Antiepileptic drugs

Question 1

Difference between seizures, convulsion and epilepsy

Answer 1

• Seizures: Brief episode of electricity in the nerves of the brain which may or may not cause convulsions
• Convulsions: Involuntary contractions(spasms)
• Epilepsy: Chronic, recurrent pattern of seizures

Question 2

Primary epilepsy

Answer 2

Idiopathic roughly 50% of cases

Question 3

Secondary Epilepsy

Answer 3

Symptomatic of a distinct cause (trauma, infection,cerbrovascular disorder)

Question 4

Classification of epilepsy

Answer 4

Generalized, Focal onset seizures and unclassified seizures

Question 5

Generalized seizures

Answer 5

• Both hemispheres, tonic (stiffening)-clonic(jerking) seizures and atonic (weaking of the muscles

Question 6

3 phases of a seizure

Answer 6

1. prodrone
2. ictal
3. post ictal

Question 7

Focal onset seizure

Answer 7

Occurs when people are awake and orientated

Question 8

What status epilepticus

Answer 8

Seizure that last 5 min or longer causing a hypotension, hypoxia, brain damage, and possibly death

Question 9

T or F Status epilepticus is not a medical emergency

Answer 9

F it is a medical emergency

Question 10

Treatment of status epilepticus

Answer 10

Diazepam is choice for immediate treatment

Question 11

Which drugs are good with seizure control and toxicity

Answer 11

• Serum concentrations of phenytoin, phenobarbital, carbamazepine, and primidone correlate better with seizure control and toxicity

Question 12

Which drugs are bad with seizure control and toxicity

Answer 12

Valproic acid, ethosuximide and clonazepam

Question 13

Antiepileptic drugs traditionally used to manage seizure disorder

Answer 13

Barbiturates
Hydantoins
Iminostilbenes plus valproic acid
Second- and third-generation antiepileptics

Question 14

Indications of antiepileptic

Answer 14

• Prevention or control of seizure activity
• Long-term maintenance therapy for chronic, recurring seizures
• Acute treatment of convulsions and status epilepticus

Question 15

MOA of antiepileptic

Answer 15

decrease nerve impulses or increases GABA

Question 16

Pharmacological effects

Answer 16

Reduce nerves ability to be stimulated, suppress transmission of impulse, decrease speed of impulse

Question 17

Adverse effects of phenytoin (long term)

Answer 17

May cause hyperplasia, acne, hirsutism, and Dilantin facies.

Question 18

Contraindication of antiepileptic drugs

Answer 18

Drug allergy, pregnancy

Question 19

Contraindications of dilantin

Answer 19

Spinal malformation such as spina bifida

Question 20

Interactions of phenytoin

Answer 20

Warfarin (increase bleeding),

Question 21

Interactions of carbamazepine

Answer 21

Increase metabolism of acetominophen

Question 22

Valproic acid interactions

Answer 22

Aspirin displaces valproic acid from protein binding to increase levels and toxic risk

Question 23

Drug monitoring is required for which drugs

Answer 23

Phenytoin, valproic acid, phenobarbital, carbamazepine

Question 24

Ex of barbitues

Answer 24

phenobarbital and primidone

Question 25

Most common adverse effects of phenobarbital and primidone

Answer 25

Sedation

Question 26

Serum drug levels of phenobarbital and primidone

Answer 26

15-40 mcg/mL

Question 27

Contraindications of phenobarbital and primidone

Answer 27

known drug allergy, porphyria, liver or kidney impairment, respiratory illness

Question 28

Hydantoins Ex

Answer 28

phenytoin sodium

Question 29

Long term therapy adverse effects of phenytoin sodium

Answer 29

lethargy, ataxia, mental confusion, gingival hyperplasia, acne, hirsutism, Dilantin facies, and osteoporosis (long term)

Question 30

Therapeutic drug levels of phenytoin sodium

Answer 30

10-20 mcg/mL

Question 31

How should phenytoin sodium IV be given

Answer 31

Diluted in normal saline and prepared with a filter

Question 32

Which drug causes an autoinduction (creation of more) of hepatic enzymes

Answer 32

carbamazepine (Tegretol®)

Question 33

Treatment of uncomplicated absence seizures

Answer 33

ethosuximide

Question 34

ethosuximide adverse effects

Answer 34

GI and CNS effects

Question 35

Ex of miscellaneous drugs

Answer 35

gabapentin, lamotrigine, Valproic acid, levetiracetam, pregabalin

Question 36

MOA of gabapentin

Answer 36

Increases the synthesis and accumulation of GABA inhibiting brain activity

Question 37

what is lamotrigine used for

Answer 37

prevent epilepsy and also treatment of bipolar disorder - can be used in pregnancy

Question 38

lamotrigine common adverse effects

Answer 38

: relatively minor CNS and GI symptoms and possible Stevens-Johnson syndrome - decrease effectiveness of oral contraceptives - DRESS: drug reaction with eosinophilia and systemic symptoms.

Question 39

Valproic acid uses

Answer 39

prevent eplipsy and used for absence and myoclonic seizures

Question 40

What happens if valproic acid is given with aspirin

Answer 40

Increases levels of valproic acid

Question 41

Valproic acid common adverse effects

Answer 41

Weight gain and hair loss

Question 42

levetiracetam is used for

Answer 42

Adjunct therapy for focal seizures with and without secondary generalization. and well tolerated

Question 43

pregabalin MOA

Answer 43

Is related to GABA and prevents activity of the brain

Question 44

pregabalin uses

Answer 44

adjunct therapy for neuropathic pain, postherpetic neuralgia

Question 45

When to take oral drugs of antiepileptic

Answer 45

Same time each day

Question 46

T or F do not take Antiepileptic Drugs with meals and fluid

Answer 46

False take with meals and at least 180-240 ml of fluid

Question 47

What fluids should you not take with Antiepileptic Drugs:

Answer 47

juice, milk and carbonated beverages

Question 48

What should you not take with carbamazepine

Answer 48

Grapejuice