Antiepileptic Medications and Seizure Types

These flashcards are designed to help students review key concepts related to antiepileptic medications and their effects on seizure types.

What is the best description of seizures that involve episodes of blank staring and eye blinking lasting 15 seconds, after which the patient resumes activity?

Absence seizures.

Which therapy is most appropriate for a child with absence seizures having difficulty paying attention in school?

Ethosuximide.

What should be considered for a 25-year-old woman with myoclonic seizures well controlled on valproate who wants to become pregnant?

Switch to lamotrigine.

What is the most likely cause of breakthrough seizures in a pregnant woman on lamotrigine?

Lamotrigine concentrations are decreasing.

What seizure type is characterized by episodes of blank staring, unresponsiveness, and automatic chewing movements lasting several minutes?

Complex partial seizures.

What is the most appropriate initial therapy for a 52-year-old man with several complex partial seizures?

Levetiracetam.

Which drug is least likely to have a pharmacokinetic interaction with carbamazepine for a patient with focal seizures?

Levetiracetam.

What medication is first-line for primary generalized tonic-clonic seizures?

Topiramate.

Which agent is most appropriate for a 75-year-old woman with post-stroke focal seizures who has multiple comorbidities?

Levetiracetam.

What is the adverse effect called when a patient on phenytoin develops overgrowth of gum tissue covering his teeth?

Gingival hyperplasia.

Which antiepileptic drug would most likely reduce the efficacy of oral contraceptives?

Carbamazepine.

What pharmacokinetic property explains the development of nystagmus, ataxia, and confusion after a small increase in the phenytoin dose?

Nonlinear (saturable) metabolism.

Which antiepileptic drug is associated with irreversible visual field loss?

Vigabatrin.

What is reserved for children with Lennox-Gastaut syndrome due to risks of aplastic anemia and hepatic failure?

Felbamate.

What adjustment is needed when a patient on valproate is also started on lamotrigine?

Decrease lamotrigine dose.

What characterizes myoclonic seizures?

Sudden, brief muscle jerks involving both arms upon awakening.

Which patient characteristic increases the risk of symptomatic hyponatremia in a patient on oxcarbazepine?

Elderly age.

What is the next appropriate step after a patient with status epilepticus receives IV lorazepam?

IV fosphenytoin.

What dose of folic acid is recommended for a woman of childbearing age with epilepsy considering pregnancy?

1-5 mg daily.

Which antiepileptic drug is most likely responsible for blue discoloration of the skin and retinal abnormalities?

Ezogabine.

What is the most common adverse effect associated with lacosamide?

Dizziness and headache.

Which antiepileptic drug is useful for both epilepsy and bipolar disorder?

Lamotrigine.

What class of adverse effect does carbamazepine-induced neutropenia and thrombocytopenia belong to?

Blood dyscrasia.

What condition should parents monitor for in a child prescribed zonisamide due to risk of decreased sweating?

Oligohidrosis.

What adverse effect is related to topiramate's carbonic anhydrase inhibition?

Nephrolithiasis.

What can carbamazepine cause in a patient with absence seizures?

Increase in seizure frequency.

Which pharmacokinetic change is most important for a patient with chronic kidney disease taking gabapentin?

Reduced renal excretion requiring dose adjustment.

Which drug commonly causes weight gain, tremor, and hair loss?

Valproate.

What is phenobarbital’s primary mechanism of action?

Enhancement of GABA-mediated inhibition.

Which antiepileptic drug is contraindicated in patients with a sulfa allergy?

Zonisamide.

What serious adverse reaction should be suspected in a patient on carbamazepine who develops rash, fever, and lymphadenopathy?

Stevens-Johnson syndrome.

What broad-spectrum agent is often used for a patient with frequent atonic seizures (drop attacks)?

Lamotrigine.

What is the most common adverse effect of phenobarbital, particularly concerning in elderly patients?

CNS depression and falls.

What active metabolite is responsible for the anticonvulsant effect of eslicarbazepine?

Eslicarbazepine (S-licarbazepine).

What is the mechanism of action of perampanel?

AMPA glutamate receptor antagonism.

What is the recommended management for a woman on lamotrigine who becomes pregnant and has decreased drug levels?

Increase lamotrigine dose.

What drug should be avoided to ensure warfarin efficacy in a patient starting an antiepileptic?

Phenytoin.

What is the preferred antiepileptic medication for a patient with both epilepsy and migraine headaches?

Topiramate.

What should be monitored in an elderly patient receiving oxcarbazepine?

Hyponatremia.

What is a potential effect of incorrectly prescribing carbamazepine for absence seizures?

Exacerbation of absence seizures.

What should a patient taking zonisamide be aware of regarding their sweating?

Monitoring for decreased sweating.

What is the primary function of lamotrigine in relation to seizure management?

Broad-spectrum activity for various seizure types.