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52 Cards in this Set
- Front
- Back
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which anti-seizure medications are for ABSENCE
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Ethosuxamide
Lamotrigine Valproate |
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what is the range for Carbamazepine
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4-12
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what is the range for phenytoin
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10-20
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which drug has the indication of alcohol prophylaxis
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carbamazepine
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name the anti-seizure medications that work by ehancing FAST sodium channel inactivation
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Carbamazepine
Oxcarbazepine Phenytoin Fosphenytoin Rufinamide Lamotrigine Topiramate Valproic Acid |
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MOA of inhibition of glutamate release by binding the synaptic vesicles in SV2A
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Levetiracetam
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which drug binds to the collapsing-response mediator PRO 2 (CRMP-2)
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Lacosamide
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what is the potential benefit of binds to the collapsing-response mediator PRO 2 (CRMP-2)
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prevents neuronal rewiring
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which is a weak carbonic anhydrase inhibitor
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Topiramate & Zonisamide
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what drug decreases glutamate and aspartate release
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Lamotrigine
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what drug increases GABA mediated chloride influs
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phenobarbital
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what drug blocks GABA reuptake in the presynaptic neuron
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Tiagabine
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what drug antagonizes AMPA/kianite activity
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Topiramate
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which increases brain levels of GABA
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gabapentin
pregabalin |
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which drug has the indication of status epilepticus
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fosphenytoin
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used for lennos-gastaut
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Rufinamide
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what is used for adjunct therapy for partial-onset seizures
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Lacosamide
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other than seizure prophylaxis (for both parital and absence) what are the other indications
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bipolar
prevention of migraine HA |
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this drug is commonly used for postherpatic neuralgia & diabetic neuropathy
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pregabalin
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which drug causes rash in HLA-B*1502 (Asians)
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carbamazepine
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hyponatremia is more common in
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oxcarbomazepine
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what does the carbamazepine rash look like
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red maculopapular
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what is the cross reactivity of oxcarbamazepine and carbamazepine
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30%
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the use of any anti-epileptic increases the risk of what?
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suidiality behavor and ideation- doubles
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which USDA pregnancy category says "Controlled studies in women fail to demonstrate a risk to the fetus"
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A- human trials say A-OK no risk
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which USDA pregnancy category says"Risk of the use of the drug in pregnant women clearly outweighs any possible benefit. The drug is contraindicated in women who are or may become pregnant."
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X- no way no how
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which USDA pregnancy category says "Animal studies have not demonstrated a risk but no controlled studies in pregnant women OR animal studies have shown adverse effect that was not confirmed in controlled studies in women
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B- no ADR in animals and no human trials
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which USDA pregnancy category says "Studies in animals show adverse effects and no controlled studies in women OR studies in women and animals are not available"
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C- ADR in animals and no human trials
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USDA category "There is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk "
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D-human risk, but benefits may outweigh the risk
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name 4 D class anti-seizure meds
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carbamazepine
phenobarbital phenytoin valproic acid |
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which drug has major risk of deformities including spina bifida
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valproic acid
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which drug causes fetal hydantoin syndrome
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phenytoin
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which drug is known to cause sedation, respiratory depression in breastfeeding
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phenabarb
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which 2 drugs casue hemorrhagic disease in the newborn
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Phenobarb
Phenytoin |
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which class C has the most data and shows ~3% cleft problems
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Lamotrigine
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which class C shows urogenital problems in 1% of newborns
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Oxcarbazine
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polytherapy increase risk by
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~2%
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KEY CONCEPT: which is the bigger risk potentially teragoenicty of seizures
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seizures- seizure control is the primary goal
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Valproic acid is the worst for teratogenicity and so should be avoided in
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child-bearing age women
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what supplement should be given to childbearing age women on anti-seizure meds
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at least 1mg/d Folic Acid
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at what freqency is the dose adjusted based on serum conc
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q1-3 mo
q2-4 wk for lamotrigine and oxcarbazepine |
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when can medication discontinuation be considered?
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seizure free for at least 2 years and normal neurological exam and EEG
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Generic is considered bioequivalent when 90% of AUC, Cmax fall within
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80% and 125% of brandeded drug
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what's the problem with bioequivalence
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may not equate with clinical equivalence due to narrow therapeutic windows and patient variability
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higher risk with AED include
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multiple AED use and generic switching
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which AEDs are associated with poor bone health
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Carbamazepine
Clonazepam Phenobarbital Valproic acid |
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is there a dose response with fractures and AED
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Yes
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what's the increased RR of verterbral fractures when using AED
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6x
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what are other risk factors for vetebral fractures
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Smoking
Alcohol use Low free androgen index Corticosteroid use |
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what is the suggested dose of Vitamin D for AED users
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4000 IU/day for adults; 2000 IU/day for children
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do you use Estrogen for Bone health in AED
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no recommended increased seizure risk, only for women, and CV risks
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what are some other options for bone health
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bisphosphonates
SERMs parathyroid hormone- but only for 2 years |
