Epilepsy drugs

Question 1

carbamazepine moa

Answer 1

decrease Na channel activity

Question 2

clonazepam moa

Answer 2

GABA allosteric agonist

Question 3

Ethosuximide moa

Answer 3

block T-type Ca2+ channel activation

Question 4

Felbamate moa

Answer 4

block NMDA; increase GABA activation

Question 5

gabapentine moa

Answer 5

blocks alpha 2 delta-1 subunit of Ca2+ channels

Question 6

lacosaide moa

Answer 6

decrease Na channel activity

Question 7

lamotrigine moa

Answer 7

decrease Na channel activity

Question 8

levetiracetam moa

Answer 8

unknown

Question 9

oxcarbaxepine moa

Answer 9

decrease Na channel activity; possibly increase K+ channel and decrease Ca2+ channel effects

Question 10

phenytoin moa

Answer 10

decrease Na channel activity

Question 11

pregabalin moa

Answer 11

blocks alpha-2 delta-1 subunit of Ca2+ channels

Question 12

topiramate moa

Answer 12

decrease na channel activity, increase K+ current, increase GABA; decrease glutamate activity

Question 13

valproate moa

Answer 13

increase GABA activity, decrease Na channels

Question 14

zonisamide moa

Answer 14

decrease na and decrease T-type Ca2+ actions

Question 15

AEDs with significant protein binding

Answer 15

phenytoin and valproate

Question 16

AED eliminated in the stool

Answer 16

phenytoin

Question 17

AEDs without CYP interactions

Answer 17

pregabalin, topiramate, levetiracetam, gabapentine

Question 18

require routine monitoring of drug levels

Answer 18

carbamazepine, ethosuximide, gabapentin, phenytoin, valproate

Question 19

topiramate/zonisamide issues

Answer 19

weak carbonic anhydrase inhibitors, decreasing renal bicarbonate loss and promoting stone formation by reducing urinary citrate excretion and increasing urinary pH; leads to metabolic acidosis

Question 20

abrupt termination of AEDs

Answer 20

can precipitate status epileptics, increase frequency or seizures and various neurologic issues

Question 21

phenytoin pharm

Answer 21

zero order elimination; protein binding displacement and CYP mediated drug-drug interactions

Question 22

fosphenytoin

Answer 22

pro-drug dosed in phenytoin equivalents

Question 23

phenytoin adverse effects

Answer 23

CNS: nystagmus most common, ataxia incoordination
gingival hyperplasia
dermatologic effects (rare) - hypertrichosis or hirsutism
hematologic changes (uncommon)

Question 24

carbamazepine adverse effects

Answer 24

hematologic changes: BBB for agranulocytosis
CNS: esp. during initial treatment phase, dizziness, drowsiness, ataxia, blurred vision, and sedation
derm effects: rare, range from rash to SJS, TEN, DRESS

Question 25

valproic acid adverse effects

Answer 25

CNS: somnolence, dizziness, paresthesias, asthenia - related to infusion rate Heme: thrombocytopenia and prolonged bleeding time Derm: range from rash to SJS, TEN, and DRESS hepatotoxicity (rare, but can occur in children)

Question 26

felbamate BBW

Answer 26

aplastic anemia, bone marrow suppression, hepatic disease

Question 27

lamotrigine BBW

Answer 27

serious rash (TEN/SJS)

Question 28

category X drug

Answer 28

valproate

Question 29

category C drug

Answer 29

lamotrigine

Question 30

category D drugs

Answer 30

carbamazepine, phenytoin, topiramate, phenobarbital

Question 31

drugs for partial generalized seizures

Answer 31

lamotrigine, carbamazepine, levetiracetam, oxcarbaxepine

Question 32

drugs for primary generalized tonic-clonic seizures

Answer 32

valproate, lamotrigine, levetiracetam

Question 33

drugs for absence seizures

Answer 33

ethosuzimide and valproate

Question 34

drugs for atypical absence myoclonic atonic seizures

Answer 34

valproate, lamotrigine, levatiracetam

Question 35

initial drug type given in status epilepticus

Answer 35

benzodiazepine (lorazepam)

Question 36

benzodiazepine moa

Answer 36

shift the dose response curve for GABA to the

Question 37

barbiturate moa

Answer 37

prolong opening time of Cl- channel

Question 38

susceptible to SJS with AED use

Answer 38

asians with HLA-B *1502 allele

Question 39

AEDs with blood toxicities

Answer 39

carbemazepine, felbamate, and valproate

Question 40

cyp induction

Answer 40

carbamazepine, felbamate, oxcarbaxepine, phenytoin