1. Which of the following drugs is not indicated for the treatment of Lennox-Gastaut syndrome according to the United States Food and Drug Administration approvals? (For purposes of this monograph, we will use both the brand and generic name for the FDA approved form of cannabidiol (Epidiolex) to differentiate it from forms available in dispensaries.)

2. Which medication is associated with increases in levels of aspartate aminotransferase and alanine aminotransferase?

3. Which of the following is true regarding the Drug Enforcement Administration scheduling status of cannabidiol (Epidiolex) in the United States?

4. Use the following CASE to answer questions 4 and 5:
RK is one of your regular patients. He has epilepsy and comes to your practice asking about treatment for his seizures using cannabidiol. RK is well controlled on his current medications, levetiracetam and lamotrigine, for his generalized tonic-clonic seizures. He read that cannabidiol (Epidiolex) was recently approved by the Food and Drug Administration (FDA) to treat seizures.

RK states that he would like to try cannabidiol (Epidiolex) so he can stop taking levetiracetam due to mild mood changes. What do you tell the patient?

5. RK ignores your recommendation and tells you that he plans to buy cannabidiol (CBD) oil from a local dispensary. Which of the following is most important to tell this patient regarding the use of CBD prepared at dispensaries?

6. A patient is picking up a new prescription for cannabidiol (Epidiolex) from your pharmacy. She wants to know how to store the medication. Which of the following is not appropriate storage for cannabidiol (Epidiolex)?

7. Which of the following is true regarding medications approved to treat Dravet syndrome (DS)?

8. Which of the following is true of Dravet syndrome (DS) but not of Lennox-Gastaut syndrome (LGS)?

9. Which of the following is a known contraindication to the use of cannabidiol (Epidiolex)?

10. A 50-year-old female patient presents to your practice wanting to try cannabidiol (Epidiolex) for seizures related to Lennox-Gastaut syndrome. She is currently taking valproate, clobazam, aspirin, rosuvastatin, and a multivitamin. She is employed in law enforcement; her place of employment has a strict no-drug policy and implements random drug testing with a highly sensitive assay. Which counseling point would be most important to tell this patient about cannabidiol (Epidiolex)?

Evaluation Questions

11. How confident are you in your decision about treatment for the 50-year-old patient described in question 10?

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