random Flashcards
Which antiepileptics have the highest increased risk of teratogenicity if given during pregnancy?
- sodium valproate
- valproic acid
Which antiepileptics have an increased risk of teratogenicity when given during pregnancy?
- carbemazepine
- primidone
- phenobarbital
- phenytoin
- lamotrigine
(CP3L) <- How to remember
(1) Which antiepileptic has increased risk of cleft palate formation if given during pregnancy? (2) Which trimester does this occur in?
(1) Topiramate
(2) First trimester
Which antiepileptics reduce the efficacy of hormonal contraception?
Enzyme-inducing
e.g. carbemazepine
For which antiepileptics does foetal growth need to be monitored when given in pregnancy?
- Topiramate
- Levetiracetam
(1) Why does folic acid need to be given during pregnancy? (2) At what dose? (3) For how long?
(1) Prevention of formation of neural tube defects
(2) 5mg OD
(3) Taken before conception until 12th week of pregnancy
What is required at birth for patients taking antiepileptics?
Vitamin K injection in newborn
What needs to be monitored when a patient taking antiepileptics is breastfeeding?
- drowsiness
- weight gain
- feeding difficulty
- developmental milestones
Which antiepileptics are present in high amounts in breastmilk?
- Zosinamide
- Ethosuximide
- Lamotrigine
- Primidone
(ZELP) <- how to remember
Which antiepileptics accumulate due to slower metabolism in the infant, if given during pregnancy?
- Phenobarbital
- Lamotrigine
Which antiepileptics can inhibit the sucking reflex of newborns, when given during pregnancy?
- Phenobarbital
- Primidone (metabolised to phenobarbital)
For which antiepileptics should abrupt withdrawal of breastfeeding be avoided, when having been given during pregnancy?
All
Phenobarbital and primidone especially
Which antiepileptics have an established risk of drowsiness in babies, when having been given in pregnancy?
- Benzodiazepines
- Phenobarbital
- Primidone
What are some symptoms of antiepileptic hypersensitivity syndrome?
- rash
- fever
- lymphadenopathy
- systematic involvement within first 1-8 weeks of starting
Which antiepileptics are associated with increased risk of antiepileptic hypersensitivity syndrome?
Same as those at increased risk of teratogenicity
- carbemazepine
- phenytoin
- phenobarbital
- primidone
- lamotrigine
(CP3L) <- how to remember
Which antiepileptics have an increased risk of cross-sensitivity between antiepileptic drugs?
Carbemazepine and phenytoin
What are some MHRA warnings associated with antiepileptics?
- small increased risk with ALL antiepileptics: suicidal behaviour and thoughts
- risk of severe respiratory depression with gabapentin
Which antiepileptic is associated with increased risk of Steven-Johnson syndrome?
Lamotrigine
Which antiepileptic is associated with increased risk of toxic epidermal necrolysis?
Lamotrigine
Which antiepileptic(s) is/ are associated with increased risk of blood dyscrasias?
- carbamazepine
- valproate
- ethosuximide
- topiramate
- phenytoin
- lamotrigine
- zonisamide
C VET PLZ <- How to remember
Which antiepileptic(s) is/ are associated with increased risk of eye problems?
- vigabatrin - visual field defects
- topiramate - acute myopia
(1) Which antiepileptic(s) is/ are associated with increased risk of encephalopathic symptoms? (2) How can this be managed?
(1) Vigabatrin - marked sedation, stupor and confusion
(2) Withdraw or lower dose
