Pharmacology IV

Question 1

What additional four conditions is Gabapentin used to treat aside from its use as an anti-epileptic?

Answer 1

Peripheral neuropathy, postherpetic neuralgia, migraine prophylaxis, bipolar disorder (p.451)

Question 2

Which two anti-epileptic drugs are also used to treat migraines?

Answer 2

Topiramate (migraine prevention); Gabapentin (migrains prophylaxis) (p.451)

Question 3

Which drug is first line in treating children for simple and complex partial seizures and for tonic-clonic seizures?

Answer 3

Phenobarbital (p.451)

Question 4

What antiepileptic drug can be used for to treat myoclonic seizures?

Answer 4

Valproic acid (p.451)

Question 5

What antiepileptic drug class can be used for seizures of eclampsia?

Answer 5

Benzodiazapines (p.451)

Question 6

What drug is first line for seizure of eclampsia?

Answer 6

MgSO4 (p.451)

Question 7

What toxicities are associated with benzodiazapines?

Answer 7

Sedation, tolerance, dependence (p.452)

Question 8

What toxicites are associated with Carbamazepine?

Answer 8

Diplopia, ataxia, blood dyscrasias (agranulocytosis, aplastic anemia), liver toxicity, teratogenesis, induction of cytochrome p450, SIADH, Stevens Johnson syndrome (p.452)

Question 9

Which anti-epileptic drugs may cause Stephens-Johnson syndrome?

Answer 9

Ethosuxamide, Carbamazepine, Phenytoin, Lamotrigine (p.452)

Question 10

What toxicities are associated with Ethosuxamide?

Answer 10

GI distress, fatigue, headache, urticaria, Stevens-Johnson syndrome (p.452)

Question 11

What toxicities are associated with Phenobarbital?

Answer 11

Sedation, tolerance, dependence, induction of cytochrome P450 (p.452)

Question 12

What toxicities are associated with Phenytoin?

Answer 12

Nystagmus, diplopia, ataxia, sedation, gingival hyperplasia, hirtuitism, megaloblastic anemia (decreased folate absorption), teratogenesis (fetal hydantoin syndrome), SLE-like syndrome, induction of cytochrome p450, lymphadenopathy, Stevens-Johnson syndrome, osteopenia (p.452)

Question 13

What toxicites are associated with Valproic Acid?

Answer 13

GI distress, rare but fatal hepatotoxicity (measure LFTs), neural tube defects in fetus (spina bifida), tremor, weight gain, contraindicated in pregnancy (p.452)

Question 14

What labs are important to monitor in a patient taking Valproic acid and why?

Answer 14

LFTs for rare but fatal hepatotoxicity (p.452)

Question 15

What major side effect is associated with Lamotrigine?

Answer 15

Stevens Johnson Syndrome (p.452)

Question 16

What toxicites are associated with Gabapentin?

Answer 16

Sedation, ataxia (p.452)

Question 17

What toxicites are associated with Topiramate?

Answer 17

Sedation, mental dulling, kidney stones, weight loss (p.452)

Question 18

What is Stevens-Johnson syndrome?

Answer 18

Prodrome of malaise and fever followed by rapid onset of erythematous/ purpuric macules (oral, ocular, genital). Skin lesions progress to epidermal necrosis and sloughing (p.452)

Question 19

Name four barbiturates.

Answer 19

Phenobarbital, pentobarbital, thiopental, secobarbital (p.452)

Question 20

What is the mechanism of action of barbiturates in treatment of epilepsy?

Answer 20

To facilitate GABA(a) action by increasing DURATION of Cl- channel opening and decreasing neuronal firing (p.452)

Question 21

What condition makes use of barbiturates contraindicated?

Answer 21

Porphyria (p.452)

Question 22

What are barbiturates used for?

Answer 22

Sedative for anxiety, seizures, insomnia, induction of anesthesia (thiopental) (p.452)

Question 23

Which barbiturate drug is most commonly used in induction of anesthesia?

Answer 23

Thiopental (p.452)

Question 24

What toxicities are associated with barbiturates?

Answer 24

Respiratory and cardiovascular depression (can be fatal), CNS depression (can be exascerbated by EtOH use), dependence, drug interactions (induces p450) (p.452)

Question 25

How is barbiturate toxicity treated?

Answer 25

Supportive therapy- assist respirations and maintain BP (p.452)