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What percentage of the population suffers from epilepsy? a. 1% b. 5% c. 10% d. 15% e. 20%

a. 1%

Medications used for the management of seizure disorders include all EXCEPT: a. Amantadine (Symmetrel) b. Clonazepam (Klonopin) c. Valproates (Depakote) d. Phenytoin (Dilantin) e. Carbamazepine (Tegretol)

a. Amantadine (Symmetrel)

Which is the mechanism of action of carbamazepine (Tegretol) in the treatment of epilepsy? a. Blocking sodium channels, blocking nerve impulse propagation b. Opening sodium channels, enhancing nerve impulse propagation c. Depression of the central nervous system at the brainstem d. Gamma-aminobutyric acid agonist, inhibiting excitatory impulses

a. Blocking sodium channels, blocking nerve impulse propagation

Which is the most difficult aspect of treating patients with seizure disorders with regard to their medications? a. Chronic toxicity b. Compliance c. Cost of medicine d. Lack of efficacy

a. Chronic toxicity

What is the approximate prevalence of seizure disorders in the general population? a. Less than 0.01% of the population b. 1% of the population c. 5% of the population d. 10% of the population

b. 1% of the population

Seizures are termed status epilepticus if they last longer than: a. 5 minutes b. 10 minutes c. 30 minutes d. 45 minutes e. 60 minutes

c. 30 minutes

Which of the following is NOT an appropriate management technique for a dental patient having a seizure? a. Tilt the patient's head to the side b. Remove dental instruments from mouth c. Immobilize the body d. Move patient to floor if possible e. Do not pry mouth open

c. Immobilize the body

All are indications for carbamazepine (Tegretol) EXCEPT: a. Trigeminal neuralgia b. Bipolar depression c. Muscle spasticity d. Seizure disorders

c. Muscle spasticity

Which antiseizure medication is most likely to cause gingival enlargement? a. Phenobarbital (Primidone) b. Diazepam (Valium) c. Phenytoin (Dilantin) d. Valproate (Depakote) e. Carbamazepine (Tegretol) f. Ethosuximide (Zarontin)

c. Phenytoin (Dilantin)

General adverse reactions of antiepileptic medications include all EXCEPT: a. Dermatologic effects (erythema multiforme, Steven-Johnson's syndrome) b. Gastrointestinal distress c. Teratogenicity (fetal development) d. Central nervous system excitation

d. Central nervous system excitation

What percent of chronic users of phenytoin (Dilantin) experience gingival hyperplasia? a. 10% b. 20% c. 30% d. 40% e. 50%

e. 50%

The drug group of choice for the treatment of status epilepticus seizures is parenteral a. Phenobarbital (Primidone) b. Valproate (Depakote) c. Carbamazepine (Tegretol) d. Phenytoin (Dilantin) e. Ethosuximide (Zarontin) f. Diazepam (Valium)

f. Diazepam (Valium)

Carbamazepine is better tolerated than lamotrigine in elderly patients who are newly diagnosed with partial or generalized seizures. true or false

false

Fatal blood dyscrasias, including aplastic anemia and agranulocytosis, have been reported related to phenytoin therapy. true or false

false

Gabapentin (Neurontin) has been approved by the Food and Drug Administration (FDA) for control of seizures. true or false

false

Generalized seizures involve no loss of consciousness. true or false

false

Lamotrigine (Lamictal) is not well tolerated as compared to other antiepileptic agents. true or false

false

Lamotrigine's mechanism of action is unknown, but though to inhibit presynaptic calcium channels. true or false

false

Partial seizures cause a total loss of consciousness. true or false

false

Phenytoin (Dilantin) is a first choice agent used to treat tonic-clonic seizures. true or false

false

Vitamin C is an effective adjunctive therapy for gingival enlargement. true or false

false

Oxcarbazepine (Trileptal) can decrease phenytoin levels by 40%. true or false

false (increase)

The postictal state is an altered state of consciousness that occurs before a seizure. true or false

false (occurs after a seizure)

Diazepam, lorazepam, and midazolam used parenterally to treat recurrent tonic-clonic seizures or status epilepticus. true or false

true

Lamotrigine is better tolerated than ethosuximide in children with absence seizures. true or false

true

Levetiracetam (Keppra) is used in children with Lennox-Gestaut syndrome. true or false

true

Other indications for gabapentin include treatment of neuropathic pain. true or false

true

Tonic refers to the stiffening of limbs; clonic refers to the limbs and face jerking. true or false

true

All of the following are oral adverse effects associated with carbamazepine (Tegretol) EXCEPT? a. Lichen planus b. Xerostomia c. Stomatitis d. Glossitis

a. Lichen planus

The most important drug interaction of the anticonvulsants involves a. Stimulation of hepatic microsomal enzymes b. Inhibition of hepatic microsomal enzymes c. Renal reabsorption in the loop of Henle d. Plasma binding

a. Stimulation of hepatic microsomal enzymes

Which of the following anticonvulsants may be used to manage trigeminal neuralgia? a. carbamazepine b. valproic acid c. ethosuximide d. phenytoin

a. carbamazepine

A patient taking phenytoin (Dilantin) is MOST LIKELY experiencing gingival hyperplasia in the: a. maxillary anterior region b. mandibular anterior region c. maxillary posterior region d. mandibular posterior region

a. maxillary anterior region

Which of the following is often the first agent used to treat clonic-tonic seizures? a. valproate b. phenytoin c. carbamazepine d. ethosuximide

a. valproate

What is the drug of choice for treatment of absence seizures? a. Valproic acid b. Ethosuximide c. Phenobarbital d. Gabapentin e. Phenytoin

b. Ethosuximide

Carbamazepine (Tegretol) is used to treat all of the following EXCEPT? a. Bipolar disorder b. Hypertension c. Seizures d. Trigeminal neuralgia

b. Hypertension

Which is the primary advantage of oxcarbazepine compared to carbamazepine? a. Induction of own metabolism b. Less induction of hepatic enzymes c. Long half-life d. Greater induction of hepatic enzymes e. Short half-life

b. Less induction of hepatic enzymes

Which antiseizure medication is associated with a syndrome causing congenital abnormality associated with maternal ingestion? a. Valproate b. Phenytoin c. Gabapentin d. Carbamazepine e. Phenobarbital

b. Phenytoin

Which would be appropriate dental management techniques for patients taking antiepileptic agents? [mark all correct answers] a. Prescribe antianxiety medication to avoid precipitation of seizure due to stress. b. Take a thorough medical history, including medications and frequency of seizures. c. Place a bite block in the mouth of a patient experiencing seizure.

b. Take a thorough medical history, including medications and frequency of seizures.

All of the following are adverse effects EXCEPT? a. Hypersalivation b. Weight loss c. Prolonged bleeding time d. Hepatotoxicity e. Teratogenicity

b. Weight loss

Of the following anticonvulsants, which of them does NOT undergo significant liver metabolism? a. valproic acid b. gabapentin c. clonazepam d. carbamazepine e. all undergo liver metabolism

b. gabapentin

Which anticonvulsant medication has been known to produce osteomalacia? a. caramazepine b. phenytoin c. ethosuximide d. gabapentin e. lamotrigine

b. phenytoin

Which is the most difficult aspect of treating patients with seizure disorders with regard to their medications? a. compliance b. lack of efficacy c. chronic toxicity d. cost of medicine

c. chronic toxicity

Which of the following does NOT describe a tonic-clonic seizure? a. Loss of consciousness b. Involves large muscle groups c. Aura often precipitates seizure d. Quick recovery e. Seizure ends with patient limp or comatose

d. Quick recovery

Which of the following is NOT an adverse effect associated with phenytoin (dilantin)? a. osteomalacia b. vitamin D deficiency c. nystagmus d. alopecia e. gingival enlargement

d. alopecia

Which of the following is NOT one of the drugs of choice used for partial seizures? a. lamotrigine b. carbamazepine c. levetiracetam d. ethosuximide

d. ethosuximide

Which of the following is the most common cause of seizure? a. infection b. trama c. metabolic alterations d. idiopathic e. circulatory disturbances

d. idiopathic

Which of the following is the most common cause of seizures? a. infection b. trauma c. circulatory disturbances d. idiopathic e. metabolic alterations

d. idiopathic

The most important drug interaction of the anticonvulsants involves? a. inhibition of hepatic microsomal enzymes b. plasma binding c. renal reabsorption in the loop of Henle d. stimulation of hepatic microsomal enzymes

d. stimulation of hepatic microsomal enzymes

Which of the following is often the first agent used to treat tonic-clonic seizures? a. ethosuximide b. carbamazepine c. phenytoin d. valproate

d. valproate


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