17 Questions
Which of the following drugs can induce the metabolism of carbamazepine?
Phenytoin and phenobarbital
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
Which of the following drugs may inhibit the clearance of carbamazepine and increase its steady-state levels?
Propoxyphene, troleandomycin, and valproic acid
Which of the following is a concentration-dependent adverse reaction of carbamazepine?
Diplopia, dizziness, unsteadiness, drowsiness, nausea
What is the mechanism of action of phenytoin?
It inhibits voltage-gated Na+ channels
At what serum concentration can phenytoin exacerbate seizures?
Greater than 50 µg/mL
What is the most important aspect of ASD use according to the text?
Individualization of therapy
In the context of elderly patients, what is a common issue related to hypoalbuminemia?
Problems with highly bound ASDs
Why might the elderly require dosage adjustments for ASDs according to the text?
Compromised renal or hepatic function
Which factor is NOT considered in the individualization of therapy for ASD use?
Seizure type
What issue do polytherapy and hypoalbuminemia in the elderly potentially contribute to?
Drug-drug interactions with ASDs
For women of child-bearing potential, which type of ASD should be avoided?
ASDs that are teratogenic (can cause birth defects)
Which factor should be considered when selecting an antiseizure drug (ASD) for a child?
The child's susceptibility to neuropsychiatric adverse effects
When selecting an ASD for an elderly patient, which factor should be considered?
The patient's susceptibility to adverse effects on cognition
If a patient has a co-morbid condition, such as migraine headaches, which type of ASD may be beneficial?
An ASD that can also treat the co-morbid condition
What should be done when starting a patient on an ASD?
Start with a low dose and gradually titrate to a moderate dose goal
If a patient is seizure-free with no adverse effects at a moderate therapeutic dose of an ASD, what should be done?
No further increase in dose is necessary
Learn about the importance of periodically screening for co-morbid neuropsychiatric disorders such as depression and anxiety in individuals with ASD, as well as the key considerations for personalized pharmacotherapy. Explore factors like seizure type, concomitant medical issues, concurrent medications, and patient-specific characteristics.
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