Neuropharmacology & Drug Interactions

Question 1

What drug would you give to a patient that starts seizing in clinic?

Answer 1

Diazepam or Midazolam

Anticonvulsant effects for ~20 min

Question 2

Difference between status epilepticus and cluster seizures

Answer 2

Status epilepticus has incomplete recovery between seizures

Cluster seizures have complete recovery between seizures

Question 3

Which drug interferes with T4 metabolism and excretion?

Answer 3

Pheobarb

does not make patient clinically hypothyroid

Question 4

Which drug increases ALP?

Answer 4

Phenobarb

Question 5

Main side effect of phenobarb?

Answer 5

Hepatotoxicity

[PB]> 30 not more effective, just more toxic

Question 6

Contraindication of KBr?

Answer 6

DO NOT USE IN CATS- fatal asthma

Patients whose diets cannot be controlled (eating excess Na)

Question 7

Why do you need to control diet of patients on KBr?

Answer 7

High sodium diets will increase excretion of Br

Question 8

What is the main side effect of KBr?

Answer 8

Bromism:

Ataxia, paraparesis, polyphagia, pica, psychosis, pruritis

Question 9

Gabapentin

Answer 9

Poor anticonvulsant except in rabbits

Question 10

Mechanism of action of Keppra

Answer 10

Ca channel blocker in brain

Question 11

Which anticonvulsant comes in extended release tablets?

Answer 11

Keppra

Question 12

Which anticonvulsants are metabolized by liver?

Answer 12

PB
Zonisamide
Felbamate

Question 13

Side effects of zonisamide

Answer 13

Sedation
Hepatopathy
Cytopenias
Immune mediated disorders

Question 14

What causes neurogenic pulmonary edema?

Answer 14

Loss of vascular tone secondary to seizure activity

Question 15

Which drugs cross BBB?

Answer 15

Small, lipophyllic compounds

TMS
Metronidazole
Ofloxacin
Chloramphenicol
Doxy
Floconazole

Question 16

What is the only corticosteroid to potentially improve outcome in acute spinal cord injury?

Answer 16

Solu-medrol

Must be given within 8 hours of event