Pharmacology

Pregabalin binds to the α2δ site, an auxiliary subunit of voltage-gated calcium channels in the CNS, inhibiting excitatory neurotransmitter release. The drug has proven effects on focal-onset seizures and more than 90% of pregabalin is eliminated renally. It has no significant effects on drug metabolism and few drug interactions. Dosage adjustments are needed in renal dysfunction

• Pregabalin

• Phenytoin

• Phenobarbital

• Carbamazepine

Pregabalin works on presynaptic ion channels to inhibit the release of neurotransmitter and reduce neuronal excitation. What ion channel does pregabalin act on?

• Potassium

• Sodium

• Chloride

• Calcium

Which is the most common treatment for epilepsy?

• Surgery

• Medication

• Special Diet

• An implanted electrical device

The symptoms of a seizure may differ from person to person, but seizures are caused by the same thing:

• A sudden change in how brain cells send electrical signals to one another

• A sudden change in blood flow in the brain

• A sudden change in how the spinal cord and brain talk to each other

• A sudden change in oxygen flow in the body

Characteristic of acute symptomatic seizure is ...

• Unprovoked seizure

• Recurrent

• Provoked seizure

• related with intracranial abnormality

A female, 38 yo, had multiple seizures and her blood glucose level was very high (600mg/dL). What was an episode that she had?

• Focal onset Epilepsy

• General onset epilepsy

• Acute symptomatic seizure

• Undetermined yet

What biomarker is used for epilepsy diagnosis?

• HVA Calcium

• MOA

• Prolactin

• COMT

Among the different types of seizures, this type is characterized by impaired consciousness and recall. If asked a question, the patient might respond with an inappropriate or unintelligible answer. Automatic movements involve the mouth and face (lip smacking, chewing, tasting, and swallowing movements), upper extremities (fumbling, picking, tapping, or clasping movements), and vocal apparatus (grunts or repetition of words and phrases), as are complex acts (such as walking or mixing foods in a bowl).

• Focal ( aware)

• Tonic-clonic

• Focal ( impaired awareness)

• Absence

Barbiturates and benzodiazepines are anticonvulsant drugs used in the treatment of epilepsy. They both bind to distinct site if the same receptor complex and differentially influence the opening and closing of chloride ion pore. What main characteristic differs the mechanism of action?

• Barbiturates increase the duration of chloride channel opening.Benzodiazepines increase the frequency of opening.

• Barbiturates prevent the removal of GABA from the synaptic cleft by blockade of GABA transport and Benzodiazepines are irreversible inhibitors of the mitochondrial enzyme GABA.

• Barbiturates increase the GABAa receptors and benzodiazepines increases GABAb receptors.

• Barbiturates increase the frequency of opening.Benzodiazepines increase the duration of chloride channel opening.

Which drug is most useful for the treatment of absence seizures?

• Topiramate - only used for focal seizures

• Levetiracetam

• Tiagabine

• Lamotrigine