Quiz
Anti-epileptics Flashcard Supplement
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Perguntas do quiz (63)
1Which of the following are First Generation anti-epileptics?
- APhenytoin
- BCarbamazepine
- CEthosuximide
- DPregabalin
- EPhenobarbital
- FLevetiracetam
- GValproic acid
- HFelbamate
- IClonazepam
2Which of the following are Second Generation anti-epileptics?
- ATopiramate
- BOxcarbazepine
- CPhenytoin
- DPregabalin
- EEthosuximide
- FValproic acid
- GFelbamate
- HLamotrigine
- IGabapentin
- JLevetiracetam
3[blank_start]Epilepsy[blank_end] is chronic disorder characterized by recurring seizures.
- AEpilepsy
4Pharmacological treatment can control but not cure epilepsy.
- AVerdadeiro
- BFalso
5Status epilepticus is a medical [blank_start]emergency[blank_end].
- Aemergency
6[blank_start]Generalized[blank_end] – no evidence of localized onset
[blank_start]Absence[blank_end] – sudden onset, abrupt cessation; 10-45 sec duration; may occur >100 times per day; characterized by a spike and wave pattern on EEG; patient may simply stare (daydream) or show postural changes, autonomic phenomena, automatisms
[blank_start]Tonic-clonic[blank_end] – tonic rigidity of all extremities, followed by relaxation, then by massive jerking of the body; patient is groggy/disoriented afterwards, urinary incontinence is common, 1-2 min duration
[blank_start]Tonic[blank_end] – increased tone of all muscles
[blank_start]Atonic[blank_end] – sudden loss of postural tone
[blank_start]Myoclonic[blank_end] – muscles spasm and limbs jerk; contractions and relaxations repeat rapidly- AGeneralized
- BAbsence
- CTonic-clonic
- DTonic
- EAtonic
- FMyoclonic
- GSimple
- HComplex
- ISecondarily generalized
- JFocal
7[blank_start]Focal (partial)[blank_end] – seizure initiates in a specific site
[blank_start]Secondarily generalized[blank_end] – focal seizure precedes a generalized
tonic-clonic seizure
[blank_start]Simple[blank_end] – minimal spread within brain; often clonic jerking, no
diminished awareness, 20-60 sec duration
[blank_start]Complex[blank_end] – localized onset but discharge spreads; alteration of
consciousness (but not unconscious), automatisms (integrated
motor behavior, e.g. lip smacking, button picking)- AFocal (partial)
- BSecondarily generalized
- CSimple
- DComplex
- ETonic-clonic
- FAbsence
- GTonic
- HAtonic
- IClonic and myoclonic
8Classify the following seizures:
[blank_start]Generalized Tonic-Clonic Seizure[blank_end]:
“When it starts, she suddenly shrieks with this unnatural cry, then she falls, and every muscle in her body seems to be
activated. Her teeth clench. Shortly after she falls, her arms and upper body start to jerk while her legs are more or less still stiff. This is the longest part of the seizure. Then it finally stops and she passes into a deep sleep.”
[blank_start]Generalized Absence Seizure[blank_end]
"He is a 7 year old boy. He often “blanks out” for a few seconds. His teacher calls his name, but he doesn’t seem to
hear her. He usually blinks a few times, and his eyes may roll up a bit. Then he is right back where he left off. Some days he has more than 50 of these spells.”
[blank_start]Secondary Generalization Focal Seizure[blank_end]
"They start with a tingling in the right thumb. Then the thumb starts jerking. In a few seconds, the whole right hand is jerking. The jerking spreads up my arm. When it reaches the shoulder, I pass out and people tell me that my whole body starts to jerk.”- ASecondary Generalization Focal Seizure
- BGeneralized Absence Seizure
- CGeneralized Tonic-Clonic Seizure
- DGeneralized Tonic Seizure
- EGeneralized Atonic Seizure
- FComplex Focal Seizure
- GSimple Focal Seizure
9What are the goals of therapy with anti-epileptics?
Improve [blank_start]quality of life[blank_end] by:
Controlling [blank_start]seizures[blank_end]
Rarely are seizures eliminated; even occasional seizures are still a concern for patients
Minimizing [blank_start]adverse effects[blank_end]
Usually lifelong treatment- Aquality of life
- Bseizures
- Cadverse effects
10Which anti-epileptic drugs have the following mechanism of action?
Inhibit voltage dependent Na+ channels- Aoxcarbazepine
- Bphenytoin
- Cvalproate
- Dtopiramate
- Efelbamate
- Fgabapentin
- Gcarbamazepine
- Hclonazepam
- Ilamotrigine
- Jethosuximide
11Which anti-epileptic drugs have the following mechanism of action?
Inhibit glutamate receptors- Avalproate
- Bfelbamate
- Cphenobarbital
- Doxcarbazepine
- Epregabalin
- Ftopiramate
12Which anti-epileptic drugs have the following mechanism of action?
Modulate glutamate release (putative)- Alevetiracetam
- Bpregabalin
- Ctopiramate
- Dethosuximide
- Efelbamate
- Fgabapentin
13Which anti-epileptic drugs have the following mechanism of action?
Increase inhibitory neurotransmission
Enhance GABA-A activity (positive allosteric modulation)- Aethosuximide
- Bclonazepam
- Clamotrigine
- Dphenobarbital
- Evalproate
- Ftopiramate
14Which anti-epileptic drugs have the following mechanism of action?
Inhibit T-type Ca2+ channels
Depolarization of thalamic neurons activates cortical neurons- Atopiramate
- Bcarbamazepine
- Cclonazepam
- Dvalproate
- Eethosuximide
- Fphenytoin
15In a normal neuron (A), excitation
and inhibition are [blank_start]balanced[blank_end]
Neurons susceptible to seizure
activity show [blank_start]decreased[blank_end] inhibition (B)
or [blank_start]increased[blank_end] excitation (C)
(D) [blank_start]Increasing[blank_end] GABA activity can
[blank_start]decrease[blank_end] seizure activity in both
situations
(D) Similarly, [blank_start]decreasing[blank_end] Glutamate activity
can also [blank_start]decrease[blank_end] seizure activity
- Abalanced
- Bunbalanced
- Cincreased
- Ddecreased
- Eincreased
- Fdecreased
- GIncreasing
- HDecreasing
- Iincrease
- Jdecrease
- Kincreasing
- Ldecreasing
- Mincrease
- Ndecrease
16Block voltage-activated calcium channels
− Neurons in thalamus are dependent on calcium channel [blank_start]pacemaker[blank_end]
currents for depolarization
− Blocking these channels slows the [blank_start]pacemaker[blank_end]
− Depolarization of [blank_start]thalamic[blank_end] neurons activates [blank_start]cortical[blank_end] neurons- Apacemaker
- Bpacemaker
- Cthalamic
- Dcortical
17Which four of the following are drugs of choice for Focal Epileptic Seizures?
- AValproate
- BGabapentin
- COxcarbazepine
- DPregabalin
- ECarbamazepine
- FEthosuximide
- GTopiramate
- HPhenytoin
- ILamotrigine
- JLevetiracetam
18Which five of the following are alternative drugs for Focal Epileptic Seizures?
- AValproate
- BTopiramate
- CGabapentin
- DOxcarbazepine
- EPhenytoin
- FClonazepam
- GCarbamazepine
- HLevetiracetam
- IPregabalin
- JLamotrigine
19Which three of the following are drugs of choice for Primary GTC Seizures?
- ATopiramate
- BValproate
- CLamotrigine
- DLevetiracetam
- EPhenytoin
- FPregabalin
20Which two of the following are alternative drugs for Primary GTC Seizures?
- ATopiramate
- BPhenytoin
- CLevetiracetam
- DGabapentin
- EValproate
- FLamotrigine
21Which two of the following are drugs of choice for Absence Seizures?
- ATopiramate
- BClonazepam
- CEthosuximide
- DLamotrigine
- EValproate
- FLevetiracetam
22Which two of the following are alternative drugs for Absence Seizures?
- ATopiramate
- BEthosuximide
- CLamotrigine
- DClonazepam
- EValproate
- FLevetiracetam
23Which five of the following are some of the adverse effects of Phenytoin?
- AHiccups
- BHepatic failure
- CNystagmus
- DDepression
- EDiplopia
- FGingival hyperplasia
- GMild parasthesias
- HAcne / Hirsuitism / Coarsening of facial features
- IAnorexia
- JConcern with HLA-B*1502 allele and skin reactions
24Which six of the following are some of the adverse effects of Phenytoin?
- AMay interfere with learning
- BSedation
- CAtaxia
- DRare serious blood dyscrasias
- EFulminant hepatitis
- FFolate and Vitamin D deficiencies (megaloblastic anemia, osteomalacia)
- GTransient diplopia
- HDizziness
- IInvoluntary movements
- JMild parasthesias
25Which five of the following are some of the adverse effects of Carbamazepine and Oxcarbazepine?
- AAtaxia
- BHyperammonemia
- CHyponatremia
- DHallucinations
- EAlopecia
- FTransient diplopia
- GDizziness
- HRare serious blood dyscrasias
- IWeight gain
- JMenstrual abnormalities
26Which five of the following are some of the adverse effects of Carbamazepine and Oxcarbazepine?
- AAnorexia
- BNausea
- CMild parasthesias
- DDependence
- EDrowsiness
- FAcute pancreatitis
- GDifficulty with speech
- HInsomnia
- ISkin rash
- JStevens-Johnson syndrome
27Which six of the following are some of the adverse effects of Valproate?
- AMenstrual abnormalities
- BHyperammonemia
- CAggression
- DAtaxia
- EFulminant hepatitis
- FDizziness
- GAlopecia
- HRare serious blood dyscrasias
- IHyponatremia
- JAcute pancreatitis
28Which six of the following are some of the adverse effects of Valproate?
- ANervousness
- BGI discomfort (tolerance)
- CStevens-Johnson syndrome
- DTremor
- EDiplopia
- FSomnolence
- GWeight gain
- HThrombocytopenia
- IPolycystic ovaries
- JFolate and Vitamin D deficiencies (Megaloblastic anemia, Osteomalacia)
29Which four of the following are the adverse effects of Ethosuximide?
- AFulminant hepatitis
- BHiccups
- CVomiting
- DDifficulty with speech
- EBehavioral changes
- FWeight gain
- GTolerance
- HDependance
- IStevens-Johnson syndrome
- JNausea
30Which four of the following are the adverse effects of Phenobarbital?
- AHepatic failure
- BSedation
- CRespiratory depression
- DImpaired concentration and memory
- EDifficulty with speech
- FLower extremity edema
- GTolerance
- HDependance
- IHyperammonemia
- JHyponatremia
31Which three of the following are the adverse effects of Clonazepam?
- ADiplopia
- BDependance
- CAnorexia
- DSedation
- ERespiratory depression
- FGingival hyperplasia
- GWeight gain
- HTolerance
- IInvoluntary movements
- JPolycystic ovaries
32Which six of the following are the adverse effects of Lamotrigine?
- ADizziness
- BSkin rash
- CHallucinations
- DConfusion
- EStevens-Johnson syndrome
- FInsomnia
- GAggression
- HHeadache
- IHiccups
- JNausea
33Which six of the following are the adverse effects of Topiramate?
- AMild parasthesias
- BDifficulty with speech
- CConfusion
- DDepression
- ENervousness
- FInsomnia
- GImpaired concentration and memory
- HHallucinations
- IAggression
- JSomnolence
34Which three of the following are the adverse effects of Gabapentin and Pregabalin?
- ALower extremity edema
- BHyperammonemia
- CAcne, Hirsuitism, Coarsening of facial features
- DStevens-Johnson syndrome
- EMild parasthesias
- FDrowsiness
- GInsomnia
- HWeight Gain
- ITolerance
- JDependence
35Which four of the following are the adverse effects of Levetiracetam?
- AIrritability
- BVomiting
- CTransient diplopia
- DAtaxia
- EHeadache
- FDepression
- GNausea
- HHallucinations
- IAcute pancreatitis
- JAggression
36Which two of the following are the adverse effects of Felbamate?
- ARespiratory depression
- BHyponatremia
- CConfusion
- DTremor
- EAplastic anemia
- FTolerance
- GRare serious blood dyscrasias
- HDependance
- ILower extremity edema
- JHepatic failure
37Which of the following are the drug-drug interactions of Phenytoin?
- ACan reduce blood levels of contraceptive hormones
- BEnzyme inducers can increase clearance
- CMetabolism inhibited by valproate
- DSignificant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
- EWarfarin: can decrease anticoagulant effect
- FNo significant drug interactions
- GSignificant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
- HInteractions due to plasma protein binding
38Which of the following are the drug-drug interactions of Valproate?
- ASignificant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
- BInteractions due to plasma protein binding
- CCan reduce blood levels of contraceptive hormones
- DEnzyme inducers can increase clearance
- ESignificant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
- FNo significant drug interactions
- GCan increase plasma levels of carbamazepine metabolite, phenytoin, phenobarbital, ethosuximide, lamotrigine and tricyclic antidepressants
39Which of the following are the drug-drug interactions of Ethosuximide?
- AAffected by CYP3A4 inducers
- BSignificant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
- CEnzyme inducers can increase clearance
- DMetabolism inhibited by valproate
- ECan reduce blood levels of contraceptive hormones
- FSignificant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
- GNo significant drug interactions
40Which of the following are the drug-drug interactions of Phenobarbital?
- AReduces blood levels of contraceptive hormones
- BWarfarin: can decrease anticoagulant effect
- CSignificant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
- DMetabolism inhibited by valproate
- ECan increase plasma levels of carbamazepine metabolite, phenytoin, phenobarbital, ethosuximide, lamotrigine and tricyclic antidepressants
- FSignificant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
- GEnzyme inducers can increase clearance
41Which of the following are the drug-drug interactions of Clonazepam?
- AInteractions due to plasma protein binding
- BMetabolized by CYP3A4
- CSignificant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
- DCan reduce blood levels of contraceptive hormones
- EMetabolism inhibited by valproate
- FSignificant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
- GNo significant drug interactions
42Which of the following are the drug-drug interactions of Lamotrigine?
- AEnzyme inducers can increase clearance
- BSignificant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
- CMetabolism induced by carbamazepine, phenobarbital, phenytoin
- DMetabolism inhibited by valproate
- EOral contraceptives can reduce levels
- FInteractions due to plasma protein binding
- GNo significant drug interactions
43Which of the following are the drug-drug interactions of Lamotrigine?
- ACan reduce blood levels of contraceptive hormones
- BAffected by CYP3A4 inducers
- CWarfarin: can decrease anticoagulant effect
- DSignificant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
- ESignificant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
- FInteractions due to plasma protein binding
- GNo significant drug interactions
44Which of the following are the drug-drug interactions of Gabapentin, Levetiracetam, and Pregabalin?
- ASignificant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
- BSignificant enzyme induction: CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP3A4
- CWarfarin: can decrease anticoagulant effect
- DEnzyme inducers can increase clearance
- ECan increase plasma levels of carbamazepine metabolite, phenytoin, phenobarbital, ethosuximide, lamotrigine and tricyclic antidepressants
- FReduces blood levels of contraceptive hormones
- GNo significant drug interactions
45Which of the following are the drug-drug interactions of Carbamazepine?
- AInduces metabolism of phenytoin, ethosuximide, valproate, clonazepam
- BEnzyme inducers can increase clearance
- CReduces blood levels of contraceptive hormones
- DDrug level affected by CYP3A4 inducers (phenytoin, phenobarbital), inhibitors
- ECan increase plasma levels of carbamazepine metabolite, phenytoin, phenobarbital, ethosuximide, lamotrigine and tricyclic antidepressants
- FSignificant enzyme induction: CYP2B6, CYP2C19, CYP2C8, CYP2C9, CYP3A4, P-glycoprotein
- GNo significant drug interactions
46Which of the following statements are true for Phenytoin?
- AMany PO formulations available – IR / ER formulations
- B10-20 mg/L is common therapeutic range
- CMetabolism: dose-dependent capacity-limited pharmacokinetics (zero order metabolism)
- DOldest non-sedating, anti-seizure drug
- EMUST MONITOR SERUM LEVELS
- FUsed in bipolar disorder
- G90% in vascular space is bound to albumin
- HAt steady-state, 10% in vascular space, 90% tissue
- IWeight loss common (80% patients; 3-4% bodyweight loss)
- JTakes up to 6 weeks to achieve steady state, depending on dose
47Which of the following statements are true for Carbamazepine?
- AOldest non-sedating, anti-seizure drug
- BAlso used for migraine prophylaxis and bipolar disorder
- CUsed in children more than adults
- DAdjunctive therapy in children with focal seizures and generalized tonic clonic seizures
- EInduces its own metabolism; t1/2 ~36 hr ~20 hr
- FUsed for migraine prophylaxis
- GUsed for neuropathic pain
- HIs often Drug of Choice for focal seizures
- I100% renal elimination
- JMonotherapy in >16 yr old for focal seizures
48Which of the following statements are true for Valproate?
- AUsed in children more than adults
- BEffective and well tolerated so used for many seizure types
- CNo longer a drug of 1st choice for women of childbearing potential
- DMany PO formulations available – IR / ER formulations
- E90% protein bound – can be significant
- FMany enzymes responsible for its metabolism (2A6, 2B6, 2C9, UGT, etc.)
- GWeight loss common (80% patients; 3-4% bodyweight loss)
- HUsed for migraine prophylaxis
- IUsed for neuropathic pain
- JUsed for bipolar disorder
49Which of the following statements are true for Phenobarbital?
- AUsed for febrile seizures
- B100% renal elimination
- CUsed for weight management
- DUsed in children more than adults
- EWeight loss common (80% patients; 3-4% bodyweight loss)
- FInfrequently used for seizures due to adverse effects and risks
- GOff label use for bipolar disorder
- HInduces its own metabolism; t1/2 ~36 hr ~20 hr
- IOldest non-sedating, anti-seizure drug
- JCommonly used in monotherapy
50Which of the following statements are true for Lamotrigine?
- AMonotherapy in >16 yr old for focal seizures
- B90% in vascular space is bound to albumin
- CUsed for migraine prophylaxis
- DAdjunctive therapy in children with focal seizures and generalized tonic clonic seizures
- EUsed for weight management
- FUsed in children more than adults
- GUsed in absence (better tolerated than ethosuximide, valproate)
- HUsed in bipolar disorder
- IUsed for neuropathic pain
- JDoes not induce or inhibit CYP enzymes
51Which of the following statements are true for Topiramate?
- AAt steady-state, 10% in vascular space, 90% tissue
- BWeight loss common (80% patients; 3-4% bodyweight loss)
- CUsed for bipolar disorder
- DOldest non-sedating, anti-seizure drug
- EUsed for migraine prophylaxis
- FUsed for weight management
- GInduces its own metabolism; t1/2 ~36 hr ~20 hr
- HUsed for neuropathic pain
- I100% renal elimination
- JAdjunctive therapy in children with focal seizures and generalized tonic clonic seizures
52Which of the following statements are true for Levetiracetam?
- A90% in vascular space is bound to albumin
- BUsed in bipolar disorder
- COldest non-sedating, anti-seizure drug
- DAdjunct for Focal and generalized tonic-clonic seizures
- ENot an inhibitor or inducer of CYP enzymes
- FCommonly used for monotherapy
- GUsed for migraine prophylaxis
- HRenal elimination (>70%)
- IUsed for weight management
- JUsed in children more than adults
53Principles of AED Therapy
Choose monotherapy agent on basis of seizure [blank_start]type[blank_end] (or epilepsy syndrome if known) & patient-specific considerations (usually [blank_start]adverse effect[blank_end] profile)
Increase to [blank_start]usual[blank_end] effective dose or to a serum level within the therapeutic range
If seizures not controlled - increase gradually to [blank_start]maximal[blank_end] tolerated dose (MTD) = highest dose a patient can tolerate without bothersome adverse effects
If monotherapy fails, choose alternate monotherapy agent and repeat process
If monotherapy fails with several drugs, try [blank_start]adjuvant therapy[blank_end]
Concern is management of [blank_start]adverse effects[blank_end] of two drugs- Atype
- Badverse effect
- Cmaximal
- Dusual
- Eadjuvant therapy
- Fadverse effects
54Which of the following drugs reduce blood levels of contraceptive hormone?
- ACarbamazepine
- BPhenobarbital
- CPhenytoin
- DFelbamate
- ELamotrigine
- FOxcarbazepine
- GTopiramate
55Antiepileptics are [blank_start]gradually[blank_end] increased to therapeutic concentrations to minimize [blank_start]adverse effects[blank_end] and are withdrawn [blank_start]gradually[blank_end] to reduce the risk of inducing [blank_start]seizures[blank_end].
- Agradually
- Badverse effects
- Cgradually
- Dseizures
56 Enhanced vitamin [blank_start]D[blank_end] metabolism can cause osteomalacia (phenytoin, phenobarbital)
Enhanced vitamin [blank_start]K[blank_end] metabolism can cause bleeding disorders (phenytoin, phenobarbital)
Many anti-epileptics enhance [blank_start]metabolism[blank_end] of other anti-epileptics (phenytoin, carbamazepine, phenobarbital)
[blank_start]Valproate[blank_end] inhibits metabolism of some anti-epileptics- AD
- BK
- Cmetabolism
- DValproate
57Pregnancy
Teratogenicity: Valproate, phenobarbital, phenytoin, carbamazepine
Prefer [blank_start]lamotrigine[blank_end] (or levetiracetam, oxcarbazepine)
Can increase drug metabolism, which can [blank_start]reduce[blank_end] seizure control
Need to switch drugs or increase dose?- Alamotrigine
- Breduce
58Hepatic disease
Avoid [blank_start]hepatotoxic[blank_end] antiepileptic drugs (e.g., valproate) when possible
Monitor free (unbound) levels of phenytoin, valproate when [blank_start]albumin[blank_end] low- Ahepatotoxic
- Balbumin
59Which of the following are contraindications / precautions for Phenytoin?
- AIV use for patients with sinus bradycardia, sinoatrial block, second- and third-degree heart block
- BRisk of dependence is high
- CBlack box warning on rate of IV administration (<50mg/min)
- DTeratogenic risk
60Which of the following are contraindications / precautions for Carbamazepine?
- AHLA-B*1502, common in Asians, linked to 10X increased incidence of Stevens-Johnson syndrome
- BTeratogenic risk
- CBlack box warning on rate of IV administration (<50mg/min)
- DCaution in patients with history of sedative dependence
61Which of the following are contraindications / precautions for Valproate?
- ANot used in children <3 yrs because of risk of liver failure
- BIV use for patients with sinus bradycardia, sinoatrial block, second- and third-degree heart block
- CDo not use in patients with history of sedative addiction
- DTeratogenic risk
62Which of the following are contraindications / precautions for Phenobarbital?
- ARisk of dependence is high
- BDo not use in patients with history of sedative addiction
- CTeratogenic risk
- DBlack box warning on rate of IV administration (<50mg/min)
63Which of the following are contraindications / precautions for Clonazepam?
- ACaution in patients with history of sedative dependence
- BTeratogenic risk
- CIV use for patients with sinus bradycardia, sinoatrial block, second- and third-degree heart block
- DHLA-B*1502, common in Asians, linked to 10X increased incidence of Stevens-Johnson syndrome
Informações
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- O usuário eliminou as informações de disciplina Quiz sobre Anti-epileptics Flashcard Supplement, criado por Usuário eliminado em 22-03-2017.
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