Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pre-Reg 22 - Nervous System > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

Five types of epileptic seizures

A

1) Focal (partial) seizure with or without secondary generalisation
2) Tonic colonic seizures
3) Absence seizures
4) Myoclonic seizures.
5) Atonic seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which antiepileptic can be given OD

A

Lamotrigine, perampanel, phenobarbital, and phenytoin,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Category one antiepileptic drugs

A
  • Carbamazepine
  • Phenytoin
  • Phenobarbital
  • Primidone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Category two antiepileptic drugs

A
  • Valproate
  • Lamotrigine
  • Clonazepam
  • Topiramate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Category two antiepileptic drugs

A
  • Levetiracetam
  • Gabapentin
  • Pregabalin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What symptoms occur in Antiepileptic hypersensitivity syndrome

A
  • fever, rash, and lymphadenopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Three things to consider when withdrawing antiepileptic drugs

A
  • Gradually reduce the dose under specialist supervision
  • Avoid abrupt withdrawal
  • Withdraw one epileptic at time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Epileptic patients can drive if…

A
  • Seizure free for one year
  • Seizure pattern has no affect on person
  • No history on unprovoked seizure
  • Seizures are due to prescribed change or withdrawal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which antiepileptic medication belong to each risk group of pregnancy

  • Highest risk:
  • Increased risk
  • Cleft plate:
A
  • Highest risk: Valproate
  • Increased risk : Carbamazepine , Phenytoin , Phenobarbital , lamotrigine.
  • Cleft plate: Topimerate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which Antiepileptic drug needs to be dose adjusted due to plasma concentration changes

A
  • Carbamazepine and Lamotrigine.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which Antiepileptic drug needs you to monitor foetal growth

A
  • Topimerate and Levetiracetam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which Antiepileptic drugs need to be referred to specialist family planning

A

All

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do you need to give to women who are pregnant, planning to become pregnant or just after pregnancy who also take antiepileptic medication:

A
  • Vitamin K

- Folic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which medication causes withdrawal effects in newborn children

A

Benzodiazepines and phenobarbital.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What to monitor in antiepileptic drugs + breastfeeding

A

Monitor drowsiness , weight gain , feeding , adverse effects, development milestones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which antiepileptic medication is present in high amounts in milk?

A

ZELP

Zosinammide, Ethosuximide , Lamotrigine , Primidone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which antiepileptic accumulates due to slower metabolism in infants

A

Phenobarbital + lamotrigine

18
Q

Which antiepileptic inhibits sucking reflex

A

Phenobarbital / Primidone

19
Q

Which antiepileptic has an increased risk of drowsiness in babies

A

Benzo , Phenobarbital and Primidone

20
Q

Which antiepileptic should you avoid abrupt withdrawal or breast feeding?

A

ALL special phenobarbital/ primidone.

21
Q

What is the main side effect with antiepileptics?

A

1) Antiepileptics hypersensitivity syndrome.
o Rash , fever and systemic involvement
2) MHRA alert: Risk of suicidal behaviour and thoughts,
3) Skin rashes
a. SJS , toxic epidermal necrolysis
4) Blood dyscarasis
5) Eye problems
a. Espc . Vigabatrin
6) Encephalopathic symptoms
(loss of memory and concentration)
7) MHRA alert: risk of severe respiratory depression without opioid medication - Elderly renal impaired respiratory compromised are at higher risk

22
Q

What is the MOA of interaction with antiepileptics

A
  • Antiepileptics are enzyme inhibitors = Increased Cp
    o E.g Sodium valproate
  • Anti-epileptics enzyme inducers = decreased Cp
    o Carbamazepine / Phenytoin / Phenobarbital.
23
Q

Uses of Phenytoin

A

Focal seizures and tonic clonic seizures

24
Q

What does Phenytoin extubate

A

Absence and myoclonic seizures

25
Phenytoin Therapeutic range
10-20mg/l or 40-80micmol/l
26
Phenytoin Plasma therapeutic drug monitoring what do you need to measure
1) Non linear relationship between dose and Cp – small changes in dose can cause large changes in plasma concentration 2) Phenytoin is highly protein bound - When protein binding I reduced measure the free plasma concentration - Risk increased in young / elderly and liver impairment pts.
27
Phenytoin Signs and symptoms of toxicity =
``` SNATCHED S – Slurred speak N – Nystagmus (uncontrolled rapid eye movement) A – Ataxia C – Confusion H – Hyperglycaemia D – Diplopia , blurred vision ```
28
Phenytoin - How to reduce risk factors
Maintain is same brand , | Different routes have different bioavailability.
29
How do you switch between different phenytoin products
100mg of Phenytoin = 92mg of phenytoin base.
30
Side effects – Phenytoin (8)
- Change in appearance - Blood dyscarasias - Hypertensive reaction o Antiepileptic hypersensitivity syndrome. - Rashes - Low vitamin D - Hepatotoxicity - Suicidal ideation - IV phenytoin: bradycardia + hypotentoion MHRA alert : risk of death with phenytoin injectable
31
Drug interaction – Phenytoin (5)
- Increased phenytoin toxicity with enzyme inhibitors - Reduced phenytoin concentration = enzyme inducers - Anticonvulsant effect antagonised. - Increased antifolate effect
32
Carbamazepine - Uses
First line in social seizures , generalised tonic colonic seizures. .
33
What does Carbamazepine extubates
atonic , colonic and ,myoclonic seizures.
34
Therpeutic range of Carbamazepine
4-12 or 20-50 micrograms | - Measure after 1 to 2 weeks
35
Signs and symptoms of toxicity of Carbamazepine
``` I HANDBAG I coordination H hyponatremia A Ataxia N Nystagmus D Drowsiness Blurred vison Arrythmias G I side effects ```
36
Side effects of Carbamazepine
``` Blood dyscrasias Hepatotoxicity Hypertensive reaction Rashes Hyponatremia This is more common with elderly patients at the start of treatment ```
37
Drug interaction of Carbamazepine
- Enzyme inhibitors = Increased carbamazepine concentration - Decreased carbamazepine concentration (enzyme inducers) - Anticonvulsants effect antagonised - Increased risk of hyponatremia - Increased risk of hepatotoxicty - Carbamazepine is an enzyme inducer , reduces concentration.
38
How to reduce risk of side effect of Carbamazepine
MR preparations
39
Sodium Valproate action for pharmacist
TBC
40
What do in patient who are status epileptic
- IV lorazepam | - AVOID IV diazepam as it can cause thrombophlebitis’s.
41
What do in patients who are non -convulsive status epileptic 1) If pt has incomplete loss of awareness 2) If pt has complete loss of awareness)
(If pt has incomplete loss of awareness) - Continue or restart usually oral antiepileptic drug (if pt has complete loss of awareness) - Treat the same as convulsive status epileptic.
42
What to do in patients who have febrile convulsion in children - First line - If more than 5 minutes
- Paracetamol (antipyretic) | - If >5 minutes treat the same as status epileptic

Pre-Reg 22 - Nervous System (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions