Deck 16: Antiepileptic Drugs

Question 1

When analyzing an EEG,the medical professional can determine that the patient has had a petit mal seizure by focusing attention on a(an):

A) Upward electrical spike wave of approximately 3 seconds
B) Flat line of approximately 3 seconds
C) Downward electrical spike wave of approximately 3 seconds
D) None of these are correct.

Answer 1

Upward electrical spike wave of approximately 3 seconds

Question 2

Using the available treatments for seizures,determine the recommended treatment that can be administered by IV or IM for status epilepticus.

A) Clonazepam
B) Diazepam
C) Lorazepam
D) All of these are correct.

Answer 2

All of these are correct.

Question 3

Identify the statement that best explains the parameters used when deciding to treat a patient with lacosamide (Vimpat).

A) Lacosamide is used as adjunct therapy with other drugs for the treatment of grand mal seizures in patients 17 or older.
B) Lacosamide is used as adjunct therapy with other drugs for the treatment of myoclonic seizures in patients 17 or older.
C) Lacosamide is used as adjunct therapy with other drugs for the treatment of partial seizures in patients 17 or older.
D) Lacosamide is used as a single therapy for the treatment of partial seizures in patients 17 or older.

Answer 3

Lacosamide is used as adjunct therapy with other drugs for the treatment of partial seizures in patients 17 or older.

Question 4

Select the mechanism of action of topiramate (Topamax).

A) Topiramate interferes with the action of Na+ ions and the generation of high-frequency action potentials. The drug may also increase the inhibitory actions of GABA.
B) Topiramate shortens the inactivation period of sodium (Ca⁺⁺) channels in the nerve membrane, leading to a reduction in the generation of high-frequency repetitive firing of action potentials from neurons involved in initiating seizures.
C) Topiramate reduces the T-type calcium currents in the thalamus, which reduces the occurrence of seizures.
D) Topiramate prolongs the inactivation period of potassium (K⁺) channels in the nerve membrane, leading to a reduction in the generation of high-frequency repetitive firing of action potentials from neurons involved in initiating seizures.

Question 5

Select the correct FDA pregnancy category for carbamazepine (Tegretol) based on the association of carbamazepine use with fetal development of spina bifida,craniofacial defects,and developmental delay.

A) Pregnancy Category B
B) Pregnancy Category C
C) Pregnancy Category D
D) Pregnancy Category X

Question 6

Select the drug used to treat partial seizures for patients who do not respond to other drugs and whose epilepsy is so severe that the benefits of therapy outweigh the risks of developing serious adverse effects.

A) Gabapentin (Neurontin)
B) Topiramate (Topamax)
C) Felbamate (Felbatol)
D) None of these are correct.

Question 7

Using the available treatments for seizures,determine the recommended treatment for a patient with partial seizures who must be prescribed a liquid medication.

A) Carbamazepine, phenytoin, or valproic acid
B) Lamotrigine, phenytoin, or levotiracetam
C) Diazepam, lacosamide, and phenytoin
D) None of these are correct.

Question 8

Select the statement that is consistent with the mechanism of action of phenytoin (Dilantin) that helps decrease the occurrence of a seizure.

A) Phenytoin prolongs the inactivation period of sodium (Na⁺) channels in the nerve membrane, leading to a reduction in the generation of high-frequency repetitive firing of action potentials from neurons involved in initiating seizures.
B) Phenytoin shortens the inactivation period of sodium (Na⁺) channels in the nerve membrane, leading to a reduction in the generation of high-frequency repetitive firing of action potentials from neurons involved in initiating seizures.
C) Phenytoin prolongs the inactivation period of potassium (K⁺) channels in the nerve membrane, leading to a reduction in the generation of high-frequency repetitive firing of action potentials from neurons involved in initiating seizures.
D) None of these are correct.

Question 9

Explain why diazepam (Valium),although effective in the treatment of status epilepticus,may require additional administration of the drug to control the seizures.

A) Diazepam has a quick onset of action.
B) Diazepam has a short duration of action.
C) Diazepam has a long half-life.
D) None of these are correct.

Question 10

Select the mechanism of action of trimethadione (Tridione) and the oxazolidinedione class of drug agents.

A) Trimethadione (Tridione) reduces the T-type calcium currents in the thalamus, which reduces the occurrence of seizures.
B) Trimethadione (Tridione) attaches to plasma protein, causing a reduction in the occurrence of seizures.
C) Trimethadione (Tridione) increases the inhibitory effects of the neurotransmitter gamma-aminobutyric acid (GABA). In the brain, this suppresses the excitability of epileptogenic neurons and makes them less likely to discharge and initiate a seizure.
D) None of these are correct.

Question 11

Tonic-clonic (grand mal) seizures are the most dramatic seizures in appearance.Describe the signs to look for in order to determine that a person has experienced a grand mal seizure.

A) Confusion, fatigue, and muscle pain and soreness usually follow a grand mal seizure.
B) Increase in blood pressure, heart rate, urination, and defecation is common.
C) Periods of alternating muscle contractions and relaxation, resembling a jerking motion, are present.
D) All of these are correct.

Question 12

Use critical thinking to determine the recommended effective treatment for a patient with absence seizures.

A) Clonazepam (Klonopin)
B) Phenobarbital (Luminal)
C)Topiramate (Topamax )
D) Diazepam (Valium)

Question 13

Determine the mechanism of action that carbamazepine,phenytoin,and valproic acid have in common.

A) Inhibit the release of GABA
B) Increase the influx of Ca++ ions
C) Increase T-type calcium currents
D) Delay the inactivation of the Na+ channels

Question 14

Differentiate between the groups of drug agents listed,and select the first-line treatment for generalized tonic-clonic seizures.

A) Phenytoin (Dilantin), valproic acid (Depakene), and carbamazepine (Tegretol)
B) Ethosuximide (Zarontin), valproic acid (Depakene), and lamotrigine (Lamictal)
C) Phenytoin (Dilantin) and lorazepam (Ativan)
D) Ethosuximide (Zarontin) and phenytoin (Dilantin)

Question 15

Identify the side effect most commonly associated with the use of oxazolidinediones.

A) Snow blindness
B) Dry mouth
C) Aplastic anemia
D) Orthostatic hypotension

Question 16

Describe the difference between anticonvulsant drug agents and antiepileptic drug agents.

A) An anticonvulsant is a drug, usually administered IM or IV, that terminates convulsive seizures. An antiepileptic is a drug, usually administered orally, that can be used prophylactically to reduce or prevent epileptic seizures.
B) An antiepileptic is a drug, usually administered IM or IV, that terminates convulsive seizures. An anticonvulsant is a drug, usually administered orally, that can be used prophylactically to reduce or prevent epileptic seizures.
C) Anticonvulsant agents and antiepileptic agents are interchangeable terms that can be used for any drug agent that is used to treat seizures, regardless of route of administration.
D) None of these are correct.

Question 17

Using adverse effects,determine the information you will need to educate a patient who takes carbamazepine (Tegretol).

A) Bone marrow depression that can lead to aplastic anemia
B) Impaired liver function that can lead to jaundice
C) Convulsions and difficulty breathing
D) All of these are correct.

Question 18

Describe the most common type of adverse effect that a patient who takes phenytoin (Dilantin) should be made aware of.

A) Dizziness and ataxia
B) Visual disturbances and postural imbalance
C) Skin rashes, hirsutism, and overgrowth of the gums
D) All of these are correct.

Question 19

Identify the type of seizure that does not involve any type of motor convulsion.

A) Atonic seizure
B) Myoclonic seizure
C) Absence seizure
D) Partial seizure

Question 20

Explain the reason why some drug agents such as phenytoin (Dilantin) and valproic acid (Depakene) can produce greater pharmacologic effects when administered with other drugs that are highly plasma protein bound.

A) Phenytoin (Dilantin) and valproic acid (Depakene) cause microsomal enzyme induction, leading to a decrease in drug metabolism causing greater pharmacologic effect.
B) Phenytoin (Dilantin) and valproic acid (Depakene) reduce the T-type calcium currents, leading to increased pharmacologic effect.
C) Phenytoin (Dilantin) and valproic acid (Depakene) are also highly plasma protein bound, causing greater pharmacologic effect.
D) None of these are correct.