Epilepsy (Overview)
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Questions and Answers

Which type of seizure involves a loss of consciousness?

  • Generalized seizures
  • Focal aware seizures
  • Absence seizures
  • Focal impaired awareness seizures (correct)

    • What is the initial treatment for status epilepticus (SE) within the first 5-20 minutes?

  • Intramuscular midazolam (Versed)
  • Diazepam rectal gel (Diastat AcuDial)
  • Intravenous lorazepam (Ativan) (correct)
  • Intravenous fosphenytoin

    • Which test is often used to accurately diagnose epilepsy?

  • Blood test
  • Electroencephalogram (EEG) test (correct)
  • CT scan
  • MRI scan

    • What is the term for seizures that originate from one side of the brain and may spread to other areas?

    <p>Focal seizures</p> Signup and view all the answers

    What is the term for seizures that simultaneously involve both sides of the brain?

    <p>Generalized seizures</p> Signup and view all the answers

    What is the term for seizures characterized by 'staring spells'?

    <p>Absence seizures</p> Signup and view all the answers

    What is the term for a seizure that lasts for an extended period, exceeding five minutes?

    <p>Status epilepticus (SE)</p> Signup and view all the answers

    Which drug is classified as a calcium blocker that increases the activity of gamma-aminobutyric acid (GABA) in the brain?

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

    Which drug works by blocking sodium channels in the brain?

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

    Which drug aims to maintain therapeutic levels between 4-12 mcg/mL?

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

    Which drug is a potent cytochrome P450 inducer and can decrease the levels of other drugs, including itself?

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

    Which drug is a sodium and calcium blocker?

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

    Which drug has formulations such as chewable tablets, orally disintegrating tablets (ODT), and regular tablets?

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

    Which drug has black box warnings that include psychiatric reactions such as psychotic symptoms, somnolence, and fatigue?

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

    Which of the following medications has a black box warning for Habit Forming, Respiratory Depression, Fetal Harm, and SJS/TEN?

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

    Which medication should be monitored for sodium levels due to the risk of hyponatremia?

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

    Which medication has a narrow therapeutic window with goal trough levels of 10 - 20 mcg/mL and free trough levels of 1 - 2.5 mcg/mL?

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

    Which medication is contraindicated with HLA-B*1502 Test (Asians), Fetal Harm, and Blood Dyscrasias?

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

    Which medication has a black box warning for metabolic acidosis, oligohydrosis, nephrolithiasis, and fetal harm?

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

    Which medication has a goal therapeutic level between 50-100 mcg/mL?

    <p>Valproic acid</p> Signup and view all the answers

    Which medication has common side effects of weight gain, CNS effects, and edema?

    <p>Valproic acid</p> Signup and view all the answers

    Which anti-epileptic drug (AED) is specifically used for absence seizures?

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

    Which AED is a pro-drug of phenobarbital and is used to manage partial and generalized seizures?

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

    Which AED carries a black box warning (BBW) for the risk of hepatic failure and aplastic anemia?

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

    Which AED is primarily used in the treatment of infantile spasms and refractory partial seizures?

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

    Which AED works by blocking sodium channels in the brain?

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

    Which AED is used to treat seizures associated with Lennox-Gastaut syndrome (LGS)?

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

    Which AED is indicated for the treatment of partial-onset seizures and primary generalized tonic-clonic seizures?

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

    Which AED is approved for the treatment of partial seizures?

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

    Which AED is prescribed for the treatment of refractory epilepsy and carries a black box warning (BBW) for the risk of permanent vision loss?

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

    True or false: Focal aware seizures involve a loss of consciousness.

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

    True or false: Generalized seizures involve both sides of the brain.

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

    True or false: Status epilepticus is a medical emergency that lasts for less than five minutes.

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

    True or false: Levetiracetam, sold under the brand name Keppra, is classified as a sodium blocker.

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

    True or false: Lamotrigine works by blocking calcium channels in the brain.

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

    True or false: Carbamazepine is contraindicated with MAOis, nefazodone, and NNRTIs.

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

    True or false: Oxcarbazepine is primarily used in the treatment of infantile spasms and refractory partial seizures.

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

    True or false: Clobazam is an AED used to treat seizures associated with Lennox-Gastaut syndrome (LGS).

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

    True or false: Brivaracetam has shown efficacy in reducing partial-onset seizures.

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

    True or false: Perampanel is indicated for the treatment of primary generalized tonic-clonic seizures.

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

    True or false: Rufinamide is primarily used to manage seizures associated with Lennox-Gastaut syndrome.

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

    True or false: Lacosamide is a sodium blocker.

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

    True or false: Topiramate has a black box warning for metabolic acidosis, oligohydrosis, nephrolithiasis, and fetal harm.

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

    True or false: Valproic acid and divalproex are contraindicated with hyperammonemia, thrombocytopenia, and lamotrigine.

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

    True or false: Oxcarbazepine can cause hyponatremia and should be monitored for sodium levels.

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

    What is the term for a seizure that lasts for an extended period, exceeding five minutes?

    <p>status epilepticus</p> Signup and view all the answers

    Which drug is commonly used for the initial treatment of status epilepticus within the first 5-20 minutes?

    <p>intravenous lorazepam (Ativan)</p> Signup and view all the answers

    What is the name of the test often used to accurately diagnose epilepsy?

    <p>electroencephalogram (EEG)</p> Signup and view all the answers

    Which two anti-epileptic drugs (AEDs) are sodium blockers?

    <p>Phenytoin and fosphenytoin.</p> Signup and view all the answers

    Which AED carries a black box warning for the risk of hepatic failure, fetal harm, and neural tube defects in pregnancy?

    <p>Valproic acid and divalproex.</p> Signup and view all the answers

    What are the common side effects of lacosamide?

    <p>Nausea, diplopia (double vision), and blurred vision.</p> Signup and view all the answers

    What is the goal therapeutic level for phenobarbital in adults and children?

    <p>20-40 mcg/mL in adults and 15-40 mcg/mL in children.</p> Signup and view all the answers

    What is the mechanism of action of eslicarbazepine?

    <p>Eslicarbazepine works by blocking sodium channels in the brain.</p> Signup and view all the answers

    What are the potential side effects of ethosuximide?

    <p>Common adverse reactions of ethosuximide include nausea, vomiting, abdominal pain, weight loss, and hiccups.</p> Signup and view all the answers

    Which AED is approved for the treatment of refractory epilepsy?

    <p>Felbamate, available as Felbatol, is an AED approved for the treatment of refractory epilepsy.</p> Signup and view all the answers

    What are the potential side effects of zonisamide?

    <p>Adverse effects of zonisamide include risk of sulfonamide allergy, oligohydrosis (decreased sweating), hyperthermia (elevated body temperature), and nephrolithiasis (kidney stones).</p> Signup and view all the answers

    What are some drugs and medical conditions that can lower the seizure threshold?

    <p>Antipsychotics, antivirals, bupropion, carbapenems (esp. imipenem), cephalosporins, alcohol withdrawal, lithium, lindane, mefloquine, meperidine, metoclopramide, Penicillins, fluoroquinolones, infections and fever, theophylline, tramadol, and varenicline.</p> Signup and view all the answers

    What factors should be taken into account when selecting an anti-epileptic drug (AED)?

    <p>Seizure type, age, pregnancy, and potential side effects.</p> Signup and view all the answers

    What are some potential side effects of levetiracetam?

    <p>Irritability, dizziness, weakness, and asthenia.</p> Signup and view all the answers

    How does lamotrigine work?

    <p>By blocking sodium channels in the brain.</p> Signup and view all the answers

    Match the following types of seizures with their correct descriptions:

    <p>Focal aware seizures = Seizures that do not involve a loss of consciousness Focal impaired awareness seizures = Seizures that are characterized by a loss of consciousness Generalized seizures = Seizures that simultaneously involve both sides of the brain Absence seizures = Seizures that are often characterized by 'staring spells'</p> Signup and view all the answers

    Match the following drugs with their correct classification:

    <p>Levetiracetam = Not a sodium blocker Lacosamide = Not a sodium blocker Eslicarbazepine = Not a sodium blocker Rufinamide = Not a sodium blocker</p> Signup and view all the answers

    Match the following drugs with their correct potential side effects:

    <p>Oxcarbazepine = Can cause hyponatremia and should be monitored for sodium levels Lacosamide = Common side effects include weight gain, CNS effects, and edema Topiramate = Has a black box warning for metabolic acidosis, oligohydrosis, nephrolithiasis, and fetal harm Zonisamide = Potential side effects include weight loss, kidney stones, and cognitive issues</p> Signup and view all the answers

    Match the following anti-epileptic drugs (AEDs) with their mechanisms of action:

    <p>Levetiracetam = Calcium blocker that increases the activity of gamma-aminobutyric acid (GABA) in the brain Lamotrigine = Blocks sodium channels in the brain Carbamazepine = Sodium blocker Oxcarbazepine = Sodium and calcium blocker</p> Signup and view all the answers

    Match the following anti-epileptic drugs (AEDs) with their common side effects:

    <p>Levetiracetam = Irritability, dizziness, weakness, and asthenia Lamotrigine = Rash, nausea, somnolence, and dizziness Carbamazepine = Nausea, dry mouth, rash, photosensitivity, and blurred vision Oxcarbazepine = No significant drug interactions</p> Signup and view all the answers

    Match the following anti-epileptic drugs (AEDs) with their black box warnings:

    <p>Levetiracetam = Psychiatric reactions such as psychotic symptoms, somnolence, and fatigue Lamotrigine = Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) Carbamazepine = Aplastic anemia, agranulocytosis, SJS/TEN (Asian HLA-B*1502 testing) Oxcarbazepine = No significant drug interactions</p> Signup and view all the answers

    Match the following anti-epileptic drugs (AEDs) with their key characteristics:

    <p>Clobazam = Used to treat seizures associated with Lennox-Gastaut syndrome (LGS) Brivaracetam = Has shown efficacy in reducing partial-onset seizures Eslicarbazepine = Marketed as Aptiom, it is an active metabolite of oxcarbazepine and works by blocking sodium channels in the brain Vigabatrin = Marketed as Sabril, it has a black box warning (BBW) for the risk of permanent vision loss</p> Signup and view all the answers

    Match the following anti-epileptic drugs (AEDs) with their potential drug interactions:

    <p>Levetiracetam = No significant drug interactions Lamotrigine = Increased by valproic acid Carbamazepine = Potent cytochrome P450 inducer and can decrease the levels of other drugs, including itself Oxcarbazepine = No significant drug interactions</p> Signup and view all the answers

    Match the following AEDs with their potential side effects:

    <p>Gabapentin = Peripheral edema, weight gain, and mild euphoria Zonisamide = Risk of sulfonamide allergy, oligohydrosis, hyperthermia, and nephrolithiasis Ethosuximide = Nausea, vomiting, abdominal pain, weight loss, and hiccups Pregabalin = Peripheral edema, weight gain, and mild euphoria</p> Signup and view all the answers

    Match the following AEDs with their specific usage:

    <p>Primidone = Used in the treatment of various types of seizures, and is a pro-drug of phenobarbital Felbamate = Approved for the treatment of refractory epilepsy, but carries a black box warning (BBW) for the risk of hepatic failure and aplastic anemia Tiagabine = Approved for the treatment of partial seizures Rufinamide = Commonly used to manage seizures associated with Lennox-Gastaut syndrome</p> Signup and view all the answers

    Match the following AEDs with their brand names:

    <p>Perampanel = Fycompa Gabapentin = Neurontin Clobazam = Onfi Eslicarbazepine = Aptiom</p> Signup and view all the answers

    Match the following anti-epileptic drugs (AEDs) with their potential side effects:

    <p>Oxcarbazepine = Nausea, somnolence, dizziness, and visual disturbances Phenobarbital = Physiological dependence, tolerance, hangover-like symptoms, and CNS effects Phenytoin and Fosphenytoin = Nystagmus, ataxia, diplopia, blurred vision, gingival hyperplasia, hair growth, and hepatotoxicity Lacosamide = Nausea, diplopia (double vision), and blurred vision</p> Signup and view all the answers

    Match the following anti-epileptic drugs (AEDs) with their black box warnings:

    <p>Phenobarbital = Habit Forming, Respiratory Depression, Fetal Harm, and SJS/TEN Phenytoin and Fosphenytoin = HLA-B*1502 Test (Asians), Fetal Harm, Blood Dyscrasias Valproic Acid and Divalproex = Hepatic failure, fetal harm, and neural tube defects in pregnancy Topiramate = Metabolic acidosis, oligohydrosis (reduced sweating), nephrolithiasis, hyperammonemia, and fetal harm</p> Signup and view all the answers

    Match the following anti-epileptic drugs (AEDs) with their contraindications:

    <p>Phenytoin and Fosphenytoin = HLA-B<em>1502 Test (Asians), Fetal Harm, Blood Dyscrasias Valproic Acid and Divalproex = Hyperammonemia (elevated ammonia levels), thrombocytopenia (low platelet count), and lamotrigine due risk of serious rash Lacosamide = Potential to prolong the PR-interval and increase the risk of arrhythmias Oxcarbazepine = HLA-B</em>1502 Test (Asians) and hyponatremia</p> Signup and view all the answers

    Match the following anti-epileptic drugs (AEDs) with their goal therapeutic levels:

    <p>Phenobarbital = 20-40 mcg/ml in adults and 15-40 mcg/ml in children Phenytoin and Fosphenytoin = 10 - 20 mcg/mL (trough levels) and 1 - 2.5 mcg/mL (free trough levels) Valproic Acid and Divalproex = 50-100 mcg/mL Lacosamide = Not mentioned in the text</p> Signup and view all the answers

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