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Pharm 4
Chap 20
| Question | Answer |
|---|---|
| Drug for status epilepticus | Diazepam, lorazepam, phenobarbital, fosphenytoin |
| Drug interaction | Carbamazepine and phenytoin induce cytochrome P450 enzymes and decrease serum levels of the drugs with which they interact |
| Drug interaction | Valproate inhibits the metabolism of the drugs with which it interacts |
| Epilepsy and pregnancy | Valproate and phenytoin cause birth defects and both can reduce folate levels |
| Carbamazepine | seizures, trigeminal neuralgia (pain on one or both side of face), bipolar disease |
| Epilepsy and pregnancy | Valproate and phenytoin cause birth defects and both can reduce folate levels |
| Carbamazepine | seizures, trigeminal neuralgia (pain on one or both side of face), bipolar disease |
| Carbamazepine | cause drowsiness, ataxia, CNS depression, GI |
| Phenytoin contraindication | not use in children and pregnancy |
| Phenytoin | cause: megaloblratic anemia, birth defects, fetal hydantoin syndrome (cardiac defects, malformation of ears, lips, palate, mouth and nasal bridge, mental retardation, microcephaly; ataxia, diplopia, nystagmus, slurred speech; |
| Phenytoin | cause osteomalacia; gingival hyperpalsia, excessive hair growth (hirsutism) |
| Topiramate use | adjunct use for partial seizures |
| Topiramate | reduce serum level of oral contraceptives |
| Topiramate s/e | ataxia, dizziness, drowsiness |
| Topiramate | have several mechanisms of actions, halflife 21 hours, metabolism induced by carbamazepine and phenytonin |
| Ethosuximide | first choice in treatment of absence seizure in children, not for adults (valproate instead) |
| Ethosuximide | valproate inhibits metabolism and increase serum levels, effect is altered by Haloperidol |
| gabapentin | GABA analogue, increase the release of GABA from central neurons, absorption from the gut is inversely related to the dose |
| gabapentin | treat all forms of partial seizures |
| gabapentin s/e | ataxia, dizziness, drowsiness, nystagmus, tremor |
| Benzo used in seizure treatment | clonazepam, diazepam (IV), lorazepam (IV) |
| Benefits of benzo | produces more sedation than other antiepileptic drugs |