GLS - Treatment of Neurological Disorders NOT FINISHED

Question 1

What is tonic-clonic epilepsy?

Answer 1

• type of generalised seizure
• involves a tonic phase where the joints are stiff
• followed by a clonic phase where the limbs violently shake

Question 2

What are the 3 main mechanisms for action of anti-epileptic drugs? Give an example of a drug for each mechanism

Answer 2

1. block Na+ currents, decrease excitation e.g. carbamazepine
2. block T-caclium current (ethosuxmide)
3. enhance GABA mediated Cl- currents e.g. clonazepan

Question 3

Which epileptic drugs are teratogenic?

Answer 3

• sodium valproate

Question 4

Why was the epileptic drug dose gradually increased?

Answer 4

• in order to prevent and reduce dose-related toxicity
• low base dose then gradually increased to the maintenance dose
• want the lowest dose to stop seizures and no more

Question 5

In what way can anti-epileptic drugs interfere with contraception?

Answer 5

• many induce cytochrome P450 action, which breaks down progesterone and oestrogen

Question 6

Are her worries about taking the drug whilst she is pregnant substantiated by pharmacological fact?
- what are the risks to herself and the baby if she were to stop taking the anti-epileptic medication?

Answer 6

• yes can be teratogenic
• risk are twice that of general pop but still on 4-6%
• the risks to the pregnancy are greater with discontinuation of her antiepileptic medication
• complications include miscarriage, premature laobour, reduce foetal heart rate, uncontrolled epilepsy