Antiepileptics in Pregnancy and Breastfeeding
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Antiepileptics in Pregnancy and Breastfeeding

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Questions and Answers

Which antiepileptic drug is noted for requiring renal adjustment?

  • Levetiracetam
  • Topiramate (correct)
  • Lamotrigine
  • Valproic acid
  • What is the first choice benzodiazepine for treating status epilepsy?

  • Diazepam (correct)
  • Midazolam
  • Lorazepam
  • Clonazepam
  • Which medication is indicated for treating absence seizures?

  • Ethosuximide (correct)
  • Valproic acid
  • Topiramate
  • Levetiracetam
  • Which antiepileptic is recommended for breastfeeding?

    <p>Levetiracetam</p> Signup and view all the answers

    What medication is listed as the longest-acting benzodiazepine?

    <p>Lorazepam</p> Signup and view all the answers

    Which medication is specifically mentioned for treating trigeminal neuralgia?

    <p>Carbamazepine</p> Signup and view all the answers

    What class of medications is indicated by the abbreviation BZDs?

    <p>Benzodiazepines</p> Signup and view all the answers

    Which substance is associated with withdrawal symptoms related to GABA?

    <p>Benzodiazepines</p> Signup and view all the answers

    What effect does valproic acid have based on the content provided?

    <p>It increases GABA levels.</p> Signup and view all the answers

    Which of the following medications is typically not associated with trigeminal neuralgia treatment?

    <p>Benzodiazepines</p> Signup and view all the answers

    What is a common side effect of phenytoin?

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

    Which drugs are strongly associated with HLA-B 1502?

    <p>Phenytoin and Oxecarbamazepine</p> Signup and view all the answers

    Which of the following is a contraindication for Topiramate?

    <p>Alcohol consumption</p> Signup and view all the answers

    What describes the action of sodium channel blockers?

    <p>Blocks sodium ion influx</p> Signup and view all the answers

    Which condition is characterized by rapid involuntary eye movement?

    <p>Nystagmus</p> Signup and view all the answers

    What syndrome is associated with hypersensitivity reactions from certain medications?

    <p>Stevens-Johnson Syndrome</p> Signup and view all the answers

    What effect does phenytoin have on plasma levels?

    <p>Direct correlation with effect</p> Signup and view all the answers

    Which of the following agents is a GABA-enhancing drug?

    <p>Barbiturate</p> Signup and view all the answers

    Study Notes

    Pregnancy and Antiepileptics

    • Topiramate is linked to pregnancy complications, including oligohydrosis.
    • Valproic acid and folic acid are relevant during pregnancy; folic acid is crucial for fetal development.
    • Levetiracetam and lamotrigine are preferred antiepileptics for pregnant women due to their safety profiles.
    • Levetiracetam is also safe for use while breastfeeding.

    Antiepileptic Medications

    • Topiramate requires renal dose adjustments in patients with impaired kidney function.
    • Ethosuximide is indicated for absence seizures (petit mal) in young children.
    • In older patients, common antiepileptics include alprazolam, oxazepam, and triazolam.

    Status Epilepticus (SE) Treatment

    • Initial treatment for SE includes benzodiazepines (BZD) such as diazepam, lorazepam, and midazolam administered intravenously.
    • Alternatives in subsequent treatment include phenytoin, valproic acid, and levetiracetam.
    • Diazepam acts the fastest, while lorazepam has the longest duration of action.
    • Clonazepam is noted for its strength among the benzodiazepines.

    Neuropathic Pain and Depression

    • Duloxetine and pregabalin are first-line treatments for neuropathic pain and depression.
    • Other options include gabapentin and venlafaxine, which may also be effective.

    Hypersensitivity and Skin Reactions

    • HLA-B 1502 allele is associated with increased hypersensitivity reactions to carbamazepine and oxcarbazepine.
    • Phenytoin may cause Stevens-Johnson Syndrome, a serious skin condition, and is associated with various side effects.

    Phenytoin Specifics

    • The effective plasma level of phenytoin correlates strongly with its therapeutic effects.
    • Dosage conversion: 100 mg phenytoin sodium is equivalent to 92 mg of phenytoin base.
    • Common side effects of phenytoin include gingival hyperplasia, nystagmus, hirsutism, acne, and purple glove syndrome.

    Sodium Channel Blockers

    • Key sodium channel blockers include phenytoin, fosphenytoin, carbamazepine, oxcarbazepine, and lamotrigine.
    • Rash is a significant adverse effect associated with lamotrigine.

    GABA Enhancing Agents

    • GABA enhancing medications include barbiturates, benzodiazepines, and valproic acid.
    • Withdrawal symptoms can occur with GABA-enhancing agents.

    Trigeminal Neuralgia

    • Carbamazepine is frequently used to treat trigeminal neuralgia, a condition characterized by intense facial pain.

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    Description

    This quiz covers important considerations regarding the use of antiepileptic medications during pregnancy and breastfeeding. It explores medications such as Topiramate, Levetiracetam, and others, along with their effects and necessary adjustments. Test your knowledge on safe practices for managing epilepsy in pregnant and nursing patients.

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