Pharmacology of Anti-Convulsants

Question 1

Patient has epilepsy > generalised tonic clonic seizures brought on by stress. What is the therapeutic objective?

Answer 1

Decrease occurrence of seizure, make seizures less severe. Give anticonvulsant drugs (consider side effects), aid patient in continuing normal lifestyle

Question 2

When seeing a patient just diagnosed with epilepsy, you have to document what?

Answer 2

advice to contact DVLA that they cannot drive

Question 3

List examples of seizures.

Answer 3

absence
focal
generalised tonic clonic
myoclonic
tonic or atonic

Question 4

What factors should you consider when prescribing anti-convulsants?

Answer 4

sex (male/female), child bearing potential (sodium valproate can have serious side effects of congenital abnormalities for offspring

Question 5

What congenital abnormalities for offspring can sodium valproate cause?

Answer 5

neural tube defects
decreased IQ
autism

Question 6

How does taking the combined oral contraceptive pill affect lamotrigine?

Answer 6

affects its efficacy, concentration decreases more rapidly (perhaps metabolised/excreted more rapidly, absorbed less) > reduces seizure control

Question 7

Many women have an increased frequency of seizures during?

Answer 7

a particular phase of the ovulatory cycle e.g. day 10-13 (oestrogen peak promotes seizures)