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Questions and Answers
Which mechanism is involved in the action of some anti-seizure drugs that prolong the inactivation of Na+ channels?
Which mechanism is involved in the action of some anti-seizure drugs that prolong the inactivation of Na+ channels?
- Inhibiting brain carbonic anhydrase enzyme
- Blocking Ca++ currents
- Increasing glutamate synaptic activity
- Enhancing GABA-mediated neuronal inhibition (correct)
What is the role of NMDA receptor antagonists in the context of anti-seizure drugs?
What is the role of NMDA receptor antagonists in the context of anti-seizure drugs?
- Inactivating voltage-gated Na+ channels
- Enhancing GABA-mediated neuronal inhibition
- Blocking Ca++ currents
- Increasing glutamate synaptic activity (correct)
How do some AEDs act on voltage-gated Na+ and Ca++ currents?
How do some AEDs act on voltage-gated Na+ and Ca++ currents?
- By inhibiting AMPA/kainate receptors
- By enhancing glutamate synaptic activity
- By blocking both currents (correct)
- By increasing GABA re-uptake in neurons
What effect do AEDs that inhibit brain carbonic anhydrase enzyme have on neurons?
What effect do AEDs that inhibit brain carbonic anhydrase enzyme have on neurons?
Which combination of mechanisms do some anti-seizure drugs act through?
Which combination of mechanisms do some anti-seizure drugs act through?
What is the initial therapy of choice for status epilepticus?
What is the initial therapy of choice for status epilepticus?
Which medication is recommended as the second therapy of choice for status epilepticus?
Which medication is recommended as the second therapy of choice for status epilepticus?
Why do neuromuscular blocking agents not stop seizures in status epilepticus?
Why do neuromuscular blocking agents not stop seizures in status epilepticus?
What can happen when patients on chronic anticonvulsant therapy take drugs that are highly protein bound?
What can happen when patients on chronic anticonvulsant therapy take drugs that are highly protein bound?
Which side effects are considered dose-related in antiepileptic drugs?
Which side effects are considered dose-related in antiepileptic drugs?
How do antiepileptic drugs exert their anticonvulsant activity?
How do antiepileptic drugs exert their anticonvulsant activity?
What is the primary mechanism of action for oxcarbazepine?
What is the primary mechanism of action for oxcarbazepine?
What is a common adverse effect associated with chronic valproate therapy?
What is a common adverse effect associated with chronic valproate therapy?
What is the recommended monitoring for patients on valproate therapy?
What is the recommended monitoring for patients on valproate therapy?
Which of the following is a non-dose-related adverse effect of valproate?
Which of the following is a non-dose-related adverse effect of valproate?
Why is valproate contraindicated in pregnancy?
Why is valproate contraindicated in pregnancy?
Which of the following is NOT a common side effect associated with chronic administration of phenobarbital?
Which of the following is NOT a common side effect associated with chronic administration of phenobarbital?
What is the mechanism of action of ethosuximide in treating absence seizures?
What is the mechanism of action of ethosuximide in treating absence seizures?
Which of the following is NOT a clinical use of valproate sodium or valproic acid?
Which of the following is NOT a clinical use of valproate sodium or valproic acid?
What is the primary route of metabolism for valproate sodium or valproic acid?
What is the primary route of metabolism for valproate sodium or valproic acid?
Which of the following statements about primidone is TRUE?
Which of the following statements about primidone is TRUE?
What is the primary mechanism of action of valproate sodium or valproic acid in treating seizures?
What is the primary mechanism of action of valproate sodium or valproic acid in treating seizures?
Which of the following statements about the pharmacokinetics of ethosuximide is TRUE?
Which of the following statements about the pharmacokinetics of ethosuximide is TRUE?
Which of the following is a potential drug-drug interaction associated with valproate sodium or valproic acid?
Which of the following is a potential drug-drug interaction associated with valproate sodium or valproic acid?
What is the approximate half-life of valproate sodium or valproic acid?
What is the approximate half-life of valproate sodium or valproic acid?
Which of the following statements about the absorption of valproate sodium or valproic acid is TRUE?
Which of the following statements about the absorption of valproate sodium or valproic acid is TRUE?
What is the mechanism of action for phenobarbital?
What is the mechanism of action for phenobarbital?
Which of the following is NOT a common adverse effect of phenytoin (Dilantin®)?
Which of the following is NOT a common adverse effect of phenytoin (Dilantin®)?
What is the primary advantage of fosphenytoin (Cerebyx®) over phenytoin?
What is the primary advantage of fosphenytoin (Cerebyx®) over phenytoin?
Which of the following statements about carbamazepine (Tegretol®) is FALSE?
Which of the following statements about carbamazepine (Tegretol®) is FALSE?
Which of the following statements about the interaction between phenytoin/carbamazepine and nondepolarizing neuromuscular blockers is TRUE?
Which of the following statements about the interaction between phenytoin/carbamazepine and nondepolarizing neuromuscular blockers is TRUE?
Which of the following statements about phenobarbital is FALSE?
Which of the following statements about phenobarbital is FALSE?
Which of the following statements about phenobarbital is TRUE?
Which of the following statements about phenobarbital is TRUE?
Which of the following adverse effects is NOT associated with carbamazepine (Tegretol®)?
Which of the following adverse effects is NOT associated with carbamazepine (Tegretol®)?
What is the recommended rate of administration for the fosphenytoin loading dose?
What is the recommended rate of administration for the fosphenytoin loading dose?
Which of the following statements about the pharmacokinetics of carbamazepine is TRUE?
Which of the following statements about the pharmacokinetics of carbamazepine is TRUE?
Oxcarbazepine undergoes auto-induction like carbamazepine.
Oxcarbazepine undergoes auto-induction like carbamazepine.
Lamotrigine is an inducer or inhibitor of the CYP450 enzyme system.
Lamotrigine is an inducer or inhibitor of the CYP450 enzyme system.
Hyponatremia (SIADH) is more common with oxcarbazepine compared to carbamazepine.
Hyponatremia (SIADH) is more common with oxcarbazepine compared to carbamazepine.
Levetiracetam belongs to the 'racetam' class of compounds and is available in both intravenous and oral formulations.
Levetiracetam belongs to the 'racetam' class of compounds and is available in both intravenous and oral formulations.
Lamotrigine decreases the presynaptic release of inhibitory amino acids like GABA.
Lamotrigine decreases the presynaptic release of inhibitory amino acids like GABA.
Carbamazepine and oxcarbazepine are both sodium channel blockers with similar mechanisms of action.
Carbamazepine and oxcarbazepine are both sodium channel blockers with similar mechanisms of action.
Valproic acid increases the metabolism and decreases the serum concentration of lamotrigine.
Valproic acid increases the metabolism and decreases the serum concentration of lamotrigine.
The primary route of metabolism for valproate is via the liver's CYP450 enzymes.
The primary route of metabolism for valproate is via the liver's CYP450 enzymes.
Oxcarbazepine is both an enzyme inducer of CYP3A4/5 and UGT, as well as an inhibitor of some CYP450 enzymes.
Oxcarbazepine is both an enzyme inducer of CYP3A4/5 and UGT, as well as an inhibitor of some CYP450 enzymes.
Which mechanism of action involves enhancing GABA-mediated neuronal inhibition?
Which mechanism of action involves enhancing GABA-mediated neuronal inhibition?
What is the primary effect of agents that prolong the inactivation of Na+ channels?
What is the primary effect of agents that prolong the inactivation of Na+ channels?
Which type of drug is more likely to act through a combination of mechanisms?
Which type of drug is more likely to act through a combination of mechanisms?
What is the effect of inactivating either voltage-gated Na+ or Ca++ currents via blockade?
What is the effect of inactivating either voltage-gated Na+ or Ca++ currents via blockade?
Which action is associated with AEDs that enhance Na+ channel inactivation?
Which action is associated with AEDs that enhance Na+ channel inactivation?
How do AEDs inhibiting brain carbonic anhydrase enzyme impact neuronal activity?
How do AEDs inhibiting brain carbonic anhydrase enzyme impact neuronal activity?
What is the primary mechanism of action of valproate sodium or valproic acid in treating seizures?
What is the primary mechanism of action of valproate sodium or valproic acid in treating seizures?
What is a common adverse effect associated with chronic valproate therapy?
What is a common adverse effect associated with chronic valproate therapy?
How do antiepileptic drugs exert their anticonvulsant activity?
How do antiepileptic drugs exert their anticonvulsant activity?
Which side effects are considered dose-related in antiepileptic drugs?
Which side effects are considered dose-related in antiepileptic drugs?
What will happen to the plasma concentrations of medications metabolized by UGT and CYP450 enzymes when co-administered with valproate sodium or valproic acid?
What will happen to the plasma concentrations of medications metabolized by UGT and CYP450 enzymes when co-administered with valproate sodium or valproic acid?
Which of the following statements about the pharmacokinetics of ethosuximide is TRUE?
Which of the following statements about the pharmacokinetics of ethosuximide is TRUE?
What is the mechanism of action of ethosuximide in treating absence seizures?
What is the mechanism of action of ethosuximide in treating absence seizures?
Which of the following statements about primidone is TRUE?
Which of the following statements about primidone is TRUE?
Which adverse effect is MORE COMMON with oxcarbazepine compared to carbamazepine?
Which adverse effect is MORE COMMON with oxcarbazepine compared to carbamazepine?
What is a potential cross-reactivity percentage of patients with hypersensitivity to carbamazepine that will have hypersensitivity to oxcarbazepine?
What is a potential cross-reactivity percentage of patients with hypersensitivity to carbamazepine that will have hypersensitivity to oxcarbazepine?
Which enzyme system is oxcarbazepine an inducer of?
Which enzyme system is oxcarbazepine an inducer of?
What is the primary clinical use of lamotrigine?
What is the primary clinical use of lamotrigine?
Which drug decreases the serum concentration and half-life of lamotrigine?
Which drug decreases the serum concentration and half-life of lamotrigine?
Which anti-seizure drug is known for causing fatal or life-threatening hypersensitivity reactions like Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)?
Which anti-seizure drug is known for causing fatal or life-threatening hypersensitivity reactions like Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)?
What is the main adverse effect associated with levetiracetam at high doses?
What is the main adverse effect associated with levetiracetam at high doses?
What is the mechanism responsible for the nonlinear (Michaelis-Menten) pharmacokinetics of phenytoin at higher plasma concentrations?
What is the mechanism responsible for the nonlinear (Michaelis-Menten) pharmacokinetics of phenytoin at higher plasma concentrations?
Which of the following patient populations is likely to have a higher free (unbound) fraction of phenytoin in the plasma?
Which of the following patient populations is likely to have a higher free (unbound) fraction of phenytoin in the plasma?
Which of the following statements regarding phenytoin's pharmacokinetics is correct?
Which of the following statements regarding phenytoin's pharmacokinetics is correct?
Which of the following adverse effects of phenytoin is most likely to be dose-related?
Which of the following adverse effects of phenytoin is most likely to be dose-related?
What is the primary reason for phenytoin's potent enzyme-inducing effects?
What is the primary reason for phenytoin's potent enzyme-inducing effects?
Which of the following statements regarding the excretion of phenytoin is correct?
Which of the following statements regarding the excretion of phenytoin is correct?
Which of the following factors is least likely to affect the therapeutic range of phenytoin?
Which of the following factors is least likely to affect the therapeutic range of phenytoin?
Which of the following statements regarding the pharmacokinetics of phenytoin is false?
Which of the following statements regarding the pharmacokinetics of phenytoin is false?
Which statement about benzodiazepines is correct?
Which statement about benzodiazepines is correct?
What is the primary mechanism of action for phenytoin (Dilantin®)?
What is the primary mechanism of action for phenytoin (Dilantin®)?
Which of the following statements about lorazepam is true?
Which of the following statements about lorazepam is true?
Which statement about the teratogenic effects of antiepileptic drugs (AEDs) is correct?
Which statement about the teratogenic effects of antiepileptic drugs (AEDs) is correct?
Which statement about the classification of antiepileptic drugs (AEDs) is correct?
Which statement about the classification of antiepileptic drugs (AEDs) is correct?
Which statement about diazepam is true?
Which statement about diazepam is true?
How do some anti-seizure drugs enhance GABA synaptic transmission?
How do some anti-seizure drugs enhance GABA synaptic transmission?
Which statement about the metabolism of benzodiazepines is correct?
Which statement about the metabolism of benzodiazepines is correct?
What is the duration criterion for a seizure to be classified as status epilepticus?
What is the duration criterion for a seizure to be classified as status epilepticus?
What is considered a neurologic emergency that requires prompt treatment to prevent permanent neurologic damage?
What is considered a neurologic emergency that requires prompt treatment to prevent permanent neurologic damage?
Which organ system can be significantly impacted when status epilepticus occurs due to its effect on ventilation?
Which organ system can be significantly impacted when status epilepticus occurs due to its effect on ventilation?
What is the potential consequence when seizures last more than 30 to 60 minutes?
What is the potential consequence when seizures last more than 30 to 60 minutes?
Why is status epilepticus considered a neurologic emergency?
Why is status epilepticus considered a neurologic emergency?
In what timeframe should treatment be initiated for status epilepticus?
In what timeframe should treatment be initiated for status epilepticus?
What is the mechanism by which some anti-seizure drugs enhance Na+ channel inactivation?
What is the mechanism by which some anti-seizure drugs enhance Na+ channel inactivation?
Which of the following statements accurately describes the mechanism of action of NMDA receptor antagonists?
Which of the following statements accurately describes the mechanism of action of NMDA receptor antagonists?
Which of the following mechanisms is NOT mentioned as a mode of action for anti-seizure drugs?
Which of the following mechanisms is NOT mentioned as a mode of action for anti-seizure drugs?
Which class of anti-seizure drugs acts by enhancing GABA reuptake?
Which class of anti-seizure drugs acts by enhancing GABA reuptake?
What is the significance of the inactivated Na+ channel remaining open but blocked by the inactivation gate?
What is the significance of the inactivated Na+ channel remaining open but blocked by the inactivation gate?
Which of the following statements accurately describes the mechanism of action of AMPA/kainate receptor antagonists?
Which of the following statements accurately describes the mechanism of action of AMPA/kainate receptor antagonists?
What will happen to the plasma concentrations of medications metabolized by UGT and CYP450 enzymes when co-administered with valproate sodium or valproic acid?
What will happen to the plasma concentrations of medications metabolized by UGT and CYP450 enzymes when co-administered with valproate sodium or valproic acid?
Which anti-seizure drug has been associated with potentially fatal hypersensitivity reactions like Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)?
Which anti-seizure drug has been associated with potentially fatal hypersensitivity reactions like Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)?
How does valproate sodium or valproic acid enhance GABA-mediated neuronal inhibition?
How does valproate sodium or valproic acid enhance GABA-mediated neuronal inhibition?
Which mechanism allows ethosuximide to specifically treat absence seizures?
Which mechanism allows ethosuximide to specifically treat absence seizures?
Which statement about the pharmacokinetics of primidone is TRUE?
Which statement about the pharmacokinetics of primidone is TRUE?
What adverse effect is considered a serious but extremely rare side effect of ethosuximide?
What adverse effect is considered a serious but extremely rare side effect of ethosuximide?
Which statement about the metabolism of oxcarbazepine is correct?
Which statement about the metabolism of oxcarbazepine is correct?
Which of the following adverse effects is more likely to occur with lamotrigine compared to carbamazepine?
Which of the following adverse effects is more likely to occur with lamotrigine compared to carbamazepine?
Which statement regarding the pharmacokinetics of lamotrigine is correct?
Which statement regarding the pharmacokinetics of lamotrigine is correct?
Which of the following statements about levetiracetam (Keppra®) is correct?
Which of the following statements about levetiracetam (Keppra®) is correct?
Which of the following adverse effects is NOT associated with oxcarbazepine (Trileptal®)?
Which of the following adverse effects is NOT associated with oxcarbazepine (Trileptal®)?
Which of the following statements about the pharmacokinetics of lamotrigine is correct?
Which of the following statements about the pharmacokinetics of lamotrigine is correct?
Which mechanism is associated with some anti-seizure drugs in enhancing GABA synaptic transmission?
Which mechanism is associated with some anti-seizure drugs in enhancing GABA synaptic transmission?
Which of the following statements regarding the teratogenic effects of antiepileptic drugs (AEDs) is correct?
Which of the following statements regarding the teratogenic effects of antiepileptic drugs (AEDs) is correct?
What is the primary mechanism of action for benzodiazepines in their anticonvulsant effects?
What is the primary mechanism of action for benzodiazepines in their anticonvulsant effects?
Which statement accurately describes the difference between diazepam and lorazepam in the treatment of status epilepticus?
Which statement accurately describes the difference between diazepam and lorazepam in the treatment of status epilepticus?
What is the primary mechanism of action for phenytoin (Dilantin®) in its anticonvulsant effects?
What is the primary mechanism of action for phenytoin (Dilantin®) in its anticonvulsant effects?
Which of the following statements accurately describes the classification of antiepileptic drugs (AEDs)?
Which of the following statements accurately describes the classification of antiepileptic drugs (AEDs)?
What will happen to the plasma concentrations of medications metabolized by UGT and CYP450 enzymes when co-administered with valproate sodium or valproic acid?
What will happen to the plasma concentrations of medications metabolized by UGT and CYP450 enzymes when co-administered with valproate sodium or valproic acid?
What is the potential consequence when seizures last more than 30 to 60 minutes?
What is the potential consequence when seizures last more than 30 to 60 minutes?
Which adverse effect is considered a serious but extremely rare side effect of ethosuximide?
Which adverse effect is considered a serious but extremely rare side effect of ethosuximide?
Which mechanism allows ethosuximide to specifically treat absence seizures?
Which mechanism allows ethosuximide to specifically treat absence seizures?
Which of the following is NOT a clinical use of valproate sodium or valproic acid?
Which of the following is NOT a clinical use of valproate sodium or valproic acid?
Which statement about the teratogenic effects of antiepileptic drugs (AEDs) is correct?
Which statement about the teratogenic effects of antiepileptic drugs (AEDs) is correct?
Which of the following statements about the pharmacokinetics of primidone is TRUE?
Which of the following statements about the pharmacokinetics of primidone is TRUE?
How do some AEDs act on voltage-gated Na+ and Ca++ currents?
How do some AEDs act on voltage-gated Na+ and Ca++ currents?
Which medication is recommended as the second therapy of choice for status epilepticus?
Which medication is recommended as the second therapy of choice for status epilepticus?
Which organ system can be significantly impacted when status epilepticus occurs due to its effect on ventilation?
Which organ system can be significantly impacted when status epilepticus occurs due to its effect on ventilation?
What is a potential life-threatening adverse effect associated with valproate sodium or valproic acid?
What is a potential life-threatening adverse effect associated with valproate sodium or valproic acid?
Which of the following is a dose-related adverse effect of chronic valproate therapy?
Which of the following is a dose-related adverse effect of chronic valproate therapy?
Why is valproate contraindicated during pregnancy?
Why is valproate contraindicated during pregnancy?
What is the primary pharmacologically active metabolite of Oxcarbazepine (Trileptal®)?
What is the primary pharmacologically active metabolite of Oxcarbazepine (Trileptal®)?
Which of the following is a non-dose related adverse effect of Valproate Sodium or Valproic Acid?
Which of the following is a non-dose related adverse effect of Valproate Sodium or Valproic Acid?
What is a serious but extremely rare adverse effect associated with ethosuximide?
What is a serious but extremely rare adverse effect associated with ethosuximide?
Which enzyme system is affected by valproate sodium or valproic acid leading to potential interactions with other medications?
Which enzyme system is affected by valproate sodium or valproic acid leading to potential interactions with other medications?
What is the main adverse effect that has been fatal in some cases associated with Oxcarbazepine (Trileptal®)?
What is the main adverse effect that has been fatal in some cases associated with Oxcarbazepine (Trileptal®)?
What are the CNS-related adverse effects associated with Valproate Sodium or Valproic Acid?
What are the CNS-related adverse effects associated with Valproate Sodium or Valproic Acid?
Study Notes
- Tolerance can develop with chronic administration of anti-epileptic drugs like Primidone, leading to side effects like nystagmus, ataxia, cognitive impairment, and respiratory depression.
- Phenobarbital, a metabolite of Primidone, can cause major fetal malformations.
- Ethosuximide, a succinimide class anti-epileptic drug, is primarily used for absence seizures and acts as a T-type Ca2+ channel blocker in thalamic neurons.
- Valproate Sodium or Valproic Acid, a broad-spectrum anti-seizure medication, is effective against various seizure types and is available in different formulations.
- Valproate Sodium increases GABA production, inhibits GABA metabolism, and has numerous drug interactions due to its enzyme inhibition properties.
- Benzodiazepines like Diazepam and Lorazepam potentiate GABA-mediated neuronal inhibition and are used for treating status epilepticus with different onset and duration of action.
- Phenytoin, an anti-epileptic agent, acts as a fast Na+ channel blocker and regulates neuronal excitability to prevent seizure spread.
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Description
Test your knowledge on the medications used for status epilepticus. Learn about the fast-acting and longer-acting agents to manage seizures effectively. Explore the initial and second-line therapies for status epilepticus.
