Pharm Antiseizure Drugs
Seizures happen because of sudden or abnormal electrical activity in the brain. When people think of seizures, they often think of convulsions in which a person's body shakes rapidly and uncontrollably but not all seizures cause convulsions. See how well you understand pharm anti-seizure drugs by taking the test below.
- 1.For each numbered item select the one lettered option which is most closely associated with it (each lettered option can be selected once, more than once, or not at all). This drug is effective in all form of epilepsy in all form of epilepsy at all age groups
- A.
Acetazolamide
- B.
Carbamazepine
- C.
Ethosuximide
- D.
Felbamate
- E.
Gabapentin
- F.
Lamotigrine
- G.
Levetiracetam
- H.
Phenytoin
- I.
Tiagabine
- J.
Topiramate
- K.
Valproic acid
- L.
Zonisamide
- 2.For each numbered item select the one lettered option which is most closely associated with it (each lettered option can be selected once, more than once, or not at all). This drug binds selectively to a synaptic vescicular protein so altering the synaptic release of glutamate and GABA..
- A.
Acetazolamide
- B.
Carbamazepine
- C.
Ethosuximide
- D.
Felbamate
- E.
Gabapentin
- F.
Lamotigrine
- G.
Levetiracetam
- H.
Phenytoin
- I.
Tiagabine
- J.
Topiramate
- K.
Valproic acid
- L.
Zonisamide
- 3.For each numbered item select the one lettered option which is most closely associated with it (each lettered option can be selected once, more than once, or not at all). This drug Inhibits GABA reuptake in both neurons and glia, so enhancing GABAergic transmission.
- A.
Acetazolamide
- B.
Carbamazepine
- C.
Ethosuximide
- D.
Felbamate
- E.
Gabapentin
- F.
Lamotigrine
- G.
Levetiracetam
- H.
Phenytoin
- I.
Tiagabine
- J.
Topiramate
- K.
Valproic acid
- L.
Zonisamide
- 4.A 35-year-old woman, who had a brain trauma 5 months ago, experienced an abrupt onset of unilateral clonic contractions of her finger that progressively involve her hand, then lower and upper arm. She was diagnosed with simple partial seizure and an appropriate drug was prescribed. Which of the following was most likely the mechanism of action of the prescribed drug?
- A.
Blockade of neuromuscular transmission
- B.
Blockade of inactivated K+ channels
- C.
Decreased release of GABA from nerve terminals
- D.
Activation of glutamate receptor in the motor cortex
- E.
Blockade of inactivated Na+ channels
- 5.A 17-year old-girl was diagnosed with epilepsy. She experienced tonic-clonic seizures that lasted about 2 minutes approximately once weekly. She was treated initially with lamotigrine, but the drug did not reduced consistently the frequency of her seizures. The neurologist decided to abandon lamotigrine and instituted a treatment with phenytoin. The blockade of which of the following type of ion channels most likely mediated the therapeutic efficacy of the drug in the patient’s disease?
- A.
Na+ channels that are in a resting state
- B.
Na+ channels that open and close at high frequency
- C.
Na+ channels that open and close at low frequency
- D.
K+ channels that are in a resting state
- E.
K+ channels that open and close at high frequency
- F.
K+ channels that open and close at low frequency
- 6.A 26-year-old woman discovered she was unexpectedly pregnant. She had been taking regularly an oral contraceptive medication for several years. Two months ago she was diagnosed with complex partial seizures and started the prescribed therapy. Which of the following drugs was she most likely taking?
- A.
Lamotigrine
- B.
Valproic acid
- C.
Clonazepam
- D.
Gabapentin
- E.
Levetiracetam
- F.
Carbamazepine
- 7.A 44-year-old man complained to his physician of burning and tickling in his hands and feet. The man was diagnosed with tonic-clonic seizures three years ago and has been receiving high dose of an antiseizure drug since then. Physical examination disclosed large inguinal lymph nodes and reflex testing showed lack of knee and ankle tendon reflexes. Further lab exams showed megaloblastic anemia. Which of the following drugs most likely caused the patient’s symptoms and signs?
- A.
Gabapentin
- B.
Lamotigrine
- C.
Clonazepam
- D.
Phenytoin
- E.
Levetiracetam
- F.
Tiagabine
- 8.A 52–year-old man recently diagnosed with complex partial seizures, started a therapy with carbamazepine, two tablets daily. Which of the following actions on CNS neurons most likely contributed to the therapeutic effect of the drug in the patient’s disease?
- A.
Enhancement of postsynaptic excitatory potentials
- B.
Inhibition of posttetanic potentiation
- C.
Enhancement of long term potentiation
- D.
Inhibition of long term depression
- E.
Inhibition of K+ conductance on neuronal cell membrane
- 9.A 27-year-old woman suddenly lost consciousness in the dining room, became rigid and fell to the floor. Her respiration temporarily ceased. About one minute later jerking of all four limbs supervened for about 3 minutes, then the woman was unconscious for about 4 minutes. She was brought to the emergency room by the ambulance. Physical examination on admission showed a drowsy but alert patient who reported that a similar episode occurred about one month ago. Vital signs were normal and the neurologic examination was unremarkable. A CT scan turned out to be negative. A presumptive diagnosis was made and a therapy was ordered .Which of the following drugs was most likely prescribed for long term management of this patient?
- A.
Carbamazepine
- B.
Ethosuximide
- C.
Clonazepam
- D.
Tiagabine
- E.
Gabapentin
- F.
Levetiracetam
- 10.A 39-year-old man, diagnosed with tonic-clonic seizures two years ago, had been receiving a drug that exhibits a dose-dependent elimination kinetics. Which of the following drugs did the patient most likely take?
- A.
Valproic acid
- B.
Lamotigrine
- C.
Phenytoin
- D.
Topiramate
- E.
Carbamazepine
- F.
Gabapentin
- 11.A 41-year-old man was admitted to the hospital after he suffered a seizure with loss of consciousness at home. Two weeks ago the man was involved in a car accident and had suffered from a closed head injury. A neurological examination and EEG lead to the diagnosis of tonic-clonic seizures. The neurologist ordered an anticonvulsant drug that most likely acts with multiple mechanisms of action including blockade of NMDA receptor mediated excitation, blockade of T type Ca++ channels in thalamic neurons and increased GABA content in the brain. Which of the following drugs was most likely prescribed?
- A.
Valproic acid
- B.
Gabapentin
- C.
Tiagabine
- D.
Levetiracetam
- E.
Ethosuximide
- F.
Clonazepam
- 12.A 12-year-old girl was admitted to the hospital because of vomiting, drowsiness, lethargy and jaundice of six hours duration. The girl had a long history of refractory absence seizure and had been receiving several drugs during the last two years. She was presently treated with two antiseizure agents and had no absence seizures for five weeks. Physical examination showed a patient in obvious distress with extensive jaundice on the skin and sclerae. Significant lab results on admission were: alanine aminotransferase 400 U/L, total bilirubin 4 mg/L. ammonia 190 mcg/dL (normal for children 36-85). Which of the following drugs most likely caused the patients symptoms and signs?
- A.
Ethosuximide
- B.
Valproic acid
- C.
Lamotigrine
- D.
Tiagabine
- E.
Levetiracetam
- F.
Zonisamide
- G.
Clonazepam.
- 13.A 2500-g girl, born at term by vaginal delivery, presented with an abnormal tuft of hair and a small dimple on the skin covering her lumbar spine. The mother, who had a long history of a bipolar disorder, was under drug treatment when the pregnancy started. She continued to take the prescribed drug for a while, in spite of the contrary advice of the gynecologist, because she was most afraid of the depressive phase of the disease. An MRI of the baby's spine disclosed that the spinal canal had remained open along several vertebrae in the lower back. A diagnosis of myelomeningocele was made. Which of the following drugs could have caused the baby’s disorder?
- A.
Lithium
- B.
Chlorpromazine
- C.
Lamotigrine
- D.
Carbamazepine
- E.
Valproic acid
- F.
Risperidone
- G.
Venlafaxine
- 14.A 45-year-old man with a long history of partial seizures came to his neurologist office for a control visit. The man had been receiving an antiseizure drug for the last three months. En EEG showed left temporal sharp waves and the neurologist decided to add lamotigrine to the patient’s regimen. A lower dose of lamotigrine was prescribed since the drug the patient was taking can inhibit the metabolism of lamotigrine. Which of the following was most likely that drug?
- A.
Phenytoin
- B.
Phenobarbital
- C.
Levetiracetam
- D.
Clonazepam
- E.
Valproic acid
- F.
Gabapentin
- 15.A 45-year-old man was recently diagnosed with complex partial seizure and started the prescribed therapy. The patient had been suffering from AV block for one year and from nephrolithiasis for three years. Which of the following antiepileptic drugs was most likely prescribed?
- A.
Carbamazepine
- B.
Phenytoin
- C.
Valproic acid
- D.
Ethosuximide
- E.
Clonazepam
- F.
Zonisamide
- 16.A 12-year-old boy recently diagnosed with absence seizures started a therapy with ethosuximide, two tablets daily. Which of the following molecular actions most likely mediated the efficacy of the drug in the patient’s disorder?
- A.
Opening of voltage-gated K+ channels
- B.
Blockade of T-type Ca++ channels
- C.
Blockade of ligand-gated Na+ channels
- D.
Activation of GABAa receptors
- E.
Blockade of NMDA receptors
- F.
Activation of 5HT-1 receptors
- 17.A 54-year-old woman with a previously well controlled seizure disorder was brought to the hospital because of recurrent, generalized tonic-clonic seizures. The patient was intubated and mechanically ventilated. She was treated with IV diazepam and IV fosphenytoin but the patient continued to exhibit intermittent seizures and did not regain consciousness between them. A diagnosis of refractory status epilepticus was made and an appropriate therapy was instituted. This most likely included the administration of a very large dose of which of the following drug?
- A.
Levetiracetam
- B.
Carbamazepine
- C.
Valproic acid
- D.
Phenobarbital
- E.
Clonazepam
- F.
Zonisamide
- 18.A 36-year-old woman recently diagnosed with simple partial seizures started a therapy with lamotigrine, two tablet daily. Which of the following adverse effects could most likely occur during the therapy?
- A.
Macrocytic anemia
- B.
Hallucinations
- C.
Liver cirrhosis
- D.
Pancreatitis
- E.
Lupoid syndrome
- F.
Erythematous skin rash
- 19.A 45-year-old man visited his physician office for consultation regarding his antimigraine medication. The man had one month history of disabling migraine headache occurring two three times weekly. About 70% of his headache attacks had been aborted with one sumatriptan tablet and rest. The patient had been suffering from idiopathic second degree AV block diagnosed three years ago and from open angle glaucoma for four years. The physician decided to initiate a prophylactic treatment to reduce the frequency of the migraine attacks. Which of the following drugs was most likely prescribed?
- A.
Metoprolol
- B.
Verapamil
- C.
Amitriptyline
- D.
Lamotigrine
- E.
Valproic acid
- F.
Felbamate
- 20.A 6-year-old girl was diagnosed with myoclonic seizures. A brain MRI showed no overt neurologic deficit. Her past medical history was negative for epileptic seizures. Which of the following drugs would be appropriate for this patient?
- A.
Carbamazepine
- B.
Haloperidol
- C.
Phenobarbital
- D.
Phenytoin
- E.
Fluoxetine
- F.
Clonazepam
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