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Pharma_L3 , Antiepileptic drugs

 L3 , Antiepileptic drugs



MCQ

1. The mechanism of action of antiseizure drugs is:
A. Enhancement of GABAergic (inhibitory) transmission
B. Diminution of excitatory (usually glutamatergic) transmission
C. Modification of ionic conductance
D. All of the above mechanisms

2. Which of the following antiseizure drugs produces  enhancement of GABA-
mediated inhibition
A. Ethosuximide
B. Carbamazepine
C. Phenobarbital
D. Lamotrigine

3. Indicate an antiseizure drug, which has an impotent effect on the T-type calcium channels in thalamic neurons
A. Carbamazepin
B. Lamotrigine
C. Ethosuximide D. Phenytoin


4. Which of the following antiseizure drugs produces a voltage-dependent
inactivation of sodium channels
A. Lamotrigine
B. Carbamazepin
C. Phenytoin
D. All of the above

5. Indicate an antiseizure drug, inhibiting central effects of excitatory amino acids
A. Ethosuximide
B. Lamotrigine
C. Diazepam
D. Tiagabine

6. The drug for partial and generalized tonic-clonic seizures is:
A. Carbamazepine
B. Valproate
C. Phenytoin
D. All of the above

7. Indicate an anti-absence drug:
A. Valproate
B. Phenobarbital
C. Carbamazepin
D. Phenytoin

8. The drug against myoclonic seizures is:
A. Primidone
B. Carbamazepine
C. Clonazepam
D. Phenytoin

9. The most effective drug for stopping generalized tonic-clonic status epilepticus in adults is:
A. Lamotrigine
B. Ethosuximide
C. Diazepam
D. Zonisamide

10. Select the appropriate consideration for phenytoin:
A. It blocks sodium channels
B. It binds to an allosteric regulatory site on the GABA-BZ receptor and prolongs the openings of the Cl-channels
C. It effects on Ca2+ currents, reducing the low-threshold (T-type) current
D. It inhibits GABA-transaminase, which catalyzes the breakdown of GABA

11.Phenytoin is used in the treatment Of :
A. Petit mal epilepsy
B. Grand mal epilepsy
C. Myoclonic seizures
D. All of the above

12.Dose-related adverse effect caused by phenytoin is
A. Physical and psychological dependence
B. Exacerbated grand mal epilepsy
C. Gingival hyperplasia
D. Extrapyramidal symptoms

13.Granulocytopenia, gastrointestinal irritation, gingival hyperplasia, and facial hirsutism are possible adverse effects of:
A. Phenobarbital
B. Carbamazepine
C. Valproate
D. Phenytoin

14.The antiseizure drug, which induces hepatic microsomal enzymes, is:
A. Lamotrigine
B. Phenytoin
C. Valproate
D. None of the above

15.The drug of choice for partial seizures is 
A. Carbamazepine
B. Ethosuximide
C. Diazepam
D. Lamotrigine

16.The mechanism of action of carbamazepine appears to be similar to that of 
A. Benzodiazepines
B. Valproate
C. Phenytoin
D. Ethosuximide

17.Which of the following antiseizure drugs is also effective in treating trigeminal neuroglia 
A. Primidone
B. Topiramate
C. Carbamazepine
D. Lamotrigine

18.The most common dose-related adverse effects of carbamazepine are:
A. Diplopia, ataxia, and nausea
B. Gingival hyperplasia, hirsutism
C. Sedation, physical and psychological dependence
D. Hemeralopia, myasthenic syndrome

19.Indicate the drug of choice for status epilepticus in infants and children:
A. Phenobarbital sodium
B. Clonazepam
C. Ethosuximide
D. Phenytoi

20- Barbiturates are used in the emergency treatment of status epilepticus in infants and children because of:
A. They significantly decrease of oxygen utilization by the brain, protecting
cerebral edema and ischemia
B. Short onset and duration of action
C. They do not have effect on sleep architecture
D. All of the above

21.Which of the following antiseizure drugs binds to an allosteric regulatory site on the GABA-BZ receptor, increases the duration of the Cl-channels openings:
A. Diazepam
B. Valproate
C. Phenobarbital
D. Topiramate

22.Adverse effect caused by phenobarbital is
A. Physical and phychological dependence
B. Exacerbated petit mal epilepsy
C. Sedation
D. All of the above

23.Which of the following antiseizure drugs is a prodrug, metabolized to phenobarbital
A. Phenytoin
B. Primidone
C. Felbamate
D. Vigabatrin

24.Indicate the antiseizure drug, which is a phenyltriazine derivative:
A. Phenobarbital
B. Clonazepam
C. Lamotrigine
D. Carbamazepine

25.Lamotrigine can be used in the treatment of
A. Partial seizures
B. Absence
C. Myoclonic seizures
D. All of the above

26. The mechanism of vigabatrin's action is:
A. Direct action on the GABA receptor-chloride channel complex
B. Inhibition of GABA aminotransferase
C. NMDA receptor blockade via the glycine binding site
D. Inhibition of GABA neuronal reuptake from synapses

27.Indicate an irreversible inhibitor of GABA aminotransferase (GABA-T):
A. Diazepam
B. Phenobarbital
C. Vigabatrin
D. Felbamate

28. Tiagabine
A. Blocks neuronal and glial reuptake of GABA from synapses
B. Inhibits GABA-T, which catalyzed the breakdown of GABA
C. Blocks the T-type Ca2+ channels
D. Inhibits glutamate transmission at AMPA/kainate receptors

29.The mechanism of both topiramate and felbamate action is:
A. Reduction of excitatory glutamatergic neurotransmission
B. Inhibition of voltage sensitive Na+ channels
C. Potentiation of GABAergic neuronal transmission
D. All of the above

30.The drug of choice in the treatment of petit mal (absence seizures) is:
A. Phenytoin
B. Ethosuximide
C. Phenobarbital
D. Carbamazepin

31.The dose-related adverse effect of ethosuximide is
A. Gastrointestinal reactions, such as anorexia, pain, nausea and vomi
B. Exacerbated grand mal epilepsy
C. Transient lethargy or fatigue
D. All of the above

32.Valproate is very effective against
A. Absence seizures
B. Myoclonic seizures
C. Generalized tonic-clonic seizures
D. All of the above

33. The drug of choice in the treatment of myoclonic seizures is:
A. Valproate
B. Phenobarbital
C. Phenytoin
D. Felbamate

34.The reason for preferring ethosuximide to valproate for uncomplicated absence seizures is:
A. More effective
B. Valproate's idiosyncratic hepatotoxicity
C. Greater CNS depressant activity
D. All of the above

35.The mechanism of valproate action is
A. Facilitation glutamic acid decarboxylase, the enzyme responsible for GABA
synthesis and inhibition of GABAaminotransferase, the enzyme responsible
for the breakdown of GABA (enhance GABA accumulation)
B. Inhibition of voltage sensitive Na+ channels
C. Inhibition of low threshold (T-type) Ca2+ channels
D. All of the above

36.Indicate the antiseizure drug, which is a sulfonamide derivative, blocking Na+channels and having additional ability to inhibit T-type Ca2+ channels:
A. Tiagabine
B. Zonisamide
C. Ethosuximide
D. Primidone

37.Indicate the antiseizure drug - a benzodiazepine receptor agonist:
A. Phenobarbital
B. Phenytoin
C. Carbamazepine
D. Lorazepam

38.Which of the following antiseizure drugs acts directly on the GABA receptor-chloride channel complex
A. Vigabatrin
B. Diazepam
C. Gabapentin
D. Valproate

39. Benzodiazepine uselfulness is limited by:
A. Tolerance
B. Atropine-like symptoms
C. Psychotic episodes
D. Myasthenic syndrome

40.A long-acting drug against both absence and myoclonic seizures is:
A. Primidone
B. Carbamazepine
C. Clonazepam
D. Phenytoin

41.Which of the following antiseizure drugs may produce teratogenicity
A. Phenytoin
B. Valproate
C. Topiramate
D. All of the above

42.The most dangerous effect of antiseizure drugs after large overdoses is:
A. Respiratory depression
B. Gastrointestinal irritation
C. Alopecia
D. Sedation

Answers

1.D
2.C
3.C
4.D
5.B
6.D
7.A
8.C
9.C
10.A
11.B
12.C
13.D
14.B
15.A
16.C
17.C
18.A
19.A
20.A
21.C
22.D
23.B
24.C
25.D
26.B
27.C
28.A
29.D
30.B
31.D
32.D
33.A
34.B
35.D
36.B
37.D
38.B
39.A
40.C
41.D
42.A

SHORT ASSAY


1.Definition of epilepsy ?

2.mention types of it ?

3.which drug block Na channel ? 

4.WHICH DRUG BLOCK Ca chanel ?

5.mention drug used in partial epilepsy ?

6.mention drug used in absence epilepsy 

7.mention newer agents of drugs ?

8. which drug is hepatic enzyme inhibitors……& which is inducer 

Answer

1. It is recurrent, transient attack of (somatic, psychic or autonomic manifestation) with or without loss of conscious

2.1.partial : simple , complex & partial with 2nd generalized

2. generalized : tonic-clonic , myoclonic , atonic & absence

3. Block Na+ Channels
Phenytoin
 Carbamazepine
Valproic acid

4. block Ca channel 
Ethosuximide.
Valproic acid

5. Valproic acid.
Carbamazepine
Phenytoin

6. Valproic acid.
Ethosuximide
Clonazepam

7.Lamotrigine
topiramate
vigabatrin
 gabapentin

8.inhibitors : valporic acids & benzodiazepine 
Inducers : phenytoin , carbamazepine & barbiturate 
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