Ch.14 Softchalk
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