Antiepileptic Drugs and Lithium Management

<p>They suppress seizures without affecting normal brain function. (A)</p> Signup and view all the answers

<p>Lithium has a narrow therapeutic index. (A)</p> Signup and view all the answers

<p>It is a prodrug that is metabolized to phenobarbital. (A)</p> Signup and view all the answers

<p>Polydipsia (B)</p> Signup and view all the answers

<p>Decreases central cAMP and IP3 formation (C)</p> Signup and view all the answers

<p>Hypericum extracts (C)</p> Signup and view all the answers

<p>Management of bipolar disorders (D)</p> Signup and view all the answers

<p>Stimulates mydriasis (D)</p> Signup and view all the answers

<p>Levodopa with nonselective MAO inhibitors (B)</p> Signup and view all the answers

<p>They do not rely on presynaptic conversion to dopamine (D)</p> Signup and view all the answers

<p>Pulmonary fibrosis (A)</p> Signup and view all the answers

<p>They can cause more neuropsychiatric disorders than levodopa (B)</p> Signup and view all the answers

<p>It may worsen conditions in patients with peripheral vascular disease (B)</p> Signup and view all the answers

<p>As initial therapy in mild PD or as adjuncts in advanced PD (C)</p> Signup and view all the answers

<p>Bromocriptine (D)</p> Signup and view all the answers

<p>Inability to sit still or motor restlessness (A)</p> Signup and view all the answers

<p>Tardive dyskinesia (C)</p> Signup and view all the answers

<p>β blockers (A)</p> Signup and view all the answers

<p>It is considered a chronic EPS and is often irreversible (A)</p> Signup and view all the answers

<p>Atypical antipsychotics (B)</p> Signup and view all the answers

<p>Increased prolactin levels (D)</p> Signup and view all the answers

<p>Hepatic failure (B)</p> Signup and view all the answers

<p>Amenorrhea and galactorrhea (B)</p> Signup and view all the answers

<p>Lamotrigine (D)</p> Signup and view all the answers

<p>Prolonged holidays from antipsychotics may reduce symptoms (B)</p> Signup and view all the answers

<p>Gingival hyperplasia (A)</p> Signup and view all the answers

<p>Vigabatrin (D)</p> Signup and view all the answers

<p>Valproic acid (B)</p> Signup and view all the answers

<p>Peripheral neuropathies (A)</p> Signup and view all the answers

<p>Zonisamide (C)</p> Signup and view all the answers

<p>Hydantoins (D)</p> Signup and view all the answers

<p>Codeine (C)</p> Signup and view all the answers

<p>Morphine (C)</p> Signup and view all the answers

<p>It can lead to respiratory depression. (B)</p> Signup and view all the answers

<p>Nausea and vomiting. (B)</p> Signup and view all the answers

<p>Semisynthetic opioids (D)</p> Signup and view all the answers

<p>Cutaneous vasodilatation (D)</p> Signup and view all the answers

<p>Depression of the medullary respiratory center (D)</p> Signup and view all the answers

<p>Respiratory depression (B)</p> Signup and view all the answers

Lithium is the drug of choice for bipolar disorders.

Lithium inhibits the formation of cAMP and IP3, reducing the neuron's response to serotonin and norepinephrine.

Lithium can interfere with the action of antidiuretic hormone, leading to increased urination and thirst.

Carbamazepine, valproic acid, and lamotrigine are antiepileptic drugs that can also be used to stabilize mood in bipolar disorder.

Antipsychotics like olanzapine and risperidone are also used in some cases to treat bipolar disorder.

Involuntary, repetitive movements of the face, jaw, tongue, trunk, neck, and limbs that occur after long-term use of antipsychotic medications.

The inability to sit still, characterized by restless movements, foot tapping, and leg shifting. Occurs within days to weeks of starting antipsychotic medication.

Symptoms resembling Parkinson's disease, including slowness of movement, tremors, and muscle rigidity. Occurs within weeks to months of starting antipsychotic medication.

A group of side effects caused by antipsychotic medications, affecting movement and muscle control.

Antipsychotic medications that block dopamine receptors, leading to a decrease in dopamine activity in the brain. Can cause Extrapyramidal Symptoms (EPS).

Antipsychotic medications that target specific dopamine receptors, resulting in fewer side effects like EPS.

Elevated levels of prolactin in the blood, a side effect of antipsychotic medications due to the blocking of dopamine receptors in the pituitary gland.

An increase in the number of dopamine receptors in the brain as a response to long-term dopamine blockade. It makes neurons oversensitive to dopamine, contributing to Tardive Dyskinesia.

Catecholamine oxidation leads to increased melanin pigment production, resulting in brown coloration of saliva, sweat, and urine.

L-dopa's effectiveness is decreased when taken with Vitamin B6 because the vitamin promotes the conversion of L-dopa to dopamine in the periphery rather than in the brain, where it's needed.

Combining levodopa with non-selective MAO inhibitors can lead to a dangerous increase in blood pressure due to the accumulation of catecholamines.

Antipsychotics, being dopamine antagonists, can worsen Parkinsonian symptoms and decrease the effectiveness of levodopa. Their use in Parkinson's patients is generally discouraged.

Dopamine receptor agonists, like bromocriptine, stimulate dopamine receptors in the striatum, mimicking dopamine's effects. They are effective in patients who haven't responded to levodopa.

Dopamine receptor agonists have a longer duration of action and are not dependent on presynaptic conversion to dopamine. This contributes to their superior efficacy in managing motor fluctuations.

Bromocriptine, an ergotamine derivative, can worsen peripheral vascular disease due to its vasoconstrictive properties. It may also cause serious cardiac problems, particularly in patients with a history of heart attacks.

Prolonged use of bromocriptine can lead to pulmonary fibrosis, a serious lung condition.

Antiepileptic drugs suppress seizures by blocking the initiation of abnormal electrical discharges from the focal area or preventing the spread of abnormal activity to adjacent brain areas.

While some drugs act on specific mechanisms, others like Felbamate have multiple targets within the CNS. Some mechanisms are not yet fully understood like Levetiracetam.

Valproic acid is the active form, and Divalproex sodium, a combination of sodium valproate and valproic acid, is converted to valproate in the gastrointestinal tract, leading to slower absorption and fewer GI side effects.

Sudden withdrawal of antiepileptic medication can trigger seizures, including potentially life-threatening status epilepticus.

Combining antiepileptic drugs with other CNS depressants can enhance the effects of the latter, potentially leading to undesirable side effects.

A natural opioid derived from the poppy plant. It has a strong affinity for mu opioid receptors and varying affinities for delta and kappa receptors.

Morphine produces analgesia by acting on opioid receptors, decreasing the release of pain signals like substance P.

Morphine can cause euphoria by increasing dopamine levels through the inhibition of GABA.

Morphine can suppress the cough reflex by acting on the medulla oblongata.

Morphine can cause respiratory depression by decreasing respiratory rate and volume, leading to CO2 retention in the blood.

Morphine can stimulate the chemoreceptor trigger zone (CTZ) in the medulla, leading to nausea and vomiting.

Morphine causes miosis (pinpoint pupils) by stimulating the oculomotor nerve (cranial nerve III), which controls the muscles of the eye.

Morphine stimulates the vagus nerve, leading to bradycardia (slow heart rate), hypotension (low blood pressure), and bronchoconstriction (narrowing of airways).

Felbamate is a medication used for refractory epilepsies (seizures that don't respond to other treatments). However, it carries a significant risk of aplastic anemia (bone marrow failure) and hepatic failure (liver failure), making it a last resort option.

Gabapentin is an antiepileptic drug used to treat seizures, neuropathic pain, and restless leg syndrome. Common side effects include sedation, headache, dizziness, ataxia (loss of balance), tremor, and tiredness.

Lamotrigine is an antiepileptic medication that can cause skin rashes, some of which can be serious and even life-threatening. The risk of rash is lower if the treatment begins with a low dose and gradually increases. Combining lamotrigine with valproate (another anti-epileptic drug) increases the risk of rash.

Levetiracetam is an antiepileptic drug known to cause mood alterations as a side effect. It can affect an individual's emotional state, leading to changes in mood and behavior.

Phenytoin is a medication used to treat seizures. It can cause a range of side effects, including nystagmus (rapid eye movements), ataxia (loss of balance), cognitive impairment, gingival hyperplasia (overgrowth of gums), hirsutism (excessive hair growth), and folate metabolism issues, possibly leading to megaloblastic anemia. Long-term use can also cause peripheral neuropathies (nerve damage) and osteoporosis (bone weakening). Additionally, it can cause fetal hydantoin syndrome, leading to birth defects, if a pregnant woman takes this medication.

Pregabalin is an antiepileptic drug used to treat seizures and nerve pain. It is known to cause weight gain and dizziness as common side effects.

Topiramate is an antiepileptic drug that can cause a variety of side effects, including drowsiness (somnolence), weight loss, paresthesias (numbness or tingling), renal stones (kidney stones), glaucoma (eye pressure), oligohidrosis (decreased sweating), and hyperthermia (high body temperature).

Valproic acid is an antiepileptic drug that can be used to treat seizures and bipolar disorder. It can cause teratogenic effects (birth defects) if taken during pregnancy, leading to neural tube defects like spina bifida. It can also cause cognitive abnormalities, elevated liver functions (rarely causing hepatotoxicity due to a toxic metabolite), weight gain, and hair loss.