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PHRM 845 > ott seizures > Flashcards

ott seizures Flashcards

1
Q

status epilepticus defined as

A

seizure lasting greater than 5 mins, or 2 + seizures without complete recovery between

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2
Q

drug therapy for status epilepticus

A

5-20 mins: lorazepam / midazolam IV
20-40 mins: IV phosphenytoin, valproic acid or keppra

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3
Q

why cant we give phenytoin quickly?

A

hypotension

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4
Q

fosphenytoin dose

A

20 mg PE/kg IV

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5
Q

what can fosphenytoin cause?

A

purple glove syndrome

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6
Q

phenytoin therapeutic serum concentration

A

10-20 mcg/mL

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7
Q

what must we obtain for phenytoin loading dose?

A

serum albumin and serum phenytoin concentration

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8
Q

valproate IV to PO conversion

A

1:1

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9
Q

desired serum concentration of valproate

A

80 mcg/mL
range 50-125

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10
Q

1A2 inducers

A

carbamazepine
phenytoin
phenobarbital

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11
Q

2C9 inducers

A

carbamazepine
phenytoin
phenobarbital

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12
Q

3A4 inducers

A

carbamazepine
phenytoin
phenobarbital
lamotrigine
oxcarbazepine
topiramate
CPP LOT

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13
Q

UGT inhibitor

A

valproate

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14
Q

lamotrigine box warning se

A

Stevens Johnson Syndrome

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15
Q

lamotrigine dosing without UGT inhibitor or inducer

A

25 mg qd x 14 days
50 mg qd x 14 days
100 mg qd x 7 days
200 mg daily

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16
Q

lamotrigine dosing with UGT inhibitor (valproate)

A

25 mg qOD x 14 days
25 mg qd x 14 days
50 mg qd x 7 days
100 mg qd

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17
Q

lamotrigine dosing with UGT inducer

A

50 mg qd x 14 deays
100 mg qd x 14 days
200 mg qd x 7 days
400 mg qd

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18
Q

what must you do before getting carbamazepine or oxcarbazepine

A

HLA-B 1502 allele screening

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19
Q

Asian patients at high risk of what

A

HLAB1502 and anticonvul hypersensitivity syndrome

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20
Q

positive ____ in northern european and asian descent may confer similar risk for DRESS

A

HLA 3101

21
Q

DRESS syndrome mortality

A

10%

22
Q

when does DRESS occur

A

2-6 weeks after starting drug therapy

23
Q

DRESS can happen from what drugs

A

carbamezapine
cenobamate
lamotrigine
phenytoin
phenobarbital
valproate
zonisamide

24
Q

drug concentrations in pregnancy may be increased due to

A

changes in VD

25
Q

teratogenic risk drugs

A

carbamezapine
clonazepam
fosphenytoin
phenobarbital
phenytoin
primidone
topiramate

26
Q

which drug can cause neural tube defects and decreased IQ

A

valproate

27
Q

infant should receive what at birth

A

vitamin K 1 mg IM to decrease risk of hemorragew

28
Q

estrogen and ____ interact and decrease eachother concentration

A

lamotrigine

29
Q

birth control recomended forms

A

high dose estrogen
progestin only - IUDs good

30
Q

which drug has risk of arrythmia

A

lamotrigine
phenytoin / fosphenytoin

31
Q

which drug has PR interval changes

A

lacosamide, pregabalin

32
Q

which drug has heart block

A

lacosamide

33
Q

which drug increase risk valvular heart disease

A

fenfluramine

34
Q

which drugs lead to SIADH, hyponatremia

A

carbemazepine, oxcarbemazepine

35
Q

which drug mess with vitamin d so increase risk osteoporosis

A

phenytoin

36
Q

which drug lead to kidney stones, metabolic acidosis, heat intolerance

A

topirimate

37
Q

which drug psychosis, suicidal thoughs, worsening depression

A

lamotrigine

38
Q

which drug life threatening neuro events

A

perampanel

39
Q

which drug hypermmonemia, acute mental status changes

A

valproate, give at night

40
Q

which drug cognitive dysfunction and visual abnormalities

A

topiramate

41
Q

which drug contraindicated if you have vision risk factors

A

vigabitran

42
Q

drug with risk of respiratory depression

A

gabapentin and pregabalin

43
Q

which drug could cause thrombocytopenia, PCOS, weight gain

A

valproate

44
Q

which drug gingival hyperplasia and hirsutism

A

phenytoin

45
Q

zonisamide contraindicated i

A

sulfa allergy

46
Q

Epidiolex is what

A

cannabidoil oral solution

47
Q

Epidiolex used for what conditions

A

Dravet Syndrome
Lennox Gastaut Syndrome

48
Q

keotgenic diet

A

3-4:1 fats to protein/carb
risk kidney stones hyperlipidemia, weight loss, constipation, decreased bone mass
only works in adults

49
Q
A

PHRM 845 (38 decks)

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