1.
Which drugs are used for partial and general seizures?
Correct Answer(s)
A. pHenytoin
B. Carbamazepine- tegretol
C. Gabapentin and pregablin
D. Topiramate- topamax
Explanation
lamotrigine is used as a MONOTHERAPY for partial seizures
2.
Which drug is used to treat trigeminal neuralgia and or hiccups?
Correct Answer
A. Carbamazepine- tegretol
Explanation
Carbamazepine, also known as Tegretol, is the drug used to treat trigeminal neuralgia and hiccups. Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, causing severe facial pain. Carbamazepine works by reducing the nerve signals that cause pain. It is also sometimes used to treat hiccups, as it can help relax the diaphragm muscle and reduce spasms. Phenytoin, lamotrigine, and topiramate are other anticonvulsant medications that may be used for different conditions, but they are not specifically indicated for trigeminal neuralgia or hiccups.
3.
Which drug do you use in bipolar disease?
Correct Answer
A. Lamotrigine- lamictal
Explanation
Lamotrigine, also known as Lamictal, is used in the treatment of bipolar disorder. It is an anticonvulsant medication that helps stabilize mood and prevent episodes of mania and depression. Lamotrigine is considered a first-line treatment for bipolar disorder, as it has shown effectiveness in reducing symptoms and preventing relapses. It works by regulating the levels of certain neurotransmitters in the brain, which helps to balance mood and prevent mood swings. Therefore, Lamotrigine is the drug of choice for bipolar disease.
4.
Which drug do you use for absence seizures only?
Correct Answer
A. Ethosuximide- zarontin
Explanation
Ethosuximide, also known as Zarontin, is the drug used specifically for absence seizures. It is a medication that helps control and prevent these types of seizures by reducing abnormal electrical activity in the brain. Valproic acid and valproate, topiramate, and lamotrigine are also antiepileptic drugs, but they are used for a wider range of seizure types and may not be as effective for absence seizures. Therefore, Ethosuximide is the correct answer for the question.
5.
What would you use for neuropathic pain?
Correct Answer
A. Gabapentin and pregablin
Explanation
Gabapentin and pregabalin are both commonly used medications for the treatment of neuropathic pain. They belong to a class of drugs called anticonvulsants, which work by reducing abnormal electrical activity in the brain that can contribute to pain. These medications are thought to modulate the release of certain neurotransmitters involved in pain signaling. Lamotrigine, phenobarbital, and carbamazepine are also anticonvulsant medications but are not typically used as first-line treatments for neuropathic pain.
6.
Which drug causes blood dyscrasia (inability to make certain blood cells)?
Correct Answer
A. Carbamazepine- tegretol
Explanation
Carbamazepine, also known as Tegretol, is a drug that can cause blood dyscrasia, which refers to the inability to produce certain blood cells. This condition can lead to various complications, such as anemia, leukopenia, and thrombocytopenia. It is important for patients taking carbamazepine to be monitored regularly for any signs of blood dyscrasia, such as easy bruising, bleeding, or infections. If detected early, the dosage of the drug may be adjusted or an alternative medication may be considered to prevent further complications.
7.
Which drug risks fetal spina bifida (neural tube fails to close)?
Correct Answer
A. Valproic acid and valproate
Explanation
Valproic acid and valproate are known to increase the risk of fetal spina bifida. Spina bifida is a condition where the neural tube, which eventually forms the baby's brain and spinal cord, fails to close properly during early development. These drugs are commonly used to treat epilepsy and bipolar disorder, but they have been found to have teratogenic effects, meaning they can cause birth defects. Pregnant women taking valproic acid or valproate should be closely monitored and alternative medications should be considered to minimize the risk to the fetus.
8.
Which drug has a narrow therapeutic window?
Correct Answer
A. pHenytoin
Explanation
Phenytoin is the correct answer because it has a narrow therapeutic window. This means that the dosage range between the minimum effective dose and the toxic dose is relatively small. It is important to closely monitor the blood levels of phenytoin to ensure that it remains within the therapeutic range and to avoid toxicity.
9.
Which drug is narrow spectrum for treating seizures?
Correct Answer
A. Ethosuximide
Explanation
Ethosuximide is a narrow-spectrum drug for treating seizures. This means that it specifically targets and treats certain types of seizures, such as absence seizures, without affecting other types of seizures. Unlike broad-spectrum drugs, which are effective against a wide range of seizure types, ethosuximide is more selective in its action, making it a suitable choice for patients with specific seizure disorders.
10.
What would happen if you were stable on phenytoin and were prescribed bactrim (sulfonamide) for a urinary tract infection?
Correct Answer
A. Increase in pHenytoin levels
Explanation
When phenytoin and bactrim are taken together, bactrim can inhibit the metabolism of phenytoin in the liver, leading to increased levels of phenytoin in the bloodstream. This can result in phenytoin toxicity, as higher levels of the drug can cause adverse effects such as dizziness, confusion, and even seizures. Therefore, the correct answer is an increase in phenytoin levels.
11.
Which drug should you check the CBC before the beginning and during treatment?
Correct Answer
A. Carbamazepine- Tegretol
Explanation
Carbamazepine, also known as Tegretol, is a medication used to treat epilepsy and certain types of nerve pain. It is known to have potential side effects on the blood, such as causing a decrease in white blood cell count. Therefore, it is important to check a complete blood count (CBC) before starting treatment with Carbamazepine and regularly monitor it during the course of treatment to ensure that the blood cell counts remain within normal range. This helps to identify any potential adverse effects on the blood and allows for appropriate management if needed.
12.
Which drug causes a hypersensitivity skin rash in kids which can be fatal in 1-2%?
Correct Answer
A. Lamotrigine- lamictal
Explanation
Lamotrigine, also known as Lamictal, is the drug that can cause a hypersensitivity skin rash in children, which can be fatal in 1-2% of cases.
13.
Which narrow spectrum drug suggests you should you check CBC at start and regularly?
Correct Answer
A. Ethosuximide- zarontin
Explanation
Ethosuximide (Zarontin) is a narrow spectrum drug used to treat absence seizures. It is important to check complete blood count (CBC) at the start of treatment and regularly thereafter because ethosuximide can cause rare but serious blood disorders, such as leukopenia (low white blood cell count) and agranulocytosis (severe decrease in white blood cells). Regular monitoring of CBC helps to detect any abnormalities early and ensure the safety and effectiveness of the treatment.
14.
What was the first drug to treat fibromyalgia (c fiber)?
Correct Answer
A. Lyrica
Explanation
Lyrica is the correct answer because it was the first drug specifically approved by the FDA to treat fibromyalgia, a condition characterized by chronic pain and other symptoms. Lamotrigine (Lamictal), topiramate (Topamax), valproic acid, and valproate are not specifically indicated for fibromyalgia treatment.
15.
Which can cause thrombocytopenia in elders AND if using aspirin displaces the drug and increases the effect of drug?
Correct Answer
A. Valproic acid and valproate
Explanation
Valproic acid and valproate are antiepileptic drugs that can cause thrombocytopenia in elders. Thrombocytopenia is a condition characterized by a low platelet count, which can lead to an increased risk of bleeding. Additionally, if valproic acid or valproate is used in combination with aspirin, it can displace the drug and increase its effect. This can potentially lead to an overdose or increased side effects.
16.
A 70 year old male comes to your office complaining of nose bleeds that keep occurring. The pt has a hx of absence seizures and says they take valproate for treatment. What should you test?
Correct Answer
A. Check anti platelet antibodies
Explanation
This drug induces thrombocytopenia. Aspirin does increase the free drug in serum and would also be a cause however checking anti-platelet antibodies would give answer as to why nose bleeds
17.
Which causes birth defects?
Correct Answer
A. Topiramate- topamax
Explanation
Topiramate, also known as Topamax, is known to have teratogenic effects, meaning it can cause birth defects. This medication is commonly used to treat epilepsy and migraines, but it has been associated with an increased risk of cleft lip and/or palate in infants when taken during pregnancy. It is important for women of childbearing age to discuss alternative treatment options with their healthcare provider if they are planning to become pregnant or are already pregnant.
18.
Neurontin and lyrica fall under the drugs of
Correct Answer
A. Gabapentin and pregablin
Explanation
The correct answer is gabapentin and pregablin. Neurontin and Lyrica are both brand names for these drugs. Gabapentin and pregabalin are both anticonvulsant medications that are commonly used to treat epilepsy, neuropathic pain, and other neurological conditions. They work by reducing the abnormal electrical activity in the brain. Lamotrigine (Lamictal), carbamazepine (Tegretol), and phenytoin are also anticonvulsant medications, but they do not fall under the same drug class as gabapentin and pregabalin.
19.
The time to achieve steady state for higher level of the drug is 4-6 weeks, which drug is it?
Correct Answer
A. pHenytoin
Explanation
Phenytoin is the correct answer because it takes 4-6 weeks to achieve steady state for higher levels of the drug. This means that it takes a significant amount of time for the drug to reach a consistent level in the body, which is a characteristic of phenytoin.
20.
Phenytoin side effects include
Correct Answer(s)
A. Nystagmus
B. Diplopia
C. Gingival hyperplasia
D. Hirsutism
E. Folic acid
F. Folic acid
G. Folic acid
H. Vitamin d metabolism interference--> osteomalacia
I. Vitamin d metabolism interference--> osteomalacia
J. Vitamin d metabolism interference--> osteomalacia
Explanation
The given answer lists the side effects of phenytoin, which include nystagmus (involuntary eye movement), diplopia (double vision), gingival hyperplasia (overgrowth of the gums), hirsutism (excessive hair growth), folic acid deficiency, and interference with vitamin D metabolism leading to osteomalacia (softening of the bones).
21.
What drug is a sub type of phenytoin that can be used IM for emergency situations
Correct Answer
A. FospHenytoin
Explanation
Fosphenytoin is a subtype of phenytoin that can be administered intramuscularly (IM) in emergency situations. It is commonly used as an anticonvulsant medication to treat seizures. Fosphenytoin is converted into phenytoin in the body and has a faster rate of absorption, making it suitable for emergency situations where rapid action is required. Topiramate, clonopin, and benzodiazepines are not subtypes of phenytoin and are not typically administered IM for emergency situations.
22.
Valium is a type of
Correct Answer
A. Benzodiazepine
Explanation
Valium is classified as a benzodiazepine. Benzodiazepines are a class of medications that are commonly prescribed to treat anxiety, insomnia, seizures, and muscle spasms. They work by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, which helps to calm the central nervous system. Valium, also known by its generic name diazepam, is one of the most widely prescribed benzodiazepines and is known for its sedative and anxiolytic properties. It is commonly used to treat anxiety disorders, alcohol withdrawal symptoms, and muscle spasms.
23.
What would you use for status epilecpticus
Correct Answer
A. IV benzodiazepine
Explanation
For the treatment of status epilepticus, IV benzodiazepine is the preferred option. Status epilepticus is a medical emergency characterized by prolonged or repeated seizures that can lead to significant brain damage or even death. Benzodiazepines, such as diazepam or lorazepam, act as central nervous system depressants and help to quickly terminate seizures. They work by enhancing the effects of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that reduces neuronal activity. IV administration ensures rapid onset of action, making benzodiazepines the first-line treatment for status epilepticus.
24.
Which drug withdrawal will cause seizures
Correct Answer
A. Benzodiazepines
Explanation
Benzodiazepines can cause seizures during withdrawal because they work by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain. Prolonged use of benzodiazepines can lead to tolerance and dependence, and sudden discontinuation or rapid tapering of these drugs can result in withdrawal symptoms, including seizures. This is because the brain becomes dependent on the presence of benzodiazepines to maintain normal levels of GABA, and when the drug is removed, the GABA levels drop rapidly, leading to hyperexcitability and the potential for seizures.
25.
What drug do you use for tonic clonic seizures
Correct Answer
A. pHenytoin
Explanation
Phenytoin is the correct answer for treating tonic-clonic seizures. It is an anticonvulsant medication that works by stabilizing the electrical activity in the brain, preventing seizures. Phenytoin is commonly used to control tonic-clonic seizures, also known as grand mal seizures, which involve loss of consciousness and convulsions. It helps to reduce the frequency and severity of these seizures, allowing individuals to better manage their condition and improve their quality of life.
26.
If at risk for absence seizures AND generalized seizures use
Correct Answer
A. Valproic acid
Explanation
see slide 30
27.
Another name for a generalized seizure that is absence is called
Correct Answer
A. Petit mal
Explanation
A generalized seizure characterized by brief lapses of consciousness is commonly known as an absence seizure. This type of seizure is also referred to as petit mal. It is different from grand mal seizures, which involve convulsions and loss of consciousness. Simple partial and focal aware seizures are not the same as absence seizures and do not involve generalized loss of consciousness.
28.
Generalized seizures are
Correct Answer(s)
A. Tonic clonic
B. Grand mal
C. Petit mal
D. Absence
Explanation
The given answer includes different types of generalized seizures. Tonic-clonic seizures, also known as grand mal seizures, are characterized by a loss of consciousness, muscle stiffness, and convulsions. Petit mal seizures, also known as absence seizures, are brief episodes of staring or absence of awareness. Therefore, the answer accurately lists tonic-clonic, grand mal, petit mal, and absence seizures as types of generalized seizures.
29.
Another name for grand mal seizure is
Correct Answer
A. Tonic clonic
Explanation
Another name for a grand mal seizure is tonic clonic. This type of seizure is characterized by a loss of consciousness and convulsions, with the body becoming rigid (tonic phase) followed by rhythmic jerking movements (clonic phase). The term "tonic clonic" accurately describes the two distinct phases of this seizure type.
30.
Which drug does aspirin increase the effects of?
Correct Answer
A. Depakote + depakene
Explanation
This is valproic acid + valproate
31.
What drug is best choice for peripheral neuropathy?
Correct Answer
A. Gabapentin
Explanation
This is a relatively SAFE drug for neuropthaic pain
32.
Which drug interferes with CYP hepatic enzymes
Correct Answer
A. Carbamazepine
Explanation
Carbamazepine is the correct answer because it is known to interfere with CYP hepatic enzymes. These enzymes are responsible for metabolizing many drugs in the liver, and when carbamazepine interacts with them, it can affect the metabolism and clearance of other drugs. This can lead to potential drug interactions and changes in the effectiveness and safety of other medications.