epilepsy
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Questions and Answers

Which of the following drugs can induce the metabolism of carbamazepine?

  • CYP3A4 inhibitors
  • Propoxyphene, troleandomycin, and valproic acid
  • Primidone, phenytoin, ethosuximide, valproic acid, and clonazepam
  • Phenytoin and phenobarbital (correct)
  • What is the effect of phenytoin and phenobarbital on the steady-state concentration of carbamazepine?

  • They decrease the steady-state concentration of carbamazepine by enzyme induction (correct)
  • They have no effect on the steady-state concentration of carbamazepine
  • They increase the steady-state concentration of carbamazepine
  • They inhibit the clearance of carbamazepine and increase its steady-state levels
  • Which of the following drugs may inhibit the clearance of carbamazepine and increase its steady-state levels?

  • CYP3A4 inhibitors
  • Propoxyphene, troleandomycin, and valproic acid (correct)
  • Primidone, ethosuximide, and clonazepam
  • Phenytoin and phenobarbital
  • Which of the following is a concentration-dependent adverse reaction of carbamazepine?

    <p>Diplopia, dizziness, unsteadiness, drowsiness, nausea</p> Signup and view all the answers

    What is the mechanism of action of phenytoin?

    <p>It inhibits voltage-gated Na+ channels</p> Signup and view all the answers

    At what serum concentration can phenytoin exacerbate seizures?

    <p>Greater than 50 µg/mL</p> Signup and view all the answers

    What is the most important aspect of ASD use according to the text?

    <p>Individualization of therapy</p> Signup and view all the answers

    In the context of elderly patients, what is a common issue related to hypoalbuminemia?

    <p>Problems with highly bound ASDs</p> Signup and view all the answers

    Why might the elderly require dosage adjustments for ASDs according to the text?

    <p>Compromised renal or hepatic function</p> Signup and view all the answers

    Which factor is NOT considered in the individualization of therapy for ASD use?

    <p>Seizure type</p> Signup and view all the answers

    What issue do polytherapy and hypoalbuminemia in the elderly potentially contribute to?

    <p>Drug-drug interactions with ASDs</p> Signup and view all the answers

    For women of child-bearing potential, which type of ASD should be avoided?

    <p>ASDs that are teratogenic (can cause birth defects)</p> Signup and view all the answers

    Which factor should be considered when selecting an antiseizure drug (ASD) for a child?

    <p>The child's susceptibility to neuropsychiatric adverse effects</p> Signup and view all the answers

    When selecting an ASD for an elderly patient, which factor should be considered?

    <p>The patient's susceptibility to adverse effects on cognition</p> Signup and view all the answers

    If a patient has a co-morbid condition, such as migraine headaches, which type of ASD may be beneficial?

    <p>An ASD that can also treat the co-morbid condition</p> Signup and view all the answers

    What should be done when starting a patient on an ASD?

    <p>Start with a low dose and gradually titrate to a moderate dose goal</p> Signup and view all the answers

    If a patient is seizure-free with no adverse effects at a moderate therapeutic dose of an ASD, what should be done?

    <p>No further increase in dose is necessary</p> Signup and view all the answers

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