neurological

Question 1

name antiepileptics

Answer 1

carbamazepine
phenytoin
sodium valproate
lamotrigine 
gabapentin

Question 2

Carbamazepine

method of action:
use:
side effects:
contraindications:

Answer 2

Method of Action – Na channel blocker

Use – Long term epilepsy, Trigeminal Neuralgia and other neurological pains

Side Effects – Thrombocytopenia, Stephens Johnson Syndrome, Teratogenic, Visual Disturbances

Contraindications – Due to the teratogenicity you shouldn’t take if you are planning to become pregnant, if you have to take it have 5mg folate daily

Question 3

Phenytoin

method of action:
use:
side effects:
contraindications:

Answer 3

Method of Action – Na channel blocker

Use – Long term epilepsy, carbamazepine also for Trigeminal Neuralgia

Side Effects – Thrombocytopenia, Stephens Johnson Syndrome, Teratogenic, Visual Disturbances, Gingival Hyperplasia

Contraindications – Due to the teratogenicity you shouldn’t take if you are planning to become pregnant, if you have to take it have 5mg folate daily

Question 4

Sodium valproate

method of action:
use:
side effects:
contraindications:

Answer 4

Method of Action – Increases GABA levels in the brain

Use – Long term epilepsy

Side Effects – Thrombocytopenia, Stephens Johnson Syndrome, Teratogenic, Visual Disturbances

Contraindications – Should NOT be given during pregnancy as it is the most teratogenic

Question 5

Gabapentin

method of action:
use:
side effects:
contraindications:

Answer 5

Method of Action – Increases GABA levels in the brain

Use – Long term epilepsy, Trigeminal Neuralgia

Side Effects – Thrombocytopenia, Stephens Johnson Syndrome, Teratogenic, Visual Disturbances

Contraindications – Due to the teratogenicity you shouldn’t take if you are planning to become pregnant, if you have to take it have 5mg folate daily

Question 6

Lamotrigine

method of action:
use:
side effects:
contraindications:

Answer 6

Method of Action – Increases GABA levels in the brain

Use – Long term epilepsy (now the gold standard for treatment as it has the least side effects)

Side Effects – Thrombocytopenia, Stephens Johnson Syndrome, Teratogenic, Visual Disturbances

Contraindications – Due to the teratogenicity you shouldn’t take if you are planning to become pregnant, if you have to take it have 5mg folate daily

Question 7

Benzodiazepine

method of action:
use:
side effects:
contraindications:

Answer 7

Method of Action – Block Na channels

Use – Status epilepticus, mental health disorders

Side Effects – Fatigue and drowsiness, addictive

Contraindications – Don’t give to people who take alcohol, opiates or MAO inhibitors as these can lead to hypotension and 2

Example – Midazolam or Diazepam

Question 8

levodopa

method of action:
use:
side effects:
contraindications:

Answer 8

Method of Action – A synthetic version of dopamine that is able to cross the blood brain barrier, it is converted to dopamine by dopadecarboxylase enzymes

Use – Parkinsons disease

Side Effects – Nausea and vomiting (caused by peripheral conversion of L-Dopa to dopamine by the enzyme)

Contraindications: Psychotic problems, depression, signs of neuroses, types of skin cancer and diabetes

Question 9

Dopadecarboxylase inhibitors

method of action:
use:
side effects:

Answer 9

Method of Action – Blocks peripheral dopadecarboxylases to prevent peripheral breakdown of L-dopa so the side effect of nausea is reduced

Use – Parkinsons disease

Side Effects – Postural hypotension, hallucination and psychosis

Question 10

Dopamine receptor antagonists

method of action:
use:
side effects:

Answer 10

Method of Action – A synthetic molecule that binds to dopamine receptors transducing a chemical signal

Use – Parkinsons disease

Side Effects – Neurological side effects including parkinsonism, dyskinesis and dystonia

Question 11

what should be prescribed if pt is pregnant but has to take phenytoin?

Answer 11

5mg folate daily