CNS Pharmacology

Anti-epileptic drugs 1. The mechanism of action of antiepileptic drugs is : a) Enhancement of GABA-ergic (inhibitory) transmission b) inhibition of excitatory (usually glutamate-ergic) transmission c) Modification of ionic conductance d) All of the above . 2. which of the following has an impotent effect on the T-type calcium channels in thalamic neurons? a) Carbamazepine b) Lamotrigine c) Ethosuximide d) Phenytoin . 3. The drug which does not produce a voltage-dependent inactivation of sodium channels is : a) Lamotrigine b) Carbamazepine c) Phenytoin d) Vigabatrine . 4. The antiepileptic drug, which produce inhibition of the central effects of excitatory amino acids is : a) Ethosuximide b) Lamotrigine c) Diazepam d) Tiagabine . 5. The drug which is not used for partial and generalized tonic-clonic seizures is : a) Carbamazepine b) Valproate c) Phenytoin d) Vigabatrine . 6. The drug which is used for absence seizures is : a) Sodium valproate b) Phenobarbital c) Carbamazepine d) Phenytoin . 7. The drug which is used for myoclonic seizures is: a) Primidone b) Carbamazepine c) Clonazepam d) Phenytoin . 8. The most effective drug in status epilepticus in adults is : a) Carbamazepine b) Ethosuximide c) Diazepam d) Zonisamide .

CNS Pharmacology
Anti-epileptic drugs 9. Regarding phenytoin: a) It effects on Ca2+ currents, reducing the low-threshold (T-type) current b) It blocks Na+ channels c) It inhibits GABA-transaminase, which catalyzes the breakdown of GABA d) None of the above . 10. Phenytoin is used in the treatment of: a) Petit mal epilepsy b) Grand mal epilepsy c) Myoclonic seizures d) None of the above . Dose-related adverse effect caused by phenytoin is: a) Physical and psychological dependence b) Gingival hyperplasia c) Exacerbated grand mal epilepsy d) Steven-Johnson syndrome .

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12. Granulocytopenia , GI irritation and facial hirsutism are possible adverse effects of: a) Phenobarbital b) Ethosuximide c) Phenytoin d) Carbamazepine . 13. which of the following does not induce hepatic microsomal enzymes ? a) Carbamazepine b) Phenytoin c) Phenobarbital d) Sodium valproate . The drug of choice for partial seizures is: a) Carbamazepine b) Diazepam c) Ethosuximide d) Phenytoin . The mechanism of action of Carbamazepine appears to be similar to that of: a) Benzodiazepines b) Sodium valproate c) Phenytoin d) Ethosuximide . Which of the following is also effective in treating trigeminal neuralgia? a) Carbamazepine b) Phenytoin c) Vigabatrine d) Lamotrigine . The most common adverse effects of Carbamazepine are:

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CNS Pharmacology
Anti-epileptic drugs a) b) c) d) 18. Diplopia, ataxia, and nausea Gingival hyperplasia, hirsutism Sedation, physical and psychological dependence All of the above .

Phenobarbital causes : a) Physical and phychological dependence b) Exacerbated petit mal epilepsy c) Sedation d) All of the above . Lamotrigine can be used alone in the treatment of all the following except : a) Partial seizures b) Absence c) Myoclonic seizures d) Generalized tonic - clonic seizures .

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20. The mechanism of action of vigabatrine 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 . 21. The mechanism of topiramates action is: a) Reduction of excitatory glutamate-ergic neurotransmission b) Inhibition of voltage sensitive Na+ channels c) Potentiation of GABA-ergic neuronal transmission d) All of the above . The drug of choice in the treatment of petit mal (absence seizures) is: a) Phenytoin b) Ethosuximide c) Phenobarbital d) Carbamazepine . adverse effects of ethosuximide are all the following except : a) Gastric upset such as anorexia, pain, nausea and vomiting b) Exacerbated grand mal epilepsy c) Fatigue , Dizziness and headache d) Aggressive behavior . Sodium valproate is very effective against all the following except : a) Absence seizures b) Myoclonic seizures c) Generalized tonic-clonic seizures d) Partial seizures . The drug of choice in the treatment of myoclonic seizures is: a) Sodium valproate b) Phenobarbital c) Phenytoin

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CNS Pharmacology
Anti-epileptic drugs d) Ethosuximide .

26.Which of the following antiepileptic drugs may produce teratogenicity? a) Phenytoin b) Valproate c) Topiramate d) All of the above . 27. The most dangerous effect of antiepileptic drugs after large overdoses is: a) Respiratory depression b) Gastrointestinal irritation c) Alopecia d) Sedation

Answers : 1.d 2.c 3.d 4.b 5.d 6.a 7.c 8.c 9.b 10.b 11.b 12.c 13.d

14.a 15.c 16.a 17.a 18.d 19.d 20.b 21.d 22.b 23.d 24.d 25.a 26.d 27.a