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Neurologic & Psych > Epilepsy Dr. Thomason > Flashcards

Epilepsy Dr. Thomason Flashcards

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1
Q

When is a patient considered to have epilepsy?

A

Must have at least one seizure or one with a high predictor to have another one

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2
Q

Which test may be performed to confirm/deny epilepsy?

A

EEG
-CBC: elevated WBC could indicate an infection such as meningitis or enephalitis
CMP: sodium (hyponatremia can cause seizures), Ca2+ (hypocalcemia)
-urine drug screen: to check for substances

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3
Q

How indicative are EEG test for seizures?

A

Not so much, over 50% of patients with seizure disorder have a normal EEG, especially when they are currently not having a seizure

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4
Q

What are the triggers for seizures?

A

-sleep deprivation
-stress
-alcohol (decreases the seizure threshold)
-elicit substances (meth, cocaine, Adderall)
-> ask for benzodiazepines (from the street) -> Withdrawal of benzos can cause seizures

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5
Q

When do we usually see alcohol associated seizures?

A

occurs when the patient undergoes withdrawal
-after the blood alcohol goes to 0
-hours after the first drink

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6
Q

Questions to ask the patient?

A

-How often and and how much do you trink alcohol?
-any neurosurgical procedures
-any concussions
-have you had a seizure before and what characteristics of the seizure (movements during seizure, feelings before the seizure)

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7
Q

What are the risk factors for having seizures?

A

-abnormal EEG
-symptomatic neurological event (concussion, lost consciousness)

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8
Q

Which side effect is on the BBW for antiseizure medications?

A

Suicidal thoughts

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9
Q

Antiseizure drugs causing Hyponatremia, bone marrow suppression

A

Carbamezapine
Oxcarbazepine
Phenytoin

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10
Q

Which of the anitseizure drugs may cause SJS?

A

Carbamaezpine
Oxcarbazepine
Phenytoin
Fosphenytoin

Lamotrigine: severe rash -> can evolve to SJS
Zonisamide

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11
Q

Which antiseizure drugs cause PR prolongation?

A

Lacosamide -> also slowed cardiac conduction
Pregabalin

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12
Q

Which one causes aplastic anemia and liver failure?

A

Felbamate
-only used when all other options failed

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13
Q

Anitseizure drugs causing euphoria

A

-Pregabalin (C-V)
-Perampanel (C-III)
-Lacosamide (Vimpat)

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14
Q

Which have DDI with contraceptives?

A

Topiramate (high dose)
Valproic acid
Phenytoin
Fosphenytoin
Carbamazepine
Oxcarbazepine

Lamotrigine - OC reduces levels of Lamotrigine -> seizure risk

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15
Q

How is Lamotrigine dosing titrated?

A

25 mg daily - two weeks
50 mg daily - two week
100 mg daily - one week
200 mg - target dose

to prevent side effect of rash

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16
Q

When does Lamotrigine need to be retitrated?

A

If a patients discontinues Lamotrigine for 5 days

17
Q

Dosing titration of Lamotrigine when the patient is also on Carbamazepine

A

50 mg daily x two weeks
100 mg daily x two weeks
200 mg daily x one week
300 or 400 mg daily - target dose

Carbamazepine speeds up the metabolism of Lamotrigine (CYP incucer)

18
Q

How do Valproic acid and Depakote affect Lamotrigine?

A

Valproic acid is a CYP inhibitor

-> dose Lamotrigine
25 mg every other day x 2 weeks
25 mg every day x 2 weeks
50 mg daily x 1 week
100 mg daily - target dose

19
Q

Therapeutic range of Valproic acid

A

50-100

20
Q

Brand name for Carbamazepine?

A

Tegretol

21
Q

Brand name for Ethosuxumide?

A

Zarontin

22
Q

Brand name for Felbamate?

A

Felbatol

23
Q

Brand name for Gabapentin?

A

Neurontin

24
Q

Brand name for Lacosamide?

A

Vimpat

25
Q

Brand name for Lamotrigine?

A

Lamictal

26
Q

Brand name for Levetiracetam?

A

Keppra

27
Q

Brand name for Oxcarbazepine?

A

Trileptal

28
Q

Brand name for Perampanel?

A

Fycompa

29
Q

Brand name for Phenytoin and Fosphenytoin?

A

Dilantin

Cerebyx

30
Q

Brand name for Pregabalin?

A

Lyrica

31
Q

Brand name for Valproic acid?

A

Depakene

32
Q

Brand name for Topiramate?

A

Topamax

“Stupid max” - brain fog

ADE: Hypohidrosis (little or no sweat, cognitive impairment, bad taste)

33
Q

Brand name for Divalproex?

A

Depakote

34
Q

Brand name for Zonisamide?

A

Zonegran

Neurologic & Psych (37 decks)

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