Pharm

Question 1

Name a l dopa

Answer 1

Levo-dopa

Question 2

What is it used for

Answer 2

It is used for Parkinson’s disease, parkinsonism

Question 3

I mechan ism of action

Answer 3

A precusor of dopamine. works by increasing dopamine which is inhibited in the pathway between the the substanca nigra in the midbrain and the corpus stratum in the basal ganglia by acting on d2 receptors
Cannot cross bbb so given with a decarboxylase inhibitor to prevent conversion before crossing.

Question 4

Side effects

Answer 4

Hypotension 
 Nausea 
Drowsiness 
Hallucinations 
Confusion

Question 5

Contraindications

Answer 5

Hypotension
Elderly
cvd disease
Those with psychotic disorders and on anti psychotics

Question 6

Interactions

Answer 6

Anti emetics
Anti psychotics
Since they also act on d2 receptors

Question 7

What is phenytoin used for

Answer 7

Seizures or status epileticus

Question 8

Moa

Answer 8

Works by binding onto the na channel receptor to prevent na influx. This prevents action potential formation so reduces neuronal excitability

Question 9

Side effects

Answer 9

Rash 
Gum hypertrophy 
Acne 
Hirutism
Skin coarsening 
Osteomalacia 
Haematological disorders

Question 10

What can occur in toxicity

Answer 10

Resp depression

Cv collapse

Question 11

Contraindicated

Answer 11

Hepatic impairment and pregnancy since or can cause foetal hydnoin syndrome and craniofacial malformations

Question 12

Interactions

Answer 12

It is an enzyme inhibitor so reduces effiaicu of drugs whhich are metabolised by p450 these include oestrogen progesterone and warfarin

Question 13

What drugs can reduce efficacy of phenytoin and causes more adverse Side effects

Answer 13

Ssri and tca

enzyme inducers such as amidarone
Diltazem
Fulconazole

Question 14

Name a drug that is used as a first line for trigeminal neuralgia

Answer 14

Carbamazepine

Question 15

What else is it used for

Answer 15

Epilepsy

Bipolar

Question 16

What does it do

Answer 16

Control pain reduces frequency and severity

It works by inhibiting na channels to reduce na influx and prevent action potential generation and therefore neuronal excitability

Question 17

Side effects

Answer 17

Nausea and vomiting 
Ataxia and dizziness 
Hypersensitivity reaction including  macopapular rash 
Oedema 
Hyponatraemia 
Anti epileptic hypersensitivity syndrome occurs in 1 in 5000 people on it or phenytoin it presents with Steven Johnson syndrome or toxic epidermal necrolysis 
Fever 
Lymphadenopathy

Question 18

Contraindications

Answer 18

Heart renal and kidney disease should use reduced doses or with caution

In pregnancy should be referred to specialise and given high dose of folic acid or an alternative since it’s associated with neural tube defects and cleft palate

Question 19

Interactions

Answer 19

Reduced efficacy of other drugs metabolised by cytochrome p450 since it is an enzyme inducer. Reduced efficacy of warfarin oestrogen and progesterone

It is also metabolised by this enzyme itself so it’s adverse effects can be increased with inhibitors such as macrolides

Ssri and tca which reduce seizure threshold can also reduce efficacy of other anti epileptic drugs

Question 20

what can sodium valoprate be used for?

Answer 20

it can be used for epilepsy and it can also be used for bipolar (acute management and propylaxis)

Question 21

moa

Answer 21

similar to previous
acts on Na channels to prevent threshold for actional potential thus reducing neuronal excitability
can also increase GABA

Question 22

SE

Answer 22

GI irritation
nausea
vomiting 
ataxia
tremors
anti-epileptic hypersensitivity syndrome 
thrombocytopenia
pancreatitis
bone marrow suppression

Question 23

contraindicated

Answer 23

child bearing age females- esp at time of conception as first trimester at high risk of foetal abnormalities and developmental delay
hepatic impairment

Question 24

interactions

Answer 24

valproate is an enzme inhibitors of -450 therefore this can increase conc of drugs metabolised by p450 since its ability to do so is impaired. this includes warfarin, progesterone and oestrogen
additionally, its efficacy itself can be reduced by cp450 inducers such as carampazepine and carbapenems
adverse events may be increased by macrolides PPI and aspirin

antiepileptic drugs are also reduced in effiaicy by drugs that reduce seizure threshold such as TCA, SSRI Tramadol

Question 25

what is lamotrigine

Answer 25

an anti- convulsant

Question 26

whats its use

Answer 26

it is used for focal and generalised seizures

used as prophylaxis for depressive episodes in bipolar disorder

Question 27

side effects

Answer 27

nausea
diarrhoea
vomiting 
headache
taxia
tremor
agitation 
dizziness 
blurred vision
rash
diplopia 
NYSTAGMUS
anti epileptic hypersensivity syndrome

Question 28

CI and caution

Answer 28

myoclonic seizures
Parkinson disease
hepatic and renal impairment

Question 29

Interactions

Answer 29

all anti epileptics

carbamazepine - increases conc of it and carbapazepine reduces conc of lamotrigine

Question 30

uses of levetiracetam

Answer 30

used in focal seizure with or without secondary generalisation
myoclonic seizures in juvenile myoclonic epilepsy
can be used for tonic clonic seizure

sometimes used for absent and myoclonic seizures but not licensed

Question 31

ci

Answer 31

do not abruptly stop- withdraw slowly

Question 32

SE

Answer 32

aggression
anorexia
nasopharyngitis 
cough
malaise
tremor
rash
dizziness
dyspepsia
vertigo
convulsions 
nausea and vomiting
headache
anxiety

Question 33

di

Answer 33

increase carbamazepine and methotrexate