Neurology Medications

Question 1

What is usually given second line to focal seizures?

Answer 1

Carbamazepine

Question 2

What is the first line towards Trigeminal Neuralgia?

Answer 2

Carbamazepine

Question 3

For which seizures is carbamazepine is not recommended to be used?

Answer 3

Absence and Myoclonic

Question 4

What is the adverse effects of Carbamazepine?

Answer 4

GI Upset (Nausea and Vomiting)

Neurological Effects- Dizziness and Ataxia

Oedema and Hyponatraemia (due to ADH Like effect)

Skin Rashes

Question 5

Warnings about the use of Carbamazepine?

Answer 5

Warning in -

Pregnancy - taking high dose of folic acid before starting on medication

Carriage of the HLA-B 1502 allele - Steven’s- Johnsons syndrome

Caution-

Hepatic

Renal

Cardiac Disease

Question 6

How does Carbamazepine interact with Cytochrome P450 enzymes?

Answer 6

It induces cytochrome p450 enzymes- reducing plasma concentration and efficacy of drugs that are metabolised by CYP enzymes…

WARFARIN, OESTROGEN AND PROGESTERONE

CYP Inhibitors (Macrolides) also increase the adverse effects.

Question 7

A patient in the GP clinic has severe knee pain and wants to talk to you about pain management. He is on the wait list for a total knee replacement, but likely needs to wait 3-6 more months.
Which of the following patient education statements are true?

Answer 7

Taking naproxen regularly for 6 months may increase the risk of GI bleeds

It is okay to mix paracetamol and naproxen, as they do not interact.

For pain management, it is often effective to mix analgesics from different classes

Question 8

Many anti-emetics (cyclizine) have anticholinergic effects. Which of the following is a side effect related to this?

Answer 8

Dry throat and mouth

The anticholinergic effects cause dry mouth either directly by inhibiting acetylcholine binding to muscarinic receptors in the salivary glands or by a secondary route through the inhibition of acetylcholine in the central nervous system.