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Paper I — 2019 July (Supplementary) (2010 Scheme) — Q1

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Paper I
2019 July (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Classify antiepileptic drugs. Describe the mechanism of action and adverse effects of phenytoin (2+2+2)

Q16 marksEssays

Answer

Classification of antiepileptic drugs

  • Hydantoins: Phenytoin
  • Barbiturates: Phenobarbitone
  • Iminostilbenes: Carbamazepine
  • Fatty acid derivatives: Sodium valproate
  • Succinimides: Ethosuximide
  • Newer agents: Lamotrigine, Levetiracetam, Gabapentin

Mechanism of action of phenytoin

  • Blocks voltage-gated sodium channels, preferentially binding to and prolonging their inactivated state
  • This use-dependent blockade reduces sustained high-frequency repetitive neuronal firing, limiting seizure spread without affecting normal transmission

Adverse effects of phenytoin

  • Gum hypertrophy, hirsutism, coarsening of facial features
  • Cerebellar signs — nystagmus, ataxia, diplopia
  • Megaloblastic anaemia (folate deficiency)
  • Osteomalacia
  • Hypersensitivity — rash, Stevens-Johnson syndrome
  • Fetal hydantoin syndrome (teratogenic)
  • Potent enzyme inducer — reduces efficacy of oral contraceptives, warfarin
  1. 1Antiepileptics

Other Years Asked

  1. 1(2023 January (Supplementary) (2019 Scheme)Essay · 15 marks
  2. 2Classify Antiepileptic drugs. Explain the mechanism of action, therapeutic uses and adverse effects of Sodium Valproate. (3+3)2025 March (Supplementary) (2010 Scheme)Essay · 6 marks
  3. 3A 30-year-old male was brought to the emergency department reporting a sudden onset of generalised tonic clonic convulsions and fall, in the nearby supermarket. His blood pressure and electrolytes were found to be normal. A diagnosis of generalised tonic clonic seizure was made.2024 August (Supplementary) (2010 Scheme)Essay · 6 marks
  4. 4A 28 years old man, while working on his computer in an IT company, suddenly went blank, fell down and appeared to be unconscious. He regains consciousness in the next 5 minutes but was confused and could not remember what happened. When he consulted a neurologist, he was diagnosed to have absence seizures. Answer the following:2014 March (2010 Scheme)Essay · 6 marks
  5. 5Classify antiepileptic drugs. Explain the mechanism of action, uses and adverse effects of phenytoin and sodium valproate. List four drugs used in status epilepticus. (2+3+1)2021 December (Supplementary) (2010 Scheme)Essay · 6 marks
  6. 6Enumerate the newer drugs used in the treatment of epilepsy. Write the mechanism of action of any two agents. Discuss the line of management of Status Epilepticus. (2+2+2)2020 February (Supplementary) (2010 Scheme)Essay · 6 marks
  7. 7A one-year-old boy with febrile seizures was brought to the emergency department. (2022 October (Supplementary) (2010 Scheme)Essay · 6 marks
  8. 8Enumerate four groups of antiepileptic drugs with examples of each. Mention four newer anti epileptics. Describe the pharmacological actions, adverse effects and therapeutic uses of any one of them. (2 + 2+ 2 = 6)2016 February (2010 Scheme)Essay · 6 marks
  9. 9Briefly describe the mechanism of action, uses and adverse effects of sodium valproate.2025 March (Supplementary (SAY)) (2019 Scheme)Short Answer · 4 marks
  10. 10Sodium valproate2022 May (Supplementary) (2010 Scheme)Short Note · 3 marks
  11. 11Sodium valproate2024 March (Supplementary) (2010 Scheme)Short Note · 3 marks
  12. 12Lamotrigine2017 February (2010 Scheme)Short Note · 3 marks
  13. 13Phenytoin2023 March (Supplementary) (2010 Scheme)Short Note · 3 marks
  14. 14Carbamazepine2013 September (Supplementary) (2010 Scheme)Short Note · 3 marks
  15. 15Carbamazepine2023 July (Supplementary) (2010 Scheme)Short Note · 3 marks
  16. 16Valproic acid2019 February (2010 Scheme)Short Note · 3 marks
  17. 17Carbamazepine2021 February (Supplementary) (2010 Scheme)Short Answer · 1 mark
  18. 18Phenytoin sodium.2025 August (Supplementary) (2010 Scheme)Short Answer · 1 mark
  19. 19Status epilepticus.2016 October (Supplementary) (2010 Scheme)Short Answer · 1 mark
  20. 20In treatment of absence seizures2018 February (2010 Scheme)Short Answer · 1 mark
  21. 21Drugs for absence seizures2021 May (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  22. 22 Carbamazepine in treatment of Trigeminal neuralgia Name the following (Two examples for each): (5x1=5)2024 March (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  23. 23Antiepileptic drugs2022 July (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
  24. 24Drugs used in Absence seizures.2023 July (Supplementary) (2019 Scheme)Short Answer · 0.2 marks

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