Six year old lucy has recently been started on

Six-year-old Lucy has recently been started on ethosuximide (Zarontin) for seizures. She should be
monitored for:
1. Increased seizure activity, as this drug may auto-induce seizures
2.
Altered renal function, including renal failure
3. Blood dyscrasias, which are uncommon but possible
4. Central nervous system excitement, leading to insomnia
____ 9.
Sook has been prescribed gabapentin to treat neuropathic pain and is complaining of feeling
depressed and having “strange” thoughts. The appropriate initial action would be:
1. Increase her dose
2. Assess for suicidal ideation
3. Discontinue the medication immediately
4. Decrease her dose to half then slowly titrate up the dose
____ 10.
Selma, who is overweight, recently started taking topiramate for seizures and at her follow-up visit
you note she has lost 3 kg. The appropriate action would be:
1. Tell her to increase her caloric intake to counter the effects of the topiramate.
2. Consult with a neurologist, as this is not a common adverse effect of topiramate.
3. Decrease her dose of topiramate.
4. Reassure her that this is a normal side effect of topiramate and continue to monitor
her weight.
____ 11.
Monitoring of a patient on gabapentin to treat seizures includes:
1. Routine therapeutic drug levels every 3 to 4 months
2. Assessing for dermatologic reactions, including Steven’s Johnson
3. Routine serum electrolytes, especially in hot weather
4.
Recording seizure frequency, duration, and severity
____ 12.
Scott’s seizures are well controlled on topiramate and he wants to start playing baseball. Education
for Scott regarding his topiramate includes:
1.
He should not play sports due to the risk of increased seizures
2. He should monitor his temperature and ability to sweat in the heat while playing
3. Reminding him that he may need higher dosages of topiramate when exercising
4. Encouraging him to use sunscreen due to photosensitivity from topiramate
____ 13.
Cara is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam includes
reminding her:
1. To not abruptly discontinue levetiracetam due to risk for withdrawal seizures
2. To wear sunscreen due to photosensitivity from levetiracetam
3. To get an annual eye exam while on levetiracetam
4. To report weight loss if it occurs
____ 14.
Levetiracetam has known drug interactions with:
1. Combined oral contraceptives
2. Carbamazepine
3. Warfarin
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4. Few, if any, drugs
____ 15.
Zainab is taking lamotrigine (Lamictal) and presents to the clinic with fever and lymphadenopathy.
Initial evaluation and treatment includes:
1. Reassuring her she has a viral infection and to call if she isn’t better in 4 or 5 days
2. Ruling out a hypersensitivity reaction that may lead to multi-organ failure
3.
Rapid strep test and symptomatic care if strep test is negative
4. Observation only, with further assessment if she worsens
____ 16.