Epilepsy and seizure conditions

Question 1

Which SSRI can cause QTc prolongation

Answer 1

Escitalopram

Citalopram

Question 2

Which ssri should be used if a pt is on methadone

Answer 2

Sertraline

Question 3

Which antidepressant should be used if a pt is on theophylline

Answer 3

Mirtazapine

Question 4

Which ssri does not have a risk of qtc prolongation

Answer 4

Sertraline

Question 5

what medication is initially used for status epilepticus

Answer 5

IV Lorazepam
or IV Diazepam
in community
buccal midazolam
or rectal diazepam

Question 6

What medication is loaded when seizures are controlled in status epilepticus

Answer 6

phenytoin

2nd line levetiracetam

Question 7

what is status epilepticus

Answer 7

a seizure that lasts over 5 minutes

or if a pt has more than one seizure within 5 minutes without regaining consciousness

Question 8

MOA of sodium valproate

Answer 8

weak inhibitor of neuronal sodium channels stabilising the membrane potential and reducing excitability.

Question 9

when is sodium valproate first line

Answer 9

Generalised seizures

Question 10

what is the MHRA alert associated with sodium valproate

Answer 10

terotogenic

CI in women of childbearing age that are not on the PPP and no othe alternatives

Question 11

how long are the prescriptions valid for
what is the maximum length of supply
for patients on teratogenic drugs as part of the PPP

Answer 11

7 day valid prescription

30 days supply

Question 12

what do patients meed to sign once they are fully informed of the risks associated with preganancy whenpart of the PPP

Answer 12

Risk assessment form

Question 13

Name the type of contraceptives a patient can use when part of the PPP

Answer 13

IUD, POP Implant,sterilisation,

COC + barrier + regular pregnancy test

Question 14

how often should pt sunder the PPP be reviewed by their GP

Answer 14

annually

Question 15

Side effects associated with sodium valproate

Answer 15

blood dyscrasias e.g leucopeonia, thrombocytopenia
hepatoxicity- discontinue if prolonged prothrombin time
Pancreatitis

Question 16

is phenytoin a CYP450 inhibitor or inducer

Answer 16

inducer

Question 17

is carbamazepine a CYP450 inhibitor or inducer

Answer 17

Inducer

Question 18

is sodium valproate a CYP450 inhibitor or inducer

Answer 18

Inhibitor

Question 19

what does sodium valproate interact with

Answer 19

lowers seizure threshold drugs- SSRI, Quinolones, TCA, Antipsychotics
hepatoxic drugs such as statins, carbamazepines, tetracyclines, fluconazole, itraconazole, sulfasalazine, isonizid, methotrexate