BNF CNS EXAM STUDY QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS GRADED A 2024

BNF CNS EXAM S TUDY QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS GRADED A 2024 Name the Anti -epileptic drugs that need to be prescribed by brand (category 1) - Phenytoin, Phenobarbital, Primidone, Carbamazepine The MHRA released a warning regarding an increased risk of what with ALL antiepileptic drugs - Suicidal thoughts & behaviours occurrig as early as one week after treatment start Patients must be seizure free for .... .... before driving again (with no history of unprovoked seizures) - one year DVLA restriction post -seizure (first) - 6 months Valproate must not be used in females of childbearing age unless a ................ is in place AND .................................... - pregnancy prevention programme, other treatment is ineffective or not tolerated First line for partial seizures - Carbamazepine or lamotrigine First line for absence seizures - Sodium valproate or ethosuximide First line for tonic clonic seizures - Sodium valproate or Lamotrigine First line for myoclonic seizures - sodium valporate (topiramate and levetiracetam alternatives) Does Carbamazepine need to remain on the same brand if being treated for trigeminal neuralgia - Not necessarily, brand specific is just for treatment of epilepsy. Valproic Acid is also licensed for ........ or ..... other than epilepsy - mania or migraine Status epilepticus - when a seizure lasts longer than 5 minutes or when seizures occur close together and the person doesn't recover between seizures. Status epilepticus Community and hospital treatment - Community 1. Oromucosal midazolam / Rectal Diazepam 2. IV Lorazepam Hospital 1. IV lorazepam repeated ONCE after 10 mins 2. IV Phenytoin / Fosphenytoin/ Phenobarb (if 25 mins from onset and still in status) 3. Midazolam, thiopental or propofol (45 mins from onset) Febrile convusion treatment - Paracetamol unless prolonged (5mins) where it is treated as status Patients taking carbamazepine should report any signs of ............ - Blood, hepatic or skin disorders eg: fever, rash mouth ulcers, bleeding, bruising, sore throat Carbamazepine, Lamotrigine, Lacosamide, Oxcarbazepine, phenobarbital, phenytoin, primidone and rufinamide are ALL associated with which rare but potentially fatal syndrome which can occur 1 to 8 weeks after exposure - Antiepileptic hypersensitivity syndrom e Carbamazepine can be used for what indication other than epilepsy - Trigeminal neuralgia, Diabetic neuropathy, Prophlaxis of bipolar disorder (unresponsive to lithium) Why do category one medicines require brand prescribingm - Bioavailability varies between formulations which could reduce seizure control.