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BCPS study guide

Pediatrics - anticonvulsants and ADHD meds and other

QuestionAnswer
first choice drugs for focal/partial seizures VPA, CBZ and PHT
First choice drugs for tonic clonic seizures VPA, CBZ and PHT
First choice drugs for myoclonic seizures VPA
First choice drugs for absence seizures ethosuximide and VPA
alternative choices for focal partial seizures keppra, lamictal, zonisamide, topiramate, oxcarbazepine, gabapentin, phenobarbital, lacosamide, tiagabine
alternative choices for tonic clonic seizures lamotrigine, topiramate, zonisamide, levetiracetam
alternative choices for myoclonic seizures topiramate, zonisamide and levetriacetam
alternative choices for absence seizures lamotrigine, zonisamide and levetiracetam
first choice drugs for Lennox Gastaut syndrome VPA, topiramate and lamotrigine
alternative choices for Lennox Gastaut syndrome rufinamide, clobazam, felbamate, zonisamide
first choice drugs for infantile seizures ACTH - $$$$$$$$$$$$$
Alternative choices for infantile seizures vigabatrin, lamotrigine, tiagabine, topiramate, VPA, zonisamide
seizure meds that tend to decrease efficacy of oral contraceptives CBZ and phenytoin, and phenobarbital
seizure meds that tend to have increased clearance in pediatric patients keppra, oxcarbazepine, tiagabine, topiramate, gabapentin
seizure meds that have hyponatremia associated with them and do they have more or less affect in peds or adults oxcarbazepine (greater in adults) carbamazepine (similar affect in adults and kids but less than in oxcarb in general)
drug classes used to treat ADHD stimulants such as amphetamines and methylphenidate containing drugs, norepinephrine reuptake inhibitors such as straterra, alpha agonists such as guanfacine and clonidine, and antidepressants [typically wellbutrin, or tricyclics in particular]
what drugs should be avoided in patients taking methylphenidate MAOIs
what ADEs are more common with Daytrana patch over other methylphenidate dosage forms tics, anorexia and insomnia. also as can be expected skin reactions
What mortality issues are associated with amphetamine products sudden cardiac death - pts should not take if they have known structural heart defects. OF NOTE: no causal relationship has been established. NOT RECOMMENDED TO WITHHOLD TREATMENT routinely
What new labeling is included with Straterra Severe liver injury though routine hepatic monitoring not recommended. Also black box warning for suicidal ideation.
What is the contraindication for Wellbutrin in the treatment of ADHD seizure disorder. buproprion lowers seizure threshold.
Which tricyclic antidepressant is typically not used for ADHD treatment and why Desipramine due to reports of sudden death
Describe the delivery system of methylphenidate OROS (Concerta) an outer capsule contains 22% of the drug while the remainder of the drug is in the tablet core which is released over 10 hours to minimize peaks and troughs
What is the advantage of Concerta over Focalin XR Focalin XR delivers bimodal peak serum concentrations at 1.5 and 6.5 hours but has a shorter duration of action than Concerta so may be problematic for afternoon symptom management.
The advantage of Lisdexamphetamine over amphetamine salts less abuse potential as it is designed as a prodrug. no therapeutic advantage over other amphetamine products
Advantages of straterra over amphetamine and methylphenidate no abuse potential as is not a stimulant and does not exacerbate tics or anxiety.
What cyp enzyme is associated with Strattera 2D6
advantage of guanfacine over clonidine in treatment of ADHD less sedating.
when should you hold vaccines when a patient is getting steroids. never unless it is a live vaccine and in that case ONLY if high dose; then give at the end of treatment or if >14 days give after a month.
Created by: mjuhlin
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