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PRP2 > CNS - Epilepsy > Flashcards

CNS - Epilepsy Flashcards

1
Q

Focal Seizures - First line

A

Levetiracetam or Lamotrigine

“Got to take 2 L’s to get u focused”

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2
Q

Focal seizures - second line

A

Carbamazepine, Oxcarbazepine, zonisamide

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3
Q

Generalised seizures types

A

Tonic clonic
Atonic
Tonic

Absence
Absence 2 (absence + other seizure type)

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4
Q

If under 55 years old generalised seizure excluding absence seizure treatment?

A

Lamotrigine or levetiracetam

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5
Q

Over 55 years old generalised seizure excluding absence treatment?

A

Sodium valproate

Second line: Levetiracetam or Lamotrigine

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6
Q

Absences alone seizure treatment

A

1st line: Ethosuximide

2nd line: Sodium Valproate

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7
Q

Sodium valproate & Pregnancy

A

Avoid - Teratogenic

Use PPP (Pregnancy prevention plan)

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8
Q

What is a Status Epilepticus?

A

Seizure lasting longer than 5mins

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9
Q

Status epilepticus treatment plan?

A

Resuscitation and immediate emergency treatment

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10
Q

Status Epilepticus - Resuscitation Facilities available treatment?

A

IV Lorazepam

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11
Q

Status Epilepticus - Carehome/Community treatment?

A

Buccal Midazolam

Or

Rectal Diazepam

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12
Q

How long after first dose of status epilepticus should second dose be given?

A

After 5-10mins and seizure hasn’t stopped

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13
Q

What if 2 benzodiazepines fail to help status epilepticus seizure?

A

Levetiracetam
Phenytoin
Sodium valproate

Give 1 if fails try another

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14
Q

If Levetiracetam, phenytoin, sodium valproate doesn’t work in status epilepticus?

A

Phenobarbital or General Anaesthesia

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15
Q

Category 1 Antiepileptic drugs?

A

Carbamazepine
Phenobarbital
Phenytoin
Primidone

Must MAINTAIN ON SPECIFIC BRAND!!!

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16
Q

Category 2 Anti epileptic drugs?

A

Clobazam, Clonazepam, Lamotrigine, oxcarbazepine, perampanel, Rufinamide, Topiramate, Valproate, Zonisamide

***Clinical judgment on brands

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17
Q

Category 3 antiepileptic drugs?

A

Ethosuximide, Gabapentin, Pregabalin, Brivaracetam, tiagabine, vigabatran, Levetiracetam, Lacosamide.

do not need to maintain brand

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18
Q

Which Anti-epileptic drugs can affect warfarin?

A

CYP INDUCERS:
Phenytoin, Phenobarbital & Carbamazepine

Will reduce warfarin levels

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19
Q

Which anti epileptic drugs are Hepatotoxic?

A

Carbamazepine, phenytoin, sodium valproate

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20
Q

Which drugs is a CYP inhibitor so will increase volume of other drugs in system?

A

Sodium valproate

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21
Q

Which drugs lower seizure thresholds?

A

Tramadol

Theophyliline

Quinolones

22
Q

Which antiepileptic causes Hyponatraemia?

A

Carbamazepine (SSRI + diuretics also cause Hyponatraemia)

23
Q

Which Anti-epileptic drug causes anti folate reactions ?

A

Phenytoin (also caused by Methotrexate, Trimethoprim)

Anti folate reaction -> Blood Dyscrasia

24
Q

What 3 Antiepileptic Drugs have severe side effects? What are the side effects?

A

Carbamazepine
Phenytoin
Sodium valproate

Depression
Hepatotoxicity
Blood Dyscrasia —-> Anti folate reaction
Vit d deficiency——> BONEPAIN

25
Q

Which anti-epileptic causes facial hair and coarsening appearance?

A

Phenytoin

26
Q

Which anti epileptic can cause pancreatitis?

A

Sodium valproate

27
Q

Which Anti-epileptic causes Steven’s-Johnson syndrome?

A

Lamotrigine

28
Q

Which antiepileptic causes hypersensitivity?

A

Carbamazepine
Phenobarbital
Phenytoin
Primidone
Lamotrigine

(CP3L)

29
Q

Which anti epileptic causes blood Dyscrasia ?

A

Carbamazepine
Valproate
Ethosuximide
Topiramate
Phenytoin
Lamotrigine
Zonisamide

(C.VET.PLZ)

30
Q

Which anti epileptics cause eye disorders?

A

Vigabatrin (Reduced visual field)

Topiramate (Secondary Glaucoma)

31
Q

Which Anti-epileptic causes Encephalopathy?

A

Vigabatrin

32
Q

Which Anti epileptic cause Respiratory Depression

A

Gabapentin or Pregabalin

33
Q

Carbamazepine therapeutic range?

A

4–12 mg/L

Think carb is 4
Rest is 12

34
Q

Carbamazepine Toxicity Signs?

A

Hyponatraemia
Ataxia (Loss of full control body move)
Nystagmus (involuntary eye movement)
Drowsiness
Blurred vision
Arrhythmias
Gastrointestinal Disturbances

35
Q

Phenytoin therapeutic range?

A

10-20mg/l

Same as Theophylline

PHEN = TEN

36
Q

Phenytoin toxicity signs?

A

Slurred speech
Nystagmus
Ataxia
Confusion
Hyperglycaemia
Double Vision

SNACHD

37
Q

Epileptic fit - can I still drive?

A

Stop immediately inform DVLA

38
Q

Driving rules: First unprovoked one or single isolated fit?

A

Stop driving for 6 months

If there are no more in those 6months
Good to drive

39
Q

Driving rules - If you have continuous seizures but no impact on consciousness, what should you do?

A

Wait 1 year to be fit free to start driving again

40
Q

Driving rules - med change or weaning off med

A

Should not drive 6 months after last dose

Eg: carbamazepine 400mg to 200mg

41
Q

Driving rule - If you have seizure as a result of dose reduction

A

License revoked for 1 year

***HOWEVER
If dose is increased back up and don’t have seizure for another 6 months u can drive —- do not need to wait the year

42
Q

Epilepsy in pregnancy

A

Epilepsy risk of harm to foetus/mother is lower than the harm it will cause to stop meds

43
Q

Epilepsy - Neural tube defect treatment?

A

Folic acid 5mg

44
Q

Epilepsy in pregnancy at birth injection?
And why?

A

Vitamin K (Phyteniadone) injected

Given to reduce risk of neonatal haemorrhage

45
Q

Which anti epileptic can cause cleft plate in pregnancy?

A

Topiramate

Use PPP (Pregnancy Prevention Programme)

46
Q

When should epilepsy breastfeeding need specialist advice?

A

Only when you have combo therapy or risk factors such as premature birth

Not if on one med for epilepsy-continue as normal

47
Q

Which anti-epileptic drug is highly present in breast milk?

A

Primidone
Lamotrigine
Ethosuximide
Zonisamide

PLEZ

48
Q

Which anti-epileptic poses a risk of drowsiness?

A

Primidone
Phenobarbital
Benzodiazepines

PPB

49
Q

What happens if you stop breast feeding with phenobarbital, Primidone, benzodiazepines & Lamotrigine?

A

Withdrawal effect

50
Q

Which antiepileptics are contraindicated in childbearing potential & pregnancy?

A

Sodium valproate & Topiramate

PRP2 (74 decks)

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