Anti-epileptics

Question 1

Benzodiazapines MoA

Answer 1

GABAa agonist

Increase Cl conductance –> hyperpolarisation

Question 2

Benzodiazapines examples

Answer 2

Diazepam, Midazolam

Question 3

Benzodiazapines warnings

Answer 3

Addiction
Airway issues
CVS collapse

Question 4

Anti-epileptic drug general MoA

Answer 4

Na channel blocker

Question 5

Phenytoin use

Answer 5

Status epilepticus or generalized seizures

Question 6

Sodium valproate MoA

Answer 6

GABAa effects and Na blocker

Question 7

Sodium valproate ADR and risk

Answer 7

Congenital malformations

Question 8

Lamotrigine MoA

Answer 8

Na and Ca channel blocker

Question 9

Lamotrigine use

Answer 9

Focal epilpsy

when sodium valproate is contra-indicated

Question 10

Levetiracetam (Keppra) MoA

Answer 10

Synpatic vesicle glycoprotein binder
stops release of neurotransmiters into synpase
reduces neuronal activity

Question 11

Levetiracetam Use

Answer 11

focal seizures
generalized seizures
safe in pregnancy

Question 12

Anti-epilpetic side effects

Answer 12

Nausea and vomiting 
Lethargy
Mood changes- suicidal idealation 
Bone marrow failure 
Thrombocytopenia
Stevens-Johnson syndrome - rashes

Question 13

CYP interactions

Answer 13

Phenytoin, Carbamazepine and barbituates induce

Vaproate inhibits

Question 14

Status epilepticus drug course

Answer 14

> 5 mins- Benzodiazapines
5-15 mins- 2nd dose benzodiazapines
15-45 mins- phenytoin or levetiracetam , IV thiamine if alcohol use
45 mins- thiopentone/ anaesthesia (ICU)