Drugs Affecting GABA Quiz

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Which of the following AEDs is a GABA analogue that binds to unknown receptors in the brain?

Gabapentin (correct)

Topiramate

Tiagabine

Benzodiazepines

What is the primary mechanism of action of tiagabine in affecting GABA?

Blocking GABA reuptake (correct)

Potentiating GABA

Blocking sodium channels

Increasing GABA synthesis

Which of the following AEDs that affect GABA is also used for the treatment of neuropathic pain?

Tiagabine

Gabapentin (correct)

Benzodiazepines

Topiramate

Which of the following AEDs that affect GABA has its absorption increased by food intake?

Gabapentin (A) Signup and view all the answers

How is gabapentin primarily eliminated from the body?

Excreted unchanged in the urine (B) Signup and view all the answers

Which of the following AEDs that affect GABA has the fastest time to peak plasma concentration after oral administration?

Tiagabine (D) Signup and view all the answers

What is the maximum daily dosage of tiagabine in adolescents?

32 mg (D) Signup and view all the answers

What is the recommended dosage increase for tiagabine in adults on enzyme-inducing AEDs?

4 to 8 mg per day (D) Signup and view all the answers

What is the maximum daily dose of tiagabine for adults on enzyme-inducing AEDs?

56 mg (B) Signup and view all the answers

What should a patient do if they miss a dose of tiagabine?

Skip the missed dose and take the next dose at the regular time (D) Signup and view all the answers

What monitoring is required for patients taking topiramate?

All of the above (D) Signup and view all the answers

What is the most common adverse reaction associated with perampanel?

Hostility and aggression (D) Signup and view all the answers

What is the primary route of excretion for perampanel?

Feces (B) Signup and view all the answers

What is the half-life of perampanel?

105 hours (C) Signup and view all the answers

Which of the following is a true statement about the pharmacokinetics of perampanel?

Both a and b (B) Signup and view all the answers

What is the recommended approach if a patient has missed multiple doses of tiagabine?

Possible retitration may be required (A) Signup and view all the answers

What is a potential effect of topiramate use on infants who ingest the drug through breast milk?

Decreased weight gain (C) Signup and view all the answers

Which adverse effect is more prevalent in patients taking topiramate compared to the control group?

Peripheral edema (B) Signup and view all the answers

Why is it advised not to abruptly discontinue topiramate?

To prevent status epilepticus (C) Signup and view all the answers

Which category is assigned to tiagabine in terms of pregnancy risk?

Category C (B) Signup and view all the answers

What is the most common central nervous system (CNS) adverse effect of gabapentin?

Somnolence (B) Signup and view all the answers

In children, what is one of the neuropsychiatric adverse effects of gabapentin?

Hostility (C) Signup and view all the answers

What is a common side effect reported in patients taking tiagabine concomitantly with other medications?

Seizures (A) Signup and view all the answers

Which group of patients should exercise caution when prescribed drugs that predispose to heat-related disorders?

Children and those in warm environments (C) Signup and view all the answers

What is the effect of abrupt tiagabine discontinuation?

Increased risk of status epilepticus (C) Signup and view all the answers

Which factor should be monitored in infants exposed to tiagabine through breast milk?

Inadequate weight gain (D) Signup and view all the answers

What neuropsychiatric symptoms have been reported in patients taking perampanel?

Irritability and aggression (A) Signup and view all the answers

What is a boxed warning for perampanel that clinicians should monitor for?

Changes in mood, behavior, or personality (D) Signup and view all the answers

Which adverse drug reaction (ADR) is commonly associated with perampanel?

Increased risk of falls (B) Signup and view all the answers

What is a potential drug interaction with perampanel that can decrease its levels?

Taking moderate or strong CYP3A4 inducers (B) Signup and view all the answers

In patients taking enzyme-inducing AEDs, what is the recommended initial dose of perampanel?

2 mg daily at bedtime (A) Signup and view all the answers

In patients with mild hepatic impairment, what is the maximum recommended daily dose of perampanel?

6 mg daily (D) Signup and view all the answers

What is the age range for which perampanel is approved for use?

Children aged 12 years and older only (A) Signup and view all the answers

What is the most common adverse drug reaction (ADR) reported in patients taking levetiracetam?

Somnolence (A) Signup and view all the answers

Which of the following is an uncommon but significant behavioral change associated with levetiracetam use?

Hostility (A) Signup and view all the answers

What age group is the extended-release formula of levetiracetam (Keppra XR) FDA approved for?

16 years and older (A) Signup and view all the answers

Which enzyme does levetiracetam not use for metabolism, reducing the likelihood of drug interactions?

CYP450 enzymes (A) Signup and view all the answers

In clinical trials of 11 antiepileptic drugs (AEDs), what was the risk of suicidal thoughts or behavior in patients randomized to one of the AEDs compared to controls?

Twice as high (A) Signup and view all the answers

Which medication is indicated for primary generalized tonic-clonic seizures in adults and children aged 6 years or older?

Levetiracetam (C) Signup and view all the answers

What adverse event may occur if levetiracetam is abruptly discontinued?

Withdrawal seizures (B) Signup and view all the answers

Which medication does not interact with levetiracetam, as mentioned in the text?

Lamotrigine (C) Signup and view all the answers

What type of seizures is levetiracetam indicated for in adolescents aged 12 or older with juvenile myoclonic epilepsy?

Myoclonic seizures (C) Signup and view all the answers

Which of the following symptoms should patients be warned about when starting on levetiracetam?

Balance issues (D) Signup and view all the answers

What is the primary route of elimination for topiramate in the body?

Renal excretion (C) Signup and view all the answers

What enzyme is primarily responsible for metabolizing tiagabine in the liver?

CYP3A4 (A) Signup and view all the answers

Which age group has the shortest half-life for tiagabine?

Children aged 3 to 10 years (D) Signup and view all the answers

What should be monitored in patients taking gabapentin due to the increased risk associated with this class of drugs?

Serum bicarbonate levels (B) Signup and view all the answers

What is a contraindication for using gabapentin?

Hypersensitivity to it (D) Signup and view all the answers

Which tricyclic antidepressant has the shortest half-life?

Protriptyline HCl (C) Signup and view all the answers

What potential adverse effect is associated with topiramate therapy in pediatric patients?

Ocular syndrome (A) Signup and view all the answers

What is the main reason gabapentin should not be abruptly discontinued?

May cause seizures (A) Signup and view all the answers

Severe metabolic acidosis has been reported in infants receiving what dose of topiramate per day?

$5$ mg/kg/day (C) Signup and view all the answers

What pharmacotherapeutic precaution is advised for patients taking gabapentin regarding suicidal behavior?

Monitor for emergence or worsening of depression and suicidal thoughts (C) Signup and view all the answers

What adverse reaction is commonly associated with topiramate use?

Hyperammonemia (C) Signup and view all the answers

Which CNS-related adverse reactions are commonly reported with tiagabine use?

Sedation (C) Signup and view all the answers

What effect may gabapentin have in combination with alcohol?

Increased sedative effects of alcohol (A) Signup and view all the answers

In pediatric patients aged 3 to 12 years, what is the usual starting dose of gabapentin for seizures?

$10-12$ mg/kg/day (B) Signup and view all the answers

What is the recommended total daily dose of topiramate for patients with partial-onset seizures?

$200-400$ mg daily (D) Signup and view all the answers

What is the recommended initial dose of topiramate for epilepsy in adolescents aged 12 to 18 years?

$4$ mg once daily (B) Signup and view all the answers

What is the usual maintenance dose of topiramate in children with epilepsy?

$5-9$ mg/kg/day (C) Signup and view all the answers

How should tiagabine dosing be adjusted if an enzyme-inducing drug is added?

Increase tiagabine dose (D) Signup and view all the answers

What renal function consideration is important for gabapentin dosing?

Decreased dosage in renal failure (A) Signup and view all the answers

Which statement about levetiracetam's mechanism of action is correct?

It inhibits burst firing without affecting normal neuronal excitability. (C) Signup and view all the answers

What is the primary route of elimination for levetiracetam?

Renal excretion, with 68% eliminated unchanged (D) Signup and view all the answers

Which of the following is a potential adverse effect of levetiracetam?

Increased risk of suicidal thoughts and behavior changes (C) Signup and view all the answers

What is the recommended approach if a patient needs to discontinue levetiracetam?

Levetiracetam should be gradually tapered to prevent withdrawal seizures. (A) Signup and view all the answers

Which statement about levetiracetam's pharmacokinetics is correct?

Time to peak concentration is delayed with extended-release formulations. (D) Signup and view all the answers

Which of the following is a precaution or contraindication for levetiracetam use?

It should be used with caution in patients with a history of depression. (D) Signup and view all the answers

Which statement about levetiracetam's use in pregnancy is correct?

It is classified as Pregnancy Category C, with potential risks based on animal studies. (D) Signup and view all the answers

Which of the following is a potential adverse effect of levetiracetam on blood cell counts?

Transient decrease in white blood cell and neutrophil counts (B) Signup and view all the answers

For which age groups is levetiracetam FDA approved for use as adjunctive therapy in partial-onset seizures?

Children aged 1 month and older, and adults (D) Signup and view all the answers

What is the recommended precaution for patients starting levetiracetam therapy?

They should not drive or operate heavy machinery until they know the effects. (A) Signup and view all the answers