Epilepsy Qs Flashcards

1
Q

Cat 1

A

C PPP

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2
Q

2

A

CC
LO
RZ
SV T
Perampanel

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3
Q

Cat 3

A

BL
LE
GP
TV

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4
Q

How soon can suicidal behaviour occur with AED use?

A

1 week
report don’t stop

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5
Q

AHS

A
  • 8 weeks
  • Stop and report
  • Rash, fever, lymphadenopathy

Cat 1 and lamotrigine

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6
Q

Focal treatment

A
  1. LL
  2. COZ
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7
Q

Tonic clonic

A
  1. SV
  2. LL
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8
Q

Absence

A
  1. E
  2. SV
  3. LL
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9
Q

Myoclonic

A
  1. SV
  2. Leve
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10
Q

Atonic/tonic

A
  1. SV
  2. lamo
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11
Q

SE 1st line

A

COMMUNITY: Buccal midazolam/
PR diazepam
HOSPITAL: IV lorazepam

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12
Q

Topiramate: foetus

A

Cleft palate
Monitor foetal growth

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13
Q

What drugs are present in high amounts in breastmilk?

A

ZELP

primidone

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14
Q

What are febrile convulsions?

A
  • Seizures/ fits as a result of a fever/hyperthermia
  • Typically in ages 6 months to 3 years old
  • Lasts under 5 minutes (may take child 10-15 minutes to wake up after seizure)
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15
Q

Do febrile convulsions occurs due to hypo or hyperthermia?

A

Hyperthermia e.g. fever

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16
Q

What do you do if febrile convulsion lasts for more than 5 minutes or that there is no recovery in between febrile convulsions?

A

Treat as SE

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17
Q

Dravet’s syndrome treatment

Often confused as febrile convulsions occurs due to hyperthermia too

A
  1. SV
  2. Sodium valproate +
    Clobazam + Stiripentol
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18
Q

Lennox-Gastault syndrome treatment

A
  1. SV
  2. Lamotrigine mono or +
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19
Q

Drugs that reduce seizure threshoold

A

Quinolone
Mefloquine
SSRIs
Antipsychotics
TCA/related antidepressants

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20
Q

SV: CI

A
  • Acute porphyrias
  • Personal/ family history of severe hepatic dysfunction
21
Q

SV: monitor

A
  1. LFTs: before, every 6m
  2. FBC - vit D, Na
  3. Weight - BMI
22
Q

SV: SE

Remember VALPROATE

A

Vomiting
Alopecia
Liver tox
Pancreatitis
Retains fat (weight increase)
Oedema
Appetite increase
Tremor
Enzyme inhibitor

23
Q
A
24
Q

SV: Interactions

A
  • Warfarin = increases anticoagulant effect
  • Lamotrigine = increase toxicity
  • Erythro/ cimetidine = increased SV
  • Inducers = decreased SV
25
Q

Phenytoin sodium = phenytoin base

A

100mg = 92mg

26
Q

Phenytoin: CI

A
  • Acute porphyrias
  • Sino-atrial and heart block if given IV
27
Q

Phenytoin: Range

A

10-20 mg/L OR
40-80 micromol/L

28
Q

Phenytoin: Monitor

A
  1. Cp
  2. LFT
  3. FBC (folate, vit D)
  4. ECG + BP (IV)
29
Q

Phenytoin: decreased protein binding

A
  • Elderly/ children
  • Pregnancy
  • Liver failure
30
Q

Phenytion: Toxicity

A

Slurred speech
Nystagmus
Ataxia
Confusion
Hyperglycaemia
Diplopia

31
Q

Phenytoin: SE

A

Paraesthesia
Hirsutism
Enlarged gums (GH)
Neurotox = dizzy, ataxia
Yellow
Teratogenic
Origin - HLAB allele
Ideation - suicidal behaviours
Nystagmus

32
Q

Phenytoin decreases concentration of:

A
  • CP
  • HRT
  • Wafarin
  • CS
  • Levo/lio
33
Q

Carbamazepine: other indications

A
  • AAW
  • Diabetic neuropathy
  • Trigeminal neuralgia
  • Bipolar
34
Q

Carbamazepine: Monitoring

A
  1. Cp
  2. FBC
  3. LFT
  4. Renal
35
Q

Carbamazepine: CI

A

Acute porphyrias
* Hx of bone marrow depression

36
Q

Carbamazepine: Range

A

4-12 mg/L OR
20-50 micromol/L

37
Q

Carbamazepine: Toxicity

Remember IHANDBAG

A

IHANDBAG
Incoordination
Hyponatraemia
Ataxia
Nystagmus
Drowsiness
Blurred vision and diplopia (double vision)
Arrhythmias
GI disturbances

38
Q

Carbamazepine: SE

Remember BASH

A

Blood disorder
AHS
Skin - HLAB allele
Hepatic disorder

39
Q

Carbamazepine + orlistat

A

Increased convulsions

40
Q

Levetiracetam: SE

A
  • Cold-like symptoms (e.g.nasopharyngitis, dizziness, drowsiness)
  • Anxiety and depression (low mood)
41
Q

Lamotrigine: CI

A
  • Parkinson’s (may be exacerbated)
  • Myoclonic seizures (may be exacerbated)
42
Q

Lamotrigine: Main SE

A
  • SJS
  • Blood disorders
43
Q

Phenobarbital: CI

A
  • Acute P
  • History of drug/alcohol abuse
  • Resp dep
44
Q

Ethosuximide: Main SE

A

Blood disorder

45
Q

Topiramate: main SE

A
  • Monitor foetal growth: cleft palate
  • Vision
  • Kidney stones (need adequate hydration to avoid)
46
Q

Topiramate: Indication other

A
  • Migraine proph
47
Q

Vigabatrin; SE

A

Visual field effect

48
Q

Zonisamide: SE

A
  • weight loss
  • speech disorder
49
Q
A