Mehl. Epilepsy/hypnotic drugs 04-14 (1)

Question 1

M. USMLE doesn’t care about MOAs for these. They care about side-effects mostly, as per my observation.

Answer 1

.

Question 2

M. Valproic acid. Moa?

Answer 2

Blocks sodium channels and­ incr. GABA

Question 3

M. Blocks sodium channels and­ incr. GABA?

Answer 3

Valproic acid.

Question 4

M. Used as an alternative to lithium in Tx of bipolar disorder.???

Answer 4

Valproic acid

Question 5

M. Used as an alternative to lithium in Tx of….??

Answer 5

Valproic acid

in Tx of bipolar disorder

Question 6

M. Valproic acid. Adverse?

Answer 6

Causes neural tube defects in pregnancy due to interference with folate metabolism.

Question 7

M. Causes neural tube defects in pregnancy due to interference with folate metabolism.? 3 drugs

Answer 7

Valproic acid
Carbamazepine
Phenytoin

Question 8

M. Carbamazepine, Moa?

Answer 8

Blocks sodium channels.

Question 9

M. Blocks sodium channels. drugs? 2

Answer 9

Carbamazepine
Phenytoin

Question 10

M. What drug is generic anti-epileptic; also used as prophylaxis for trigeminal neuralgia.??

Answer 10

Carbamazepine.

Question 11

M. Carbamazepine prophylaxis for what?

Answer 11

also used as prophylaxis for trigeminal neuralgia.

Question 12

M. Carbamazepine adverse in pregnancy?

Answer 12

Causes neural tube defects in pregnancy due to interference with folate metabolism.

Question 13

M. Carbamazepine adverse in non-pregnant?

Answer 13

Can cause aplastic anemia and SIADH.

Question 14

M. Phenytoin Moa?

Answer 14

Blocks sodium channels.

Question 15

M. Phenytoin. Generic anti-epileptic.

Answer 15

.

Question 16

M. Phenytoin. adverse in pregnancy?

Answer 16

Causes neural tube defects in pregnancy due to interference with folate metabolism

Question 17

M. Phenytoin. what syndrome in pregnant can cause?

Answer 17

Can cause fetal hydrantoin syndrome (finger nail hypoplasia + abnormal facies).

Question 18

M. Phenytoin. when used for status epilepticus?

Answer 18

when BZD fails.
Its second step drug.

Question 19

M. Ethosuximide Moa?

Answer 19

Blocks thalamic calcium channels. Only anti-epileptic USMLE might ask MOA.

Question 20

M. Blocks thalamic calcium channels. Only anti-epileptic USMLE might ask MOA. Drug?

Answer 20

Ethosuximide

Question 21

M. Ethosuximide for what seizures Tx?

Answer 21

Used for absence seizures.

Question 22

M. BZD - Diazepam, lorazepam, midazolam, chlordiazepoxide, etc.

Answer 22

.

Question 23

M. BZD moa?

Answer 23

Bind to GABA-A receptor, which ­incr. frequency of Cl- channel opening, thereby allowing Cl- to flow into the neuron, hyperpolarizing it and inhibiting it (i.e., decr. firing).

Question 24

M. Bind to GABA-A receptor, which ­incr. frequency of Cl- channel opening, thereby allowing Cl- to flow into the neuron, hyperpolarizing it and inhibiting it (i.e., decr. firing). Drugs?

Answer 24

BZD

Question 25

M. BZD. sleep etc uses? 3

Answer 25

Hypnotic (induces sleep); anxiolytic (reduces anxiety); anti-convulsant.

Question 26

M. first line status epilepticus drug?

Answer 26

BZD

Question 27

M. BZD. Clonazepam used for .....?

Answer 27

insomnia/anxiety (shows up on NBME).

Question 28

M. Tx of stimulant intoxication (i.e., cocaine, amphetamine, PCP).??

Answer 28

BZD

Question 29

M. Tx for specific phobia (e.g., fear of flying).???

Answer 29

BZD

Question 30

M. Tx for alcohol withdrawal (delirium tremens / alcoholic hallucinosis).

Answer 30

BZD

Question 30

M. Tx social phobia 2nd-line if patient has asthma, since we don’t give propranolol in this setting (asked on NBME).???

Answer 30

BZD

Question 31

M. BZD. USMLE wants you to know that alcohol also binds to and activates GABA-A receptor, but at a different location from benzos. There’s an NBME Q where you have to select the illustration of an alcohol molecule and benzo binding to the same receptor, but at different sites.

Answer 31

.

Question 32

M. BZD what adverse?

Answer 32

Can cause respiratory depression.

Question 33

M. BZD overdose Tx? antidote

Answer 33

Treat overdose with flumazenil (antagonist of benzo receptor).

Question 34

M. Barbiturates. Phenobarbital, thiopental, etc.

Answer 34

.

Question 35

M. Barbiturates. Moa?

Answer 35

Bind to GABA-A receptor; ­incr. duration of chloride channel opening, making them more efficacious (and dangerous) than benzos.

Question 36

M. Bind to GABA-A receptor; ­incr. duration of chloride channel opening, making them more efficacious (and dangerous) than benzos. drug?

Answer 36

Barbiturates.

Question 37

M. Barbiturates. used in what specific case?

Answer 37

Used for general anesthesia.

Question 38

M. Barbiturates. as third line Tx in what case?

Answer 38

Used for unremitting status epilepticus if benzos and phenytoin fail. 3rd step in status epilepticus

Question 39

M. Non-benzo hypnotics. drugs? 2

Answer 39

Zolpidem, zaleplon

Question 40

M. Non-benzo hypnotics. Zolpidem, zaleplon. Moa?

Answer 40

Activate GABA-A receptor, but bind to a different subunit from benzos.

Question 41

M. Non-benzo hypnotics. Zolpidem, zaleplon. adverse?

Answer 41

Can cause addiction similar to benzos

Question 42

M. Magnesium Tx and prevention for what?

Answer 42

Used for Tx and prevention of eclamptic seizures in pregnancy.

Question 43

M. Magnesium for prevention in babies?

Answer 43

Given to pregnant women giving birth <32 weeks’ gestation for neuroprotection for the fetus.

Question 44

M. Magnesium in what cardiac cases? 2

Answer 44

Used for torsades arrhythmia and digoxin toxicity.

Question 45

M. Lamotrigine Moa?

Answer 45

Blocks sodium channels. General anti-epileptic.

Question 46

M. Lamotrigine adverse?

Answer 46

Can cause Stevens-Johnson syndrome.