Anticonvulsants- Dr. Lui

Question 1

What is the structure of Phenytoin and what class is it?

Answer 1

• Hydantoin

- Look up the structure in your notes

Question 2

What is the structure of Valproic acid and what class is it

Answer 2

• “Other”

- Look up the structure from your notes

Question 3

What is the structure of Phenobarbital and what class is it?

Answer 3

• Barbiturate

- Look up the structure in your notes

Question 4

What does Primidone get metabolised into?

Answer 4

-PEMA

Question 5

Why is the metabolism of benzodiazepines so complex?

Answer 5

• Formation of active metabolites

- Enterohepatic recycling

Question 6

Nordiazepam

Answer 6

-Is an active metabolite of benzodiazepines

Question 7

What are 3 ways that nordiazepam can be formed

Answer 7

1) Chlordiazepoxide (By amide hydrolysis and N-oxide reduction)
2) Prazepam and diazepam (By N-dealkylation)
3) Chemically from clorazepate (in gastric acid)

Question 8

Lamotrigine half life when given as monotherapy

Answer 8

-about 24hrs

Question 9

Lamotrigine half life when given with phenobarbital, phenytoin, or carbazepine

Answer 9

-about 12hrs

Question 10

Lamotrigine half life when given with valproate

Answer 10

-about 48hrs

Question 11

Know what the structure of nordiazepam looks like

Answer 11

-Look it up dweeb

Question 12

Why is Oxcarbazepine > Carbamazepine?

Answer 12

• Improved tolerance/ side effect profile
• Fewer drug interactions
• They basically look the same but OX has a ketone