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FRCA Pharmacology > Antiepileptics > Flashcards

Antiepileptics Flashcards

1
Q

Sodium valproate:

Is contraindicated in children

A

False. Valproate can be safely used in children down to 1 month of age.

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2
Q

Sodium valproate:

Is used to treat petit mal seizures

A

True. It is used to treat generalised, mixed and partial seizures.

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3
Q

Sodium valproate:

Is used to treat grand mal seizures

A

True

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4
Q

Sodium valproate:

Can be used safely in liver disease patients

A

False. It is contraindicated in severe hepatic or renal failure.

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5
Q

Sodium valproate:

Acts by enhancing concentrations of the neurotransmitter GABA

A

True. Sodium valproate acts by weakly blocking sodium ion channels. It inhibits GABA transaminase, which would deactivate gamma-Aminobutyric Acid (GABA) and may also stimulate GABA synthesis.

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6
Q

Valproic acid:

Is metabolised in the liver

A

True. 75% is metabolised by the CYP450 system.

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7
Q

Valproic acid:

Is a liquid fatty acid at room temperature

A

True. Valproate is a liquid at room temperature but can be reacted with a base to form a solid salt.

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8
Q

Valproic acid:

Enhances platelet aggregation

A

False. Valproate interferes with platelet aggregation and can cause blood dyscrasias.

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9
Q

Valproic acid:

Takes at least 3 weeks to have it’s effect

A

False. It is effective 14 days after treatment commences.

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10
Q

Valproic acid:

Has been used to treat migraines

A

True. Though mainly in the US.

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11
Q

Phenytoin:

Inhibits the enzyme intestinal conjugase

A

True. Phenytoin does inhibit intestinal conjugase, which causes folate deficiency, not vitamin B2 deficiency.

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12
Q

Phenytoin:

Has a half life of about 4hrs

A

False. Phenytoin’s half life is 6 to 24 hours.

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13
Q

Phenytoin:

Is an CYP450 enzyme inhibitor

A

False. It is an enzyme inducer.

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14
Q

Phenytoin:

Can cause Vitamin B2 deficiency

A

False

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15
Q

Phenytoin:

Causes hypotension

A

True. When administered IV, Phenytoin can cause hypotension and arrhythmias and should be administered with cardiac monitoring.

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16
Q

Phenytoin:

Does not cause glycosuria

A

False. Phenytoin can cause hyperglycaemia & glycosuria due to insulin inhibition.

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17
Q

Phenytoin:

Is highly protein bound

A

True. It is mainly bound to Albumin.

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18
Q

Phenytoin:

Undergoes zero order kinetics with a wide therapeutic index

A

False. Phenytoin follows saturatable first order kinetics which converts to zero order kinetics when the enzyme system is overwhelmed. It has a narrow therapeutic index and blood levels are therefore monitored.

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19
Q

Phenytoin:

Toxicity can cause diminished tendon reflexes

A

False. Toxicity causes blurred vision, mydriasis and brisk tendon reflexes.

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20
Q

Phenytoin:

Oral bioavailability is high and absorption is rapid

A

False. Bioavailability is good, but oral absorption is slow, variable & can be only partial. Volume of distribution is approx 70% of body weight.

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21
Q

Phenytoin:

Causes megaloblastic anaemia due to Vitamin B12 deficiency

A

False. Phenytoin causes macrocytic, megaloblastic anaemia due to folate deficiency.

22
Q 
Phenytoin:
Is a class Ia antiarrhythmic
A

False. It is a class Ib antiarrhythmic agent, like Lidocaine.

23
Q

Phenytoin:

Has no effect on Thyroid function

A

True. Causes falsely low TFTs after long term treatment.

24
Q

Phenytoin:

Is absorbed rapidly via IM or IV routes

A

False. Not effective IM, only PO (slowly) and IV.

25
Q

Phenytoin:

Phenyotin is carcinogenic

A

False. There is no good evidence that Phenytoin is carcinogenic.

26
Q

Phenytoin:

Can be used to treat Digoxin induced dysrhythmias

A

True

27
Q

Phenytoin:

Is metabolised in the liver by the enzyme rhodanase

A

False. Phenytoin is metabolised by hepatic microsomal enzymes.

28
Q

Phenytoin:

Can cause significant side effects including nystagmus

A

True. It can cause horizontal gaze nystagmus, gum overgrowth, acne as well as blood disorders.

29
Q

Phenytoin:

Is effective with the oral contraceptive pill

A

True. Phenytoin is effective in the presence of the OCP but the contraceptive effect may not be effective due to enzyme induction.

30
Q

Phenytoin:

Stabilises excitable membranes

A

True

31
Q

Phenobarbitone/Phenobarbital:

Is the most widely used anticonvulsant

A

False.

32
Q

Phenobarbitone/Phenobarbital:

Lasts longer than Phenytoin

A

True. Phenobarbital is extremely long acting, with a half life of 50 - 100 hours or more.

33
Q

Phenobarbitone/Phenobarbital:

Is used in the treatment of generalised seizures

A

True. It is effective in all seizure activity except absence seizures.

34
Q

Phenobarbitone/Phenobarbital:

Is ineffective in absence seizures

A

True.

35
Q

Phenobarbitone/Phenobarbital:

Is highly protein bound

A

False. Protein binding is in the order of 20 - 45%.

36
Q

Phenytoin is safe in pregnancy

A

False. Phenytoin is teratogenic and can cause Fetal Hydantoin Syndrome (like Carbamazepine).

37
Q

Fetal Hydantoin syndrome is associated with Carbamazepine treatment only

A

False. FHS causes intra-uterine groth retardation, microcephaly, craniofacial abnormalities and limb defects.

38
Q

Phenobarbital is also a sedative agent

A

True. Use of Phenobarbital as a sedative has largely been superceded by benzodiazepines.

39
Q

Phenytoin act to stabilise active voltage gated sodium channels in the CNS

A

False. Phenytoin stabilises sodium channels in their inactive state

40
Q

Phenytoin can cause skin rashes

A

True.

41
Q

Phenytoin only very rarely provokes an allergic reaction

A

False. Phenytoin can cause severe allergic reactions and must be given with vigilance.

42
Q

Phenytoin is mainly excreted unchanged in the urine

A

False. Primarily, Phenytoin is initially excreted in the bile as inactive metabolites and reabsorbed before being excreted in the urine. Only a small amount is excreted unchanged renally.

43
Q

Phenytoin can be used to treat trigeminal neuralgia

A

True

44
Q

Sodium valproate can cause tremors

A

True

45
Q

10% of people treated with Sodium valproate experience hair loss

A

True

46
Q

Carbamazepine:

Is safe in pregnancy

A

False. Carbamazepine can cause spina bifida & other neurodevelopmental problems after intrauterine exposure.

47
Q

Carbamazepine:

Can be used in chronic pain

A

True

48
Q

Carbamazepine:

Has a short half life

A

False. Half life is in the order of 25 - 65 hours

49
Q

Carbamazepine:

Can cause severe thrombocytopenia

A

True. Carbamazepine can reduce serum sodium & WBC levels at normal drug levels, but also cause life-threatening loss of platelets.

50
Q

Carbamazepine:

Increases the risk of developing Lupus in women

A

True. Lupus risk increases by nearly 90% (probably only in women).

FRCA Pharmacology (13 decks)

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