Antiepileptics: carbamazepine in trigeminal neuralgia: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pharmacology · Antiepileptics: carbamazepine in trigeminal neuralgia

Sample item

A 60-year-old woman with lancinating facial pain triggered by touching her cheek is diagnosed with trigeminal neuralgia. Which is the drug of choice, and which adverse effect should be monitored?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Carbamazepine, with monitoring for hyponatraemia and blood counts

Carbamazepine blocks voltage-gated sodium channels and is the first-line drug in trigeminal neuralgia. Adverse effects include hyponatraemia from enhanced ADH action, aplastic anaemia, hepatotoxicity and skin reactions.

Option by option

  • A. Phenytoin, with monitoring for goitre

    Phenytoin is a second option and does not cause goitre.

  • B. Ethosuximide, with monitoring for rash

    Ethosuximide is for absence seizures.

  • C. Valproate, with monitoring for neutropenia only

    Valproate is not first line for trigeminal neuralgia.

  • D. Carbamazepine, with monitoring for hyponatraemia and blood counts (correct)

    Correct. Carbamazepine, watch sodium and counts.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Carbamazepine, with monitoring for hyponatraemia and blood counts. Carbamazepine blocks voltage-gated sodium channels and is the first-line drug in trigeminal neuralgia.

Why is "Phenytoin, with monitoring for goitre" not the answer?

Phenytoin is a second option and does not cause goitre.

Why is "Ethosuximide, with monitoring for rash" not the answer?

Ethosuximide is for absence seizures.

Why is "Valproate, with monitoring for neutropenia only" not the answer?

Valproate is not first line for trigeminal neuralgia.

What concept does this question test?

It tests Antiepileptics: carbamazepine in trigeminal neuralgia in Pharmacology. Adverse effects include hyponatraemia from enhanced ADH action, aplastic anaemia, hepatotoxicity and skin reactions.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antiepileptics: carbamazepine in trigeminal neuralgia?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.