Term
| T/F: Phenytoin is mostly plasma protein bound |
|
Definition
|
|
Term
| Therapeutic levels of phenytoin? |
|
Definition
Total: 10-20 mcg/mL
Free: 1-2 mcg/mL |
|
|
Term
| What diluent is co-formulated in the injectable formulation of phenytoin? |
|
Definition
| Ethylene glycol- rate-related hypotension risk |
|
|
Term
| Can phenytoin be administered IM? |
|
Definition
|
|
Term
| What vitamin should be administered with long-term phenytoin therapy? |
|
Definition
|
|
Term
| How is fosphenytoin diff from phenytoin? |
|
Definition
No ethyelne glycol diluent- no hypotension related to rate
Can be administered IM |
|
|
Term
| Therapeutic level of carbamazepine? |
|
Definition
|
|
Term
| What blood test should be routinely monitored in pts taking carbamazepine? |
|
Definition
|
|
Term
| Which gene may be associated with the rash caused by carbamazepine? |
|
Definition
|
|
Term
| Which anticonvulsant has the longest half life (75-125 hrs)? |
|
Definition
|
|
Term
| What blood levels need to be monitored in pts taking topiramate? |
|
Definition
| Serum bicarbonate (it is a carbonic anhydrase inhibitor) |
|
|
Term
| Do we need to monitor blood levels of levetiracetam? |
|
Definition
|
|
Term
| T/F: levetiracetam is 100% bioavailable |
|
Definition
|
|
Term
| Which anticonvulsant should be avoided in pts w/ history of psychiatric disorder? |
|
Definition
|
|
Term
| Which drug binds to SV2A receptor better: levetiracetam or brivaracetam? |
|
Definition
|
|
Term
| What lab test should be monitored in pts on Na channel antagonists? |
|
Definition
| EKG- may prolong PR interval |
|
|
Term
| Therapeutic level of ethosuximide? |
|
Definition
|
|
Term
| What other anticonvulsant can decrease ethosuximide metabolism? |
|
Definition
|
|
Term
| Therapeutic range of felbamate? |
|
Definition
|
|
Term
| Therapeutic level of lamotrigine? |
|
Definition
|
|
Term
| Therapeutic level of VPA? |
|
Definition
|
|
Term
| What blood test should be monitored in pts taking VPA? |
|
Definition
|
|
Term
| Which anticonvulsant is usually reserved for treatment of acute seizures due to tachyphylaxis? |
|
Definition
|
|
Term
| Order of IV therapy in acute status epilepticus? |
|
Definition
| Benzodiazepines > Na channel blockers (phenytoin)/barbiturate > VPA/levetiracetam/lacosamide > REFRACTORY status epilepticus = continuous propofol or ketamine |
|
|
Term
| Which anticonvulsants reduce the effectiveness of oral contraceptives? |
|
Definition
Carbamazepine
• Oxcarbazepine
• Phenytoin
• Phenobarbital
• Topiramate >200
mg/day |
|
|
Term
| Which anticonvulsants do not interact w/ oral contraceptive therapy? |
|
Definition
• Gabapentin
• Lamotrigine
• Levetiracetam |
|
|
Term
| Which anticonvulsants should be avoided in a woman prior to conception? |
|
Definition
| VPA. phenytoin, phenobarbital |
|
|
Term
| What type of seizures are more likely to relapse upon w/drawal of medication? |
|
Definition
|
|
Term
| How long should a pt be seizure-free before considering withdrawal of medication? |
|
Definition
|
|
Term
| First-line in tx of acute headaches? |
|
Definition
|
|
Term
| Which two triptans can be administered intranasally? |
|
Definition
| Sumatriptan, zolmitriptan |
|
|
Term
| Which triptan has the longest half-life? |
|
Definition
|
|
Term
| Which anticonvulsant is associated w/ metabolic acidosis? |
|
Definition
|
|
Term
| Which anticonvulsant can coarsen facial features over time? |
|
Definition
|
|
Term
| Which anticonvulsants can prolong the PR interval? |
|
Definition
|
|
Term
| What anticonvulsant drug classes are directly and indirectly GABAergic? |
|
Definition
Direct- barbiturates
Indirect (allosteric)- benzodiazepines |
|
|
Term
| MOA of gabapentin/pregabalin? |
|
Definition
| Inhibit alpha-2-delta Ca++ receptors |
|
|
Term
| What anticonvulsant drug is a K+ channel blocker? |
|
Definition
|
|
Term
| MOA of levetiracetam, brivaracetam? |
|
Definition
| Bind to synaptic vesicle (SV2a)- prevent release of glutamate |
|
|
Term
| Which anticonvulsant can cause hyperammonemia? |
|
Definition
|
|
Term
| MOA and indication of ethosuximide? |
|
Definition
Indication- absence
MOA: selectively inhibits Ca++ channels |
|
|
Term
| Which headache medication should be avoided in pts with WPW (wolff-parkinson white) syndrome? |
|
Definition
|
|
Term
|
Definition
| Serotonin 1d/1b agonists- prevent vasodilation |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Serotonin 1d agonists --> vasoconstriction |
|
|
Term
|
Definition
|
|
