30 Questions
Which of the following criteria is NOT used to diagnose epilepsy?
A history of 1 provoked seizure due to fever
What is the minimum time gap required between 2 unprovoked seizures for the diagnosis of epilepsy?
24 hours
Which anti-epileptic drug is represented by the abbreviation 'CBZ'?
Carbamazepine
What does EEG stand for in the context of epilepsy diagnosis?
Electroencephalogram
How many unprovoked seizures are required for a patient to be diagnosed with epilepsy, according to the provided text?
1
What is the abbreviation for the anti-epileptic drug 'Phenobarbital'?
PB
Which anti-epileptic drug is commonly known as 'divalproex'?
Valproic Acid
Which organization published the report on the treatment of new-onset epilepsy?
American Academy of Neurology and the American Epilepsy Society
Where can the Ontario Epilepsy Guidelines be found?
Online
Who authored the article 'Antiseizure medications: Mechanism of action, pharmacology, and adverse effects'?
Schachter SC
What is the DOI of the report on the treatment of new-onset epilepsy?
10.1212/WNL.0000000000005755
Who is the publisher of UpToDate?
Wolters Kluwer
What is the title of the clinical guidelines for the management of epilepsy in adults and children?
Clinical Guidelines for the Management of Epilepsy in Adults and Children
Which organization is responsible for the content of UpToDate?
Wolters Kluwer
When were the Ontario Epilepsy Guidelines licensed?
August 9, 2023
Who reviewed the content of UpToDate?
PharmAchieve Corporation Ltd
What do anti-epileptic agents primarily target to prevent firing of abnormally excitable neurons?
Potassium, calcium, sodium, and chloride channels
What is the recommended duration of antiepileptic therapy before considering discontinuation?
2-4 years of achieving seizure freedom
Which type of seizures originate from a neural network in only one side of the brain and can have motor and/or non-motor components?
Focal (partial) seizures
What is the term used to describe the risk of experiencing a seizure?
Seizure threshold
Which class of drugs, including phenobarbital and primidone, is associated with chronic side effects like behavioral and cognitive problems, mood changes, and sedation?
Barbiturates
Which triggers are known to be associated with seizures?
Stress, photostimulation, hyperventilation, sleep deprivation, and hormonal changes
What is upregulation of Synaptic Vesicle protein 2A (SV2A) linked to?
Epilepsy
Which type of drug is associated with permanent vision loss as a side effect?
GABA derivatives
Which type of drug may require early dose adjustment after delivery to avoid toxicity?
Iminostilbene derivatives
Which type of drug is associated with chronic and idiosyncratic side effects, with complex dosing due to saturation kinetics?
Hydantoin derivatives
Which type of drug is associated with teratogenicity and hepatic toxicity as common side effects?
Carboxylic acid derivatives
Which type of drug's metabolism is induced during pregnancy?
Iminostilbene derivatives
Which type of drug may increase fetal vitamin K degradation, necessitating routine administration of vitamin K to newborns?
Carboxylic acid derivatives
According to the text, what should be the primary consideration when choosing an epilepsy treatment drug?
Seizure control effectiveness
Study Notes
Antiepileptic Drug Properties and Side Effects
- Carboxylic acid derivatives include valproic acid/divalproex with CNS and GI side effects, teratogenicity, and hepatic toxicity
- GABA derivatives like vigabatrin and gabapentin have CNS and vision-related side effects, with vigabatrin causing permanent vision loss
- Hydantoin derivatives such as phenytoin have chronic and idiosyncratic side effects, with complex dosing due to saturation kinetics
- Iminostilbene derivative oxcarbazepine causes CNS effects and hyponatremia, and its metabolism is induced during pregnancy
- Oxcarbazepine levels rise quickly after delivery, requiring early dose adjustment to avoid toxicity
- Enzyme-inducing AEDs may increase fetal vitamin K degradation, necessitating routine administration of vitamin K to newborns
- The drug of choice for epilepsy treatment should be the one that best controls seizures
- Teratogenicity and hepatic toxicity are common side effects of carboxylic acid derivatives
- GABA derivatives like vigabatrin and gabapentin have CNS and vision-related side effects, with vigabatrin causing permanent vision loss
- Hydantoin derivatives such as phenytoin have chronic and idiosyncratic side effects, with complex dosing due to saturation kinetics
- Iminostilbene derivative oxcarbazepine causes CNS effects and hyponatremia, and its metabolism is induced during pregnancy
- Oxcarbazepine levels rise quickly after delivery, requiring early dose adjustment to avoid toxicity
Test your knowledge of antiepileptic drug properties and side effects with this quiz. Explore the effects of carboxylic acid, GABA, hydantoin, and iminostilbene derivatives, as well as considerations for pregnancy and newborns.
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