Lamotrigine: Clinical Uses and Pharmacodynamics

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What is the primary use of lamotrigine in children aged 2 years and older?

Prevention of febrile seizures
Treatment of partial seizures (correct)
Management of migraine headaches
Control of vertigo episodes

How does lamotrigine impact voltage-sensitive sodium channels?

Stabilizes them
Activates them
Inhibits them (correct)
Has no effect on them

What is the mechanism of action of lamotrigine in bipolar disorder treatment?

Blocks acetylcholine receptors
Increases dopamine levels
Not known (correct)
Inhibits serotonin reuptake

Where does lamotrigine cross during pregnancy?

Placenta (C) Signup and view all the answers

When does immediate-release lamotrigine peak after oral administration?

2 hours (D) Signup and view all the answers

What percentage of lamotrigine is protein-bound?

55% (A) Signup and view all the answers

When prescribing lamotrigine, what is warranted?

Consultation with a neurologist (D) Signup and view all the answers

Which of the following should NOT be monitored when a patient is taking lamotrigine?

Cardiovascular health (A) Signup and view all the answers

How should patients take lamotrigine tablets?

Take them exactly as prescribed without crushing or chewing (A) Signup and view all the answers

What should patients do if they develop a rash while taking lamotrigine?

Report it to their provider immediately (B) Signup and view all the answers

Which of the following potential adverse drug reactions (ADRs) should patients and their families be warned about when taking lamotrigine?

Neuropsychiatric reactions, including suicidal thoughts and behavioral changes (A) Signup and view all the answers

What lifestyle management strategies are recommended for patients with seizures who are taking lamotrigine?

Get adequate sleep and exercise, avoid stressful situations (B) Signup and view all the answers

What is a concerning potential side effect associated with lamotrigine use?

Increased suicidal thoughts (C) Signup and view all the answers

How should lamotrigine be tapered off to avoid withdrawal seizures?

Tapered off over 2 weeks (D) Signup and view all the answers

Which of the following is a rare reaction associated with lamotrigine?

Aplastic anemia (A) Signup and view all the answers

What is the most concerning drug interaction with lamotrigine?

Increased risk of life-threatening rash when taken with valproate (D) Signup and view all the answers

How does lamotrigine interact with oral estrogen-containing contraceptives?

Decreases lamotrigine levels by approximately 50% (A) Signup and view all the answers

What is the initial dosing for patients aged 12 years and older who are not taking enzyme-inducing antiepileptic drugs (AEDs)?

$25 mg per day for 2 weeks (B) Signup and view all the answers

What does the concurrent administration of valproate with lamotrigine increase the risk of?

$200% increase in life-threatening rash development (D) Signup and view all the answers

How is dosing adjusted for children aged 2 to 12 years who are not taking enzyme-inducing AEDs?

$0.3 mg/kg per day for weeks 1 and 2 (D) Signup and view all the answers

What should be avoided when prescribing regular or chewable tablets of lamotrigine?

$Crushing or chewing the tablets (B) Signup and view all the answers

Which of the following statements regarding lamotrigine metabolism is correct?

It is metabolized via glucuronic acid conjugation in the liver. (A) Signup and view all the answers

Which of the following is a contraindication for lamotrigine?

Hypersensitivity to the drug or its ingredients (B) Signup and view all the answers

Which of the following is a potential life-threatening adverse reaction associated with lamotrigine?

Disseminated intravascular coagulation (B) Signup and view all the answers

Which of the following statements regarding lamotrigine and rash is incorrect?

Pediatric patients are less likely to have serious rashes than adults. (A) Signup and view all the answers

Which of the following is a potential risk associated with lamotrigine use?

Suicidal thoughts and depression (B) Signup and view all the answers

Which of the following statements regarding lamotrigine withdrawal is correct?

Lamotrigine should be withdrawn slowly over at least 2 weeks. (D) Signup and view all the answers

Which of the following statements regarding lamotrigine and pregnancy is correct?

Lamotrigine decreased folate levels in animal studies. (A) Signup and view all the answers

Which of the following statements regarding lamotrigine and breastfeeding is incorrect?

Maternal lamotrigine levels remain constant during the postpartum period. (A) Signup and view all the answers

For which of the following conditions is lamotrigine FDA approved for use in children aged 2 years and older?

Lennox-Gastaut syndrome (D) Signup and view all the answers

Which of the following adverse reactions has a Black Box Warning associated with lamotrigine use?

Stevens-Johnson syndrome (SJS) (B) Signup and view all the answers

What is the usual maintenance dose of lamotrigine for pediatric patients aged 2 to 12 years who are not taking valproate?

1 to 5 mg/kg per day (C) Signup and view all the answers

What is the initial dose of lamotrigine in patients older than age 12 years who are taking valproate?

25 mg per day (C) Signup and view all the answers

How should the dose of lamotrigine be adjusted in children who weigh less than 30 kg?

Increased by as much as 50% (C) Signup and view all the answers

What is the dosage adjustment for lamotrigine in adult patients with bipolar disorder who are taking carbamazepine?

50 mg daily in weeks 3 and 4 (A) Signup and view all the answers

In patients taking oral contraceptives along with lamotrigine, how is the lamotrigine dose altered?

Increased by 50% weekly (A) Signup and view all the answers

What is the dose of lamotrigine for pediatric patients aged 2 to 12 years taking valproate?

25 mg every other day for weeks 1 and 2 (D) Signup and view all the answers

What should be noted about the escalation schedule of lamotrigine in patients taking valproate?

.It involves a slower escalation due to decreased clearance (D) Signup and view all the answers