Question

Question 1 A 30 years old female patient came to the dental clinic complaining of bleeding and swollen gum, history reveals that she is an epileptic patient and taking anti-epileptic during since 5 years. Task No.1:Which one of the following drug is most likely the cause? Task No.2:What is its mode of action? Task No.3:Task No.4:What is pregnancy category of PHENYTOIN? Task No.5:How does PHENYTOIN work to suppress seizure activity?

Question 2: A 35 years old patient came to emergency department with paresthesia, tingling, pin and needle sensation on left forearm. On examination, his left hand had signs of tetany. Task No. 1: Name the intravenous calcium preparation recommended for the treatment of tetany Task No. 2: What are the different therapeutic calcium preparations Task No. 3: Name the drugs which are used for the treatment of Hypercalcemia Task No. 4: What is the mode of action of Bisphosphonates Task No. 5: Name one clinical indication of Calcitonin

Question 3: A 45 years old male had been taking sleep inducer Tab. Clonazepam 0.5mg at bed time for the last 1 year. Since last two months, the patient experienced decrease sleep. For the present complaint the patient visited the physician and the physician increased the dose to 1mg at bed ti Task No.1; Name the phenomenon which shows gradual decrease in drug response. Task No.2:Define Tachyphylaxis? Task No.3:What is physical dependence? Task No.4:What are the types of above mentioned phenomena? Task No.5: What is intolerance?

Answer 1

Answer 1.

1.Phenytoin is an anti epileptic drug .One of the major side effects of it in younger patient is gingival hyperplasia. Here the gums are swollen and it bleeds.

2.Mode of action

This drug after administration acts by blocking the sodium channel .As a result the influx of sodium is inhibited .If this is inhibited the action potential cannot take place as a result the post tetanic stimulation is inhibited. Also the inhibitions takes place in the motor cortex of the brain which can cause seizure

3,4.The pregnancy category of the drug Phenytoin is "D" because it can harm unborn fetus

5.The drug suppresses the seizure activity in the following way

This drug alters the electrical activities of the brain by sodium channel inhibitions

Which is responsible for the action potential .It prevents the influx of the sodium into the cells or else prevents removes the sodium from reaching the cells. Hence the neuronal hyperactivity is controlled. Also inhibitions of the motor cortex stimulation together can prevent and control the symptoms of seizure .