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Chapter 56
Self Assessment Quiz - Epilepsy
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1 Epilepsy is a common neurologic disorder characterized by recurrent seizures. Which of the following statements concerning this disorder is
false?
A) Displays a unimodal distribution, with incidence being highest during infancy/childhood.
B) Displays a relatively high frequency in elderly patients.
C) Sleep deprivation, sleep, hormonal fluctuations, and alcohol withdrawal may all precipitate seizures in patients with epilepsy.
D) The incidence of idiopathic generalized epilepsy is higher in children compared with older adults.
E) In elderly patients with epilepsy, partial seizures are more common than primary generalized seizures.

2 The etiology of epilepsy in adults appears to be multifactorial and may include all the following except

A) cerebrovascular disease.
B) ethnicity.
C) head trauma.
D) neurodegenerative disorders.
E) brain tumor.

3 LM is a 29-year-old man who presents to your pharmacy with a history of recent-onset complex-partial seizures (four during the past 6 days)
that are believed to be secondary to a closed head injury suffered in a motor vehicle accident 2 months ago. The patient has no known drug
allergies. The most reasonable initial medication for this patient would be
A) phenobarbital.
B) clonazepam.
C) primidone.
D) carbamazepine.
E) none of the above.

4 TK is a 7-year-old girl who has been diagnosed recently as having multiple staring spells during the day in class. A diagnosis of typical
childhood absence seizures is made. She is allergic to penicillin. Which of the following would be the most appropriate initial therapy for this
patient?
A) Carbamazepine
B) Phenytoin
C) Phenobarbital
D) Valproic acid
E) None of the above

5 You are a consultant for a long-term care skilled nursing facility. During one of your visits, you are approached by one of the local internists.
He is caring for LK, an 80-year-old man who has developed secondarily generalized tonic-clonic seizures after suffering a stroke. This patient
has a history of depression, for which he is currently receiving amitriptylline (Elavil). The physician wants to start an antiepileptic drug but is
worried about causing any pharmacokinetic drug interactions. Which of the following medication options is least likely to cause a drug-drug
interaction?
A) Carbamazepine
B) Lamotrigine
C) Phenytoin
D) Gabapentin
E) Two of the above

6 BT is a 19-year-old with a history of myoclonic seizures. She is new to your pharmacy and presents with complaints of excessive weight gain
and tremor. She also reports that she has noticed some hair thinning. You try to obtain a medication history from this patient, but she is
unable to recall what medication her neurologist recently started. Based on her presentation, her medication likely is
A) valproic acid.
B) ethosuximide.
C) lamotrigine.
D) gabapentin.
E) none of the above.

7 Rash is a common adverse effect of many antiepileptic drugs. For which of the following drugs is the risk of rash increased when the drug is
started at too high of a dose and/or when it is given in conjunction with valproic acid?
A) Topiramate
B) Carbamazepine sustained release
C) Lamotrigine
D) Phenytoin
E) Carbamazepine suspension

8 Patients with renal insufficiency may require dosage adjustments of which of the following antiepileptic drugs?

A) Carbamazepine
B) Phenytoin
C) Gabapentin
D) Valproic acid
E) None of the above

9 A 22-year-old woman with complex partial seizures is currently receiving a low-dose oral contraceptive agent. Which of the following
antiepileptic drugs would you predict to potentially cause contraceptive failure because of cytochrome p450 enzyme induction?
A) Phenytoin
B) Carbamazepine
C) Oxcarbazepine
D) Topiramate
E) All of the above

10 Neural tube defects (spina bifida) is a well-recognized birth defect that is most commonly associated with

A) phenytoin.
B) valproic acid.
C) phenobarbital.
D) lamotrigine.
E) none of the above.

11 Factors that possibly increase the chance for antiepileptic drug associated fetal malformations include

A) therapy with multiple drugs.

B) folate deficiency.
C) family history of birth defects.
D) high-drug doses.
E) all of the above.

12 Which of the following antiepileptic drugs is most commonly associated with significant cognitive impairment and depression?

A) Lamotrigine
B) Gabapentin
C) Phenobarbital
D) Valproic acid
E) None of the above

13 Significant weight loss and cognitive impairment can be frequent adverse effects of which of the following antiepileptic drug, especially if it is
titrated too quickly?
A) Lamotrigine
B) Topiramate
C) Gabapentin
D) Phenytoin
E) Carbamazepine

14 Which of the following antiepileptic drugs does not have an active metabolite that may contribute to both efficacy and toxicity?

A) Zonisamide
B) Primidone
C) Carbamazepine
D) Oxcarbazepine
E) a and b

15 Most commonly used drugs display linear elimination pharmacokinetics. Which of the follwoing medications would you expect to display
nonlinear, saturable kinetics at therapeutically used doses/serum concentrations?
A) Phenobarbital
B) Lamotrigine
C) Phenytoin
D) Carbamazepine
E) Levatiracetam

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