Anti-epileptic Drugs

Question 1

Examples of voltage gated sodium channel blockers

Answer 1

Carbamezepine, Lamotrigine, Phenytoin

Question 2

Mechanism of action of voltage gated sodium channel blockers

Answer 2

Block voltage gated sodium channels slowing the rate of firing of neurones

Question 3

ADRs of carbamezepine

Answer 3

Dizziness, Rashes, Ataxia, Tingling, GI upset, Hyponatremia, Myelosuppression

Question 4

ADRs of Phenytoin

Answer 4

Dizziness, Rashes, Ataxia, Headache, Nystagmus, Gingival, Hyperplasia

Question 5

ADRs of Lamotrigine

Answer 5

Dizziness, Rashes, Nausea

Question 6

DDIs of carbamezepine

Answer 6

Displacement of plasma protein bound drugs, Reduced effect with anti-depressants, Reduced effectiveness with Warfarin and steroids

Question 7

DDIs of Phenytoin

Answer 7

Displacement of plasma protein bound drugs

Question 8

DDIs of Lamotrigine

Answer 8

Displacement of plasma protein bound drugs, Reduced levels with OCP

Question 9

Monitoring with phenytoin

Answer 9

Plasma levels monitored with a saliva test

Question 10

Examples of GABA mediated inhibitors

Answer 10

Valproate, Benzodiazepines

Question 11

Examples of benzodiazepines

Answer 11

Lorazepam, Diazepam

Question 12

ADRs of Valproate

Answer 12

Ataxia, Weight gain, Liver failure

In pregnancy: Neural tube defects, reduced Vit K

Question 13

ADRs of Benzodiazepines

Answer 13

Sedation, Confusion, Aggression, Tolerance, Resp depression, CNS depression, Rapid withdrawal causes seizures

Question 14

DDIs of Valproate

Answer 14

Reduced efficacy with anti-depressants

Question 15

Treatment of Benzodiazepine overdose

Answer 15

Flumazenil

Question 16

Management of general seizures

Answer 16

1. Valproate

2. Lamotrigine

Question 17

Management of partial seizures

Answer 17

Carbamezepine

Question 18

Management of status epilepticus

Answer 18

After 5 min give lorazepam
After 10 min give second dose of lorazepam
After 15 min give IV phenytoin
After 30 min paraylise and ventilate