AED

Question 1

What are the AED safe for pragnancy?

Answer 1

1. Lamotrigine (can be used a monotherapy)
2. Oxcarbazepine
3. Topiramate
4. Gabapentin
5. Levetiracetam

Question 2

AED that are hepatic enzyme inducers:

Answer 2

1. Phenytoin
2. Carbamazepine ( autoinduction)
3. Barbiturates
4. Oxcarbazepine
5. Topiramate (weak)

Question 3

AED that mainly renal excreted:

Answer 3

1. Gabapentin
2. Levetiracetam

Question 4

AED should be avoided in young women:

Answer 4

1. Valproate (higher teratogenic risk)
2. Phenytoin (cosmatic effects, hirutism)

Question 5

When to check AED drug level?

Answer 5

1. Assessment of compliance to drug treatment for or with refractory epilepsy
2. Pt with symptoms suspected for AED toxicity (e.g. cerebellar signs)
3. Titration of phenytoin level

Question 6

What are the AED that block the neuronal inactive form sodium channels, to decrease seizure activities?

Answer 6

1. Phenytoin
2. Carbamazepine

Question 7

What are the AED with Action of increasing GABAergic inhition (by inhibiting the breakdown of GABA)?

Answer 7

1. Phenobarbital
2. Valproate
3. Vigabatrin

Question 8

What is the MOA of keppra?

Answer 8

Levetiracetam binds to the symaptic protein SV2A , altering neurotransmitter release (e.g. decrease glutamate release), in the presynaptic boutons of neurons

Question 9

AEDs are the glutamate blockers

Answer 9

1. NMDA inhibitor: felbamate, levetiracetam
2. AMPA/KAINATE inhitor: tropiramate

Question 10

What are the GABA enhancer:

Answer 10

1. GABA A Agonist ( barbuturates, benzodiazepines, progestorone and ganaloxone)
2. Block GABA update ( tiagabine)
3. Inhibit the metabolism ofnGABA by GABA transminase ( Vigabatrine)
4. Prodrug: (progabide)

Question 11

S.e. of phenytoin:

Answer 11

1. LOA, nausea
2. Poor coordination, drowsiness
3. Increased hair growth and enlargement of the gums
4. Liver toxicity
5. Bone marrow suppression
6. Hypotension
7. TEN
8. Teratogenic
9. Osteoproesisis

Question 12

S.e of carbamazepine:

Answer 12

1. Nausea/vomiting
2. Constipation
3. Poor coordination, drowsiness
4. Headache and migraine
5. Leukopenia and thrombocytopenia
6. Hyponatremia (SIADH, INCREASE production of ADH)
7. TENS ( HLA-B 1502, higher risk for SJS)
8. teratogenic

Question 13

Carbamazepine with variable T1/2 due to:

Answer 13

Autoinduction

Question 14

Properies of carbamazepine:

Answer 14

1. Oral form ( CR is available) No IV form
2. Well obsorpted after oral admistration
3. It is a strong hepatic inducer and autoinduction
4. With variable T1/2
5. T1/2 shorten to 15hr when it given repeatedly

Question 15

DDR: carbamazapine PDC will increase if is is given with:

Answer 15

1. Erythromycin
2. Cimetidine
3. CCB

Question 16

What drug might increase phenytoin toxity?

Answer 16

1. Warfarin
2. Trimethoprim

Question 17

S.e of valproate

Answer 17

1. N/V, constipation
2. Poor coordination, drowsiness
3. Hepatotoxity
4. Thrombocytopenia, leukopenia
5. Pancreatitis
6. Suicidal behaviours and thoughts
7. Teratogenic