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Pre Reg Exam > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

What is epilepsy?

A

Electrical imbalance that causes epileptic seizures

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2
Q

List drugs that are taken once daily(at bed time)

A

LP3
Lamotrigine
Phenytoin
Phenobarbital
Perampanel

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3
Q

Why are some drugs taken once daily?

A

They have longer action/ long half life

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4
Q

What is the criteria of category 1 drugs

A

Needs to be given on specific brands (only for epilepsy)

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5
Q

List drugs on Category 1

A

CP3

  • carbamazepine (Tegretol, carbagen)
  • phenytoin
  • phenobarbital
  • primidone

All cause hypersensitivity syndrome

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6
Q

What is category 2 drugs?

A

Need for continuity depends on patient and doctors

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7
Q

List drugs under category 2v

A

Sodium valproate
Lamotrigine
Clobazam
Clonazepam
Topiramate

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8
Q

What are category 3 drugs?

A

No need to maintain brands unless pt wants it for confusion, dosing error etc

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9
Q

List category 3 drugs?

A

Gabapentin
Pregabin
Levetiracetam
Tiagabine
Brivaracetam
Ethosuximide
Vigabatrine

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10
Q

List drugs that cause anti epileptic hypersensitivity syndrome

A

CP3
Lamotrigine
Lacosimide
Rufinamide

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11
Q

List symptoms of AE HS?

A

Fever
Rash
Liver dysfunction
Renal & pulmonary abnormalities
Multi organ failure

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12
Q

When do you monitor patient for HS and how long does symptoms start?

A

First 2 months of starting meds

1 to 8 weeks

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13
Q

What is the MHRA warning when taking AE drugs?

A

Suicidal thoughts and behavior within 1 week of starting

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14
Q

Benzodiazepines withdrawal period is how long?

A

6 months or longer

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15
Q

What are the DVLA rules?

A

-Stop driving immediately and inform dvla if driver has seizures

  • if you have unprovoked (unknown) seizures or isolated one - stop driving for 6 months

-established seizures - can drive if there is no harm

  • if there is a change of meds or withdrawal don’t drive for 6 months after last dose
  • if seizure occurs during that change- hold license for 1 year
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16
Q

What happens when you take AE drugs during pregnancy?

A

Increased risk of teratogenicity especially during 1st trimester

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17
Q

Which drugs has the highest risk during pregnancy and what is the requirement?

A

Sodium valproate

Must not be used in women of childbearing unless they meet the PpP criteria and no other options

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18
Q

Which drug carries increased risk of congenital malformations and what does it cause?

A

Topiramate - causes Cleft Palate

19
Q

Which vitamin should you give at birth yo minimize risk of neonatal haemorrhage?

A

Vitamin K

20
Q

List drugs that causes drowsiness in breastfeeding?

A

Phenobarbital
Primidone
Benzodiazepines
Lamotrigine

21
Q

What are the two types of seizures

A

Generalized and focal seizures

22
Q

What is the first line treatment for all generalized seizure?

A

Sodium valproate

23
Q

List the four types of generalized seizures?

A

Tonic clonic
Absence
Myoclonic
Atonic&tonic

24
Q

List the drugs that can’t completely be used in the types of generalized seizures except Tonic-clonic seizure?

A

Carbamezapine
Vigabatrin

Exacerbates symptoms

25
Q

What is the drugs used for absence seizure?

A

First line - Sodium valproate or ethosuximide

Alternative- Lamotrigine

(SEAL)

26
Q

Describe absence seizure?

A

Mainly in Childress
Brief loss of consciousness, resolves in few seconds
No convulsions

27
Q

Describe tonic clonic seizure

A

Body stiffens
Loss of consciousness
Body shakes (convulses)
Loss of bladder/bowel movement

28
Q

Treatment of tonic clonic seizure

A

Sodium valproate or carbamazepine/lanotrigine

29
Q

Describe myoclonic seizures?

A

Jerking
Muscle contraction - Arm/elbow

30
Q

List the treatment for myoclonic?

A

(SALT)

Sodium valproate - first line

Levetiracetam, Topiramate- alternative

31
Q

Describe tonic-atonic seizure

A

Brief loss of consciousness
Stiff
Fall to ground

32
Q

Treatment for tonic-atonic?

A

(SLART)

Sodium valproate or Lamotrigine - first line

Rufinamide, Topiramate- alternative

33
Q

List treatment of focal seizure?

A

Carbamazepine
Lamotrigine

(Cal)

34
Q

Describe focal seizures

A

One part of brain

35
Q

List the two types of focal seizures and explain them

A

Simple focal seizures- muscle jerk in one arm or leg, no loss of consciousness

Complex focal seizure- consciousness affected

36
Q

What is status epilepticus?

A

Seizure that last more than 5 minutes or multiple seizure within 30 mins

37
Q

What is the treatment of status epilepticus

A

Diazepam rectal solution
Or
Midazolam oromucosal soln

38
Q

First seizure - impaired consciousness (Group 1- cars and motor cycles), how long should you avoid driving?

A

Do not drive for six months

39
Q

Epileptic seizure - impaired consciousness (Group 1)?

A

Don’t drive for 1 year

40
Q

No loss of consciousness seizure?

A

Seek DVLA advice

41
Q

First seizure (group two-buses and lorries)

A

Don’t drive for 5 years

42
Q

More than one seizure (group 2)

A

Don’t drive for 10 years

43
Q

When do you withdraw med after pt is seizure free?

A

Min 2 years

Pre Reg Exam (11 decks)

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