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ADAMS > AEDs > Flashcards

AEDs Flashcards

1
Q

If a woman with sz has been off epilepsy meds for a time before getting pregnant and had sz during pregnancy, what are her best options for AEDs:

A

Phenytoin

Levetiracetam

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2
Q

Percent of major birth defects with LTG plus VPS

A

12%

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3
Q

Percent of major birth defects with LTG

A

Less than 3%

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4
Q

Percent of major birth defects with other AEDs

A

3-4%

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5
Q

Risk of NTDs greatest with

A

Valproate

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6
Q

In utero exposure to Valproate is associated with what effect to children at age 4 compared to LTG

A

Lower IQ (by 9 pts)

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7
Q

Most frequent idiosyncratic rxns to AEDs

A

Rashes

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8
Q

Rashes - most often responsible AEDs

A 
Phenytoin
Carbamazepine
Phenobarbital
Primidone
Lamotrigine
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9
Q

High degree of cross reactivity within what AEDs

A

Phenytoin
Carbamazepine
Phenobarbital
Lamotrigine

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10
Q

Rashes are most often seen in _________ month of use

A

1st

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11
Q

Rashes are associated with what certain polymorphisms

A

HLA B*1502

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12
Q

Associated with skin eruptions in Caucasians

A

HLA A*3101

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13
Q

High fever, rash, lymphadenopathy, pharyngitis, eosinophilia, hepatitis

A

Systemic hypersensitivity syndrome

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14
Q

After 2 yrs on a single AED during which no sz had occurred,

Rate of relapse: _____ in 2.5 yrs, _____ in 5 yrs after discontinuation

A

40%

50%

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15
Q

Sz recurrence rate for patients remaining on meds after 2yrs on a single AED and sz-free

A

20%

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16
Q

First line for myoclinic epilepsy in adolescence

A

Valproate

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17
Q

Do not coarsen facial features, do not produce gum hypertrophy or breast enlargement

A

CBZ

Valproate

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18
Q

Rash, fever, lympadenopathy, eosinophilia, other blood dyscrasias, polyarteritis

A

Idiosyncratic phenytoin hypersensitivity

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19
Q

Prolonged use causes hirsutism, gum hypertrophy, facial feature coarsening, peripheral neuropathy, cerebellar degeneration

A

Phenytoin

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20
Q

Overdose causes ataxia, diplopia, stupor

A

Phenytoin

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21
Q

Idiosyncratic SE of phenytoin

A

Choreoathetosis

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22
Q

Mild leukopenia

A

CBZ

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23
Q

Rare SE: pancytopenia, hyponatremia (SIADH), DI

A

CBZ

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24
Q

CBC to be checked regularly

A

CBZ

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25
Q

Marrow toxicity

A

Oxcarbazepine

26
Q

Weight gain during 1st month of tx (ave 5.8kg)

27
Q

Menstrual irregularities, PCOS

28
Q

Pancreatitis - rare but important complication

29
Q

Maximum IV rate for valproate

A

3mg/kg/min

30
Q

Drowsiness, mental dullness, nystagmus, staggering

31
Q

Similar SE as Primidone: behavioral problems in developmentally delayed children

32
Q

Selectively blocks Na (slow) channel, preventing the release of excitatory transmitters glutamate and aspartate

A

Lamotrigine

33
Q

First line and adjunctive drug for generalized and focal sz

A

Lamotrigine

34
Q

If with Valproate, its serum level increases

A

Lamotrigine

35
Q

Serious rash with LTG

36
Q

Lesser dermatologic eruptions with LTG

37
Q

Concurrent use with phenytoin causes rare reversible chorea

A

Lamotrigine

38
Q

Alternative to Valproate in young women; does not cause weight gain & ovarian problems

A

Lamotrigine

39
Q

First line for pxs with organ failure, require numerous meds, with hepatically-metabolized chemotherapy

A

Levetiracetam

40
Q

Causes sleepiness, dizziness if in high doses

A

Levetiracetam

41
Q

Irritability and depression

A

Levetiracetam

42
Q

Chemically similar to GABA

A

Gabapentin

43
Q

Enhance intrinsic inhibitory system of GABA in brain

A

Gabapentin

Vigabatrin

44
Q

Apparent effect on Ca channels; anticonvulsant mechanism is not well known

A

Gabapentin

45
Q

Moderately effective in partial & secondary generalized sz

A

Gabapentin

46
Q

Not metabolized by liver

A

Gabapentin

47
Q

SE retinal damage

Withdrawn from the market

A

Vigabatrin

48
Q

Inhibitor of GABA transaminase

A

Vigabatrin

49
Q

Inhibitor of GABA reuptake

A

Tiagabine

Topiramate

50
Q

Inhibitor of GABA reuptake but broader effectiveness than Tiagabine

A

Topiramate

51
Q

Renal stones in 1.5%

A

Topiramate

52
Q

angle closure glaucoma

A

Topiramate

53
Q

Hyperchloremic metabolic acidosis

A

Topiramate

54
Q

Potent drug for focal onset and generalize or remain focal;
Mainly as adjunctive tx;
MOA is not entirely known;
Modulates voltage gated Na channel activity

A

Lacosamide

55
Q

SE- headache, diplopia, prolonged P-R interval, worsen heart failure

A

Lacosamide

56
Q

Like Valproate for absence sz;

Fewer cognitive SE

A

Ethosuximide

57
Q

DOC for benign absence attacks that are associated with photosensitivity, myoclonus, clonic-tonic-clonic sz (including JME)

A

Valproate

Alt- Methsuximide

58
Q

Combination produce Absence status

A

Valproateb plus Clonazepam

59
Q

Preferred for sz in infancy

A

Phenobarbital

60
Q

Most difficult to treat in childhood- LGS;

No effective combination;

What are the AED options?

A

VPA 900-2400mg/day - reduce frequency of spells in approx 50%

Lamotrigine, Topiramate, Vigabatrin - effective in 25%

61
Q

AED which can cause SIADH or DI

A

Carbamazepine

ADAMS (2 decks)

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