AEDs

Question 1

Agents that enhance VGSC inactivation

Answer 1

Phenytoin
Carbamazepine
Lamotrigine

Question 2

Phenytoin metabolism

Answer 2

Metabolism by CYP2C9, 2C19
Potent inducer of CYP and UGT-glucuronidation
95% protein bound

Question 3

Phenytoin adverse effects

Answer 3

Hirsutism
Osteomalacia
Teratogenic
Megaloblastic anaemia
Arrhythmia
Insulin inhibited
Lymphadenopathy
Ataxia
Neuropathy/Nystagmus
Diplopia
SJS/TEN
Lupus syndrome
Agranulocytosis/aplastic anaemia
Gum hyperplasia
Hepatotoxicity

Question 4

Carbamazepine metabolism

Answer 4

Metabolism by CYP3A4
Potent CYP inducer

Question 5

Carbamazepine adverse effects

Answer 5

Dizziness, ataxia
Headache, drowsiness
Diplopia, blurred vision
Mild generalised rash
Leukopenia
Agranulocytosis
SIADH

Question 6

Lamotrigine metabolism

Answer 6

Metabolism by UGT-glucuronidation

Question 7

Lamotrigine adverse effects

Answer 7

Maculo-papular rash
SJS/TEN/DRESS
Hypersensitivity
Diplopia/blurred vision
Photosensitivity
Tremor
Agitation
Nausea/vomiting
Aplastic anaemia

Question 8

HLA associated with Carbamazepine induced SJS

Answer 8

HLA 1502

Question 9

Ethosuximide MOA

Answer 9

T-type Ca channel blocker

Question 10

Ethosuximide adverse effects

Answer 10

Fatigue
GI upset
Headache
Itch
SJS

Question 11

Ethosuximide metabolism

Answer 11

CYP3A4

Question 12

Keppra mechanism of action

Answer 12

Binds to neuronal synaptic vesicle glycoprotein 2A

Question 13

Keppra adverse efects

Answer 13

Depression, agitation
Diarrhoea/vomiting
Dyspepsia
Drowsiness
Diplopia
Dyscrasias
DRESS/SJS/TEN
Psychosis

Question 14

Sodium valproate MOA

Answer 14

Increases GABA levels
Blocks VGSCs and VGCCs

Question 15

Sodium valproate pharmacology

Answer 15

CYP metabolism
Mostly protein bound

Question 16

Sodium valproate adverse reactions

Answer 16

Nausea/vomiting
Alopecia
Liver toxicity
Pancreatitis
Weight gain
Oedema
SIADH
Ataxia
Agranulocytosis/aplastic anaemia
Tremor
Teratogenic
TEN
SJS
Encephalopathy

Question 17

Topiramate MOA

Answer 17

Blocks VGSC
Antagonist at AMPA/Kainate-Rs
Augments GABA

Question 18

Topiramate adverse effects

Answer 18

Psychosis
Acute angle glaucoma
Nephrolithiasis
Drowsiness
Anhidrosis

Question 19

Vigabatrin MOA

Answer 19

Structure analogue of GABA –> increases GABA levels

Question 20

Vigabatrin adverse effects

Answer 20

Visual field defects
Depression

Question 21

Gabapentin MOA

Answer 21

GABA analogues

Question 22

Gabapentin adverse effects

Answer 22

Myoclonus
Oedema
Dizziness
Ataxia
Somnolence/sedation

Question 23

Oxcarbazepine MOA

Answer 23

Blocks VGSCs

Question 24

Lacosamide MOA

Answer 24

Blocks VGSCs

Question 25

Lacosamide adverse effects

Answer 25

AV block AF

Question 26

Perampanel MOA

Answer 26

Non-competitive antagonist at post-synpatic AMPA glutamate receptors

Question 27

Perampanel adverse effects

Answer 27

Homicidal ideation

Question 28

Tiagiabine MOA

Answer 28

inhibits neuronal GABA uptake

Question 29

Tiagiabine adverse effects

Answer 29

Sedation, confusion

Question 30

Zonisamide MOA

Answer 30

Blocks VGSCs and VGCCs Modulates GABA

Question 31

Zonisamide adverse effects

Answer 31

Psychosis Acute angle glaucoma Nephrolithiasis Drowsy/poor concentration Anhidrosis