Neurology Flashcards

1
Q

Brand name: Phenytoin

A

Dilantin

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2
Q

Brand name: Carbamazepine

A

Tegretol

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3
Q

Brand name: Valproic acid

A

Depakote

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4
Q

Brand name: Levetiracetam

A

Keppra

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5
Q

General therapeutic recommendations for treatment of epilepsy in pregnancy

A

Smallest effective dose, monotherapy preferableFolate supplementation of 4 mg daily

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6
Q

History to document in the epileptic patient

A

Aura - present or absentSeizure description by eyewitness, including durationPostictal phase - description, durationExacerbating factorsBirth history, esp if seizure onset was neonatal or early childhoodHistory of febrile convulsions, CNS infections, or head trauma w/ LOCFamily history

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7
Q

Fetal complications of epilepsy

A

Fetal lossPerinatal deathCongenital malformations (4-8%, or twice baseline risk)Low birth weightPrematurityDevelopmental delayChildhood epilepsy

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8
Q

Preconception counseling of the epileptic patient

A

There is a small risk of having a child with a malformation because of the sz disorder or the drugs used in its treatment. This risk is probably about double that for the nonepileptic patient (4-8%, compared with 2-3% for the general population), but there is still more than 90% chance that she will have a normal child. Preconception folic acid (4 mg) may be considered to reduce the risk of major congenital malformations.

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9
Q

Preconception counseling: when can an anticonvulsant be stopped, and when should the patient attempt conception

A

Consider neuro consultation regarding tapering off AEDs if the patient has been seizure free for > 2 years and has a nl EEG. The patient should be observed for 6-12 months off AED before attempting conception.

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10
Q

Seizure freedom for at least __ months before pregnancy is associated with a high likelihood of remaining seizure-free during pregnancy

A

9 months

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11
Q

Risk of epilepsy in offspring

A

2-3%

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12
Q

Prenatal care of the epileptic patient

A

Folic acid 4 mg/dayAnatomic US at 11-13w to identify severe defectsAFP at 15-18w gestation for NTDsTargeted US at 16-20wFetal echo at 22w+/- growth US at 32wNeonates should receive 1 mg IM Vit K at birth

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13
Q

Which anticonvulsants should have levels monitored during pregnancy?

A

LamotrigineCarbamazapinePhenytoinLevetiracetamOxcarbazepine

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14
Q

Anticonvulsants that interfere with oral contraceptives

A

Enzyme-inducing AEDS:PhenytoinPhenobarbitalCarbemazepineTopiramate (>200 mg/day)Primidone

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15
Q

Drugs that may interfere with absorption of anticonvulsants

A

Folic acid may lower plasma phenytoin levelAntacidsAntihistamines

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16
Q

Does prenatal vitamin K in women with epilepsy reduce the risk of newborn hemorrhagic complications?

A

Evidence is inadequate to determine

17
Q

Postpartum considerations for mothers with epilepsy

A

Do not bathe child while home aloneAvoid stair climbing while carrying the babyPortable changing bad on floor should be usedAvoid using front or back carrierWomen taking enzyme-inducing anticonvulsants who desire OCPs should take one w/ >50 mcg of ethinyl estradiol

18
Q

Treatment of status epilepticus

A

IV diazepam (10-30 mg)IV lorazepam (4-8 mg)