Random mix

Question 1

AEDs which are also enzyme inducers?

Answer 1

carbamazepine, phenytoin, topiramate

Question 2

Best contraception in epileptics on AEDs?

Answer 2

Copper coil, mirena, implant

Question 3

Best emergency contraception in epileptics on AEDs?

Answer 3

Copper coil
EC with levonorgestrel or ullipristal acetate affected by enzyme inducers
Can also consider 3mg levonorgestrel (double dose)

Question 4

What drug interaction can increase seizure risk?

Answer 4

lamotrigine and oestrogen containing contraceptives
(lamotrigine levels decrease)

Question 5

Conditions which need bridging with treatment dose dalteparin prior to gynae procedures

Answer 5

VTE in past 3 months
AF + stroke in past 3 months
AF + previous stroke/TIA + CCF/HTN/>75y/DM
Mechanical heart valve

Question 6

When to stop apixaban prior to surgery in normal renal function?

When can it be restarted?

Answer 6

24 hours before

6-12 hours after

Question 7

When to stop warfarin prior to surgery?

When can it be restarted?

Answer 7

5 days prior, and check INR day before. If INR >1.5 can give vit K (phytomenadione)

12-24 hours after. Start LMWH to bridge until taregt INR achieved.

Question 8

Drugs that can be used for heart failure in pregnancy?

Answer 8

Beta blockers - metoprolol safest
Diuretics sparingly - furosemide, thiazides
Hydralazine with care (can cause uterine hypoperfusion)