Epilepsy in Pregnancy

Question 1

Sodum valproate

Answer 1

Spina bifida

Question 2

Carbamazepine

Answer 2

Spina bifida

Question 3

5 recommendations for discontinuation of antiepileptic drugs

Answer 3

seizure free more than 2 years
explained risk and benefits
risk of recurrence
withdrawal must be guided by specialist
carried out slowly 3-6 months

Question 4

Phenytoin

Answer 4

cleft lip and palate, chd

Question 5

Best in acute manic episode in the first trimester

Answer 5

Haloperidol

Question 6

Best in maintenance across trimester but not good in managing manic episodes

Answer 6

Lamotrigine

Question 7

Lithuim

Answer 7

Ebstein and renal defects

Question 8

Leviteracetam

Answer 8

skeletal abnormalities

Question 9

Antiepileptic drugs contraindicated in breastfeeding (2)

Answer 9

Lamotrigine
Leviteracetam

Question 10

3 mecahnisms of teratogenicity for antiepileptic drugs

Answer 10

folate depletion
epoxide depletion
supression of neuronal signaling

Question 11

4 antiepileptic drugs that cause breaktrough bleeding and contraceptive failure and 1 drug that can cause decrease in efficacy of COC

Answer 11

phenobarbital
primidone
phenytoin
carbamazepine

topiramate

Question 12

All the AED are FDA category C except for the following AEDs that are category D (6)

Answer 12

valproate
phenobarbital
primidone
phenytoin
carbamazepine
and topiramate

Question 13

4 AED thatCross the breast milk

Answer 13

Gabapentin, pregabalin, lamotrigine, leviteracetam