazepine

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7
Q

Generic name of: Epitol

A

Carbamazepine

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8
Q

Generic name of: Carbatrol

A

Carbamazepine

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9
Q

Generic name of: Depakene

A

Valproic Acid

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10
Q

Generic name of: Depakote

A

Divalproex Sodium

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11
Q

Generic name of: Depacon

A

Valproate Sodium

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12
Q

Generic name of: Neurontin

A

Gabapentin

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13
Q

Generic name of: Lamictal

A

Lamotrigine

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14
Q

Generic name of: Topamax

A

Topiramate

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15
Q

Generic name of: Trileptal

A

Oxcarbazepine

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16
Q

Generic name of: Oxtellar XR

A

Oxcarbazepine ER

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17
Q

Generic name of: Keppra

A

Levetiracetam

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18
Q

Generic name of: Lyrica

A

Pregabalin

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19
Q

What happens when Lamictal (Lamotrigine) is added to an AED regimen containing Valproate?

A

Dosing changes whether you are using an inducer or inhibitor

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20
Q

Petit Mal is known as what kind of seizure?

A

Absence

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21
Q

Grand Mal is known as what kind of seizure?

A

Tonic-Clonic

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22
Q

What is the DOC for absence seizure?

A

Ethosuximide (Zarontin) or Depakote is a good choice if that can’t be used

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23
Q

What is the therapeutic range for Carbamazepine?

A

4-12

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24
Q

What is the therapeutic range for Ethosuximide

A

40-100

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25
Q

What is the therapeutic range for Phenobarbital?

A

15-40

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26
Q

What is the therapeutic range for Primidone?

A

5-12

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27
Q

What is the therapeutic range for Phenytoin?

A

10-20

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28
Q

What is the therapeutic range for Valproic Acid?

A

50-150

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29
Q

What test is used to measure seizure activity?

A

EEG

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30
Q

After initial dosing has been initiated, which anticonvulsant requires higher doses to achieve the same effects after several days?

A

Carbamazepine d/t auto-induction

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31
Q

Which anticonvulsant should you avoid in sulfa allergy?

A

Zonisamide

32
Q

Which anticonvulsant should you avoid in patients with a previous hypersensitivity reaction to carbamazepine?

A

Felbatol

33
Q

Which voltage-dependent channels are inhibited by some AEDs?

A

Na+ and Ca2+

34
Q

What does GABA stand for?

A

Gamma Amino Butyric Acid

35
Q

What are some common drugs that decrease seizure threshold?

A

Caffeine, Anti-depressants (e.g., Bupropion), Tramadol (>400mg), Meperidine (use morphine instead), Anti-psychotics (Clozapine, Chorpromazine), Theophylline

36
Q

What is the broad spectrum AED that can be used in almost all patients?

A

Valproate

37
Q

What is Status Epilepticus?

A

Continuous grand mal seizures lasting at least 5 (up to 30) minutes, or two or more sequential seizures without full recovery of consciousness between seizure attacks. Medical emergency. CAN’T USE ORAL MEDICATIONS

38
Q

What are the DOC’s for Status Epilepticus?

A

Diazepam (Valium, Diastat rectal gel) OR Lorazepam. Valproate sodium (Depacon) can always be used an an alternate

39
Q

What are the DOC’s for Partial Seizures?

A

Carbamazepine. Valproate as an alternative

40
Q

What are the DOC’s for Tonic-Clonic Seizures?

A

Valproate OR Carbamazepine

41
Q

Which AEDs can cause Hyponatremia?

A

Oxcarbazepine, Carbamazepine

42
Q

Which AEDs can cause Hyperammonemia?

A

Valproic Acid

43
Q

Which AEDs can cause Pancreatitis?

A

Valproic Acid

44
Q

Which AEDs can cause Polycystic Ovaries?

A

Valproic Acid, Carbamazepine

45
Q

Which AEDs can cause Fatal Aplastic Anemia?

A

Felbamate

46
Q

Which AEDs can cause Kidney Stones?

A

Zonisamide, Topiramate

47
Q

Which AEDs can cause Gingival Hyperplasia?

A

Phenytoin

48
Q

Which AEDs can cause SJS?

A

Lamotrigine

49
Q

Which AEDs can cause Hiccups?

A

Ethosuximide

50
Q

Which AEDs can cause Purple Glove Syndrome?

A

Phenytoin

51
Q

Which AEDs can cause QTc Prolongation?

A

Ezogabine

52
Q

Which AEDs can cause Urinary Retention?

A

Ezogabine

53
Q

What are the C-IV AEDs?

A

All benzos, Phenobarbital, Mephobarbital

54
Q

What are the C-V AEDs?

A

Pregabalin, Lacosamide, Ezogabine

55
Q

What are the AEDs that can have loading doses?

A

Fosphenytoin, Phenobarbital, Valproate Sodium

56
Q

What are the AEDs that are big enzyme inducers?

A

Carbamazepine, Oxcarbazepine, Phenytoin, Fosphenytoin, Phenobarbital, Primidone, Topiramate (> 200mg)

57
Q

When would be a time when Valproic acid would not be an appropriate choice?

A

Hepatic impairment

58
Q

How does Oxcarbazepine compare to Carbamazepine?

A

Oxcarbazepine is advantages over CBZ in every way except that it causes hyponatremia

59
Q

Why does Carbamazepine have so many SEs?

A

Because it is metabolized into 10,11-epoxide

60
Q

How does Phenytoin compare to Fosphenytoin?

A

Phenytoin: infuse at 50mg/min in saline only. Fosphenytoin: infuse at 150mg/min in saline or dextrose

61
Q

What pregnancy category do most AEDs fall into?

A

Category D

62
Q

What are the Pregnancy Category D AEDs?

A

BZDs, Phenobarbital/primidone, VPA, Carbamazepine, Phenytoin/Fosphenytoin, Topiramate

63
Q

What patients need to be screened before CBZ?

A

Asian descent for the HLA-B*1502 gene

64
Q

When should you dose adjust Phenobarbital?

A

Decrease dose in renal or hepatic dysfunction

65
Q

What seizure type must Phenytoin be avoided in?

A

Absence seizures

66
Q

When is Phenytoin contraindicated?

A

Heart issues (2nd or 3rd degree AV block, sinus bradycardia, sino-atrial block)

67
Q

What is the generic of Onfi?

A

Clobazam (Benzo)

68
Q

What genetic polymorphism should be identified for Clobazam users?

A

CYP 2C19, polymorphism causes higher levels of drug, need to lower dose

69
Q

What is the BBW for Valproate?

A

Hepatotoxicity, Teratogenicity, Pancreatitis

70
Q

What is Stavzor?

A

Delayed-release capsules of Valproate

71
Q

What is the BBW for Lamotrigine?

A

Life-threatening rashes. Slow gradual titration of dose may reduce the incidence

72
Q

What do you need to advise patients who are going to start Topiramate?

A

Increase fluid intake to decrease risk of kidney stones

73
Q

What is the generic for Oxtellar XR?

A

Oxcarbazepine extended release tabs

74
Q

What are the drug interactions like with Keppra?

A

None clinically important, not metabolized by CYP450

75
Q

What is the generic of Sabril?

A

Vigabatrin

76
Q

What is Vigabatrin indicated for?

A

Refractory Epilepsy Infantile Spasms (IS)

77
Q

What is the BBW for Vigabatrin?

A

Causes progressive and permanent bilateral concentric visual field constriction in a high percentage of patients (REMS program)