Anti-Epilepsy Drugs

Question 1

1st line for simple partial?

Answer 1

Carbamazepine

Question 2

1st line for simple complex?

Answer 2

Carbamazepine

Question 3

1st line for tonic clonic?

Answer 3

Phenyton, carbamazepine, valproic acid

Question 4

1st line for absence?

Answer 4

Ethosuximide

Question 5

1st line for acute status epilipeticus?

Answer 5

BZD

Question 6

1st line for prophylaxis and recurrence for status epilepticus?

Answer 6

Phenytoin

Question 7

1st line for trigeminal neuralgia?

Answer 7

Carbamazepine

Question 8

1st line in children?

Answer 8

Phenobarbital

Question 9

Which drugs may cause Stevens Johnson?

Answer 9

Carbamazepine, Ethosuximide, Lamotrigine, Phenytoin

Question 10

Which drugs are CYP450 inducers?

Answer 10

Carbamazepine, phenYtoin, Phenobarbital (CYP)

Question 11

AEs of ethosuximide?

Answer 11

Ethosuximide, Fatigue, GI, HA (EFGH)

Question 12

What may cause blood dyscrasias such as agranulocytosis and aplastic anemia?

Answer 12

Carbamazepine

Question 13

Which drug may cause SIADH?

Answer 13

Carbamazepine

Question 14

Which drug may cause hirsutism?

Answer 14

Phenytoin

Question 15

Which may cause SLE-like syndrome?

Answer 15

Phenytoin

Question 16

Which is a teratogen and may cause fetal hydantoin syndrome?

Answer 16

Phenytoin

Question 17

Which may cause megaloblastic anemia?

Answer 17

Phenytoin

Question 18

Which may cause fatal hepatotoxicity?

Answer 18

Valproic acid

Question 19

Which may cause neural tube defects such as spina bifida?

Answer 19

Valproic acid

Question 20

MOA of phenytoin, carbamazepine?

Answer 20

Use-dependent Na channel blockade, inhibits glutamate release from excitatory presynaptic neuron

Question 21

MOA of barbs?

Answer 21

Facilitate GABAa action by increasing duration of Cl channel opening, decreasing neuron firing

Question 22

When are barbs contraindicated?

Answer 22

Porphyria

Question 23

MOA of BZDs?

Answer 23

Facilitate GABAa action by increasing frequency of Cl channel opening

Question 24

Which BZDs are short acting and thus highly addictive?

Answer 24

Triazolam, Oxazepam, Midazolam (TOM)

Question 25

What 3 things bind to the GABAa receptor?

Answer 25

BZDs, barbs, EtOh

Question 26

MOA of ethosuximide?

Answer 26

Blocks thalamic T-type Ca channels

Question 27

MOA of gabapentin?

Answer 27

GABA analog, primarily inhibits high-voltage-activated Ca channels

Question 28

MOA of tiagabine?

Answer 28

Inhibits GABA reuptake

Question 29

MOA of vigabatrin?

Answer 29

Irreversibly inhibits GABA transaminase, increasing GABA

Question 30

Fosphenytoin?

Answer 30

Used parenterally

Question 31

1st line for myoclonic seizures?

Answer 31

Valproic acid

Question 32

Also used in migraine prevention?

Answer 32

Topiramate

Question 33

Also used for seizures of ecclampsia?

Answer 33

BZDs

Question 34

1st line for ALL partial seizures?

Answer 34

Carbamazepine

Question 35

2nd line for absence?

Answer 35

Valproic acid

Question 36

What may cause generalized LAD (pseudolymphoma)?

Answer 36

Phenytoin

Question 37

Status epilepticus algorithm?

Answer 37

1) IV lorazapam + phenytoin
2) If still seizing = phenobarbital
3) If still seizing = intubate and give general anesthesia

Question 38

Which BZDs are not metabolized by P450 in liver?

Answer 38

Oxazepam, Temazepam, Lorazepam (Outside The Liver), avoid in liver failure