You are a hospital pharmacist who provides antiepileptic drug services to the Neurology clinic. Jessie, a 24-year-old lady who has just been married, is contemplating pregnancy in the future. She has a known medical history of generalized tonic clonic epilepsy since the age of 14. The frequency of convulsions is about once a month. Her current medication includes sodium valproate 400 mg twice daily. 

(a) She would like to seek your advice on the use of oral contraceptive pills ("OCP"). Please advise and explain if OCP is a safe contraceptive method for her. (2 marks) 

(b) Name TWO fetal risks of sodium valproate exposure in utero in a lady considering future pregnancy. (2 marks) 

(c) Discuss the BENEFITS and RISKS of the following THREE approaches on epilepsy management during pregnancy. (6 marks) 

(i) Withdraw of valproate 

(ii) Switch from valproate to an alternative treatment 

(iii) Unchanged treatment with valproate 

(d) If Jessie chooses to continue sodium valproate treatment during pregnancy, what would be the ideal maximal dosage? (1 mark) 

(e) If Jessie decides to change to other alternative antiepileptic drugs before conceiving, suggest TWO alternative drugs which have lower risk of teratogenicity and are effective in controlling generalized seizures, but do not interfere the function of OCP. (2 marks) 

(f) What supplement and dosage of the supplement should Jessie take before and during pregnancy in order to prevent fetal malformation? (1 mark) 

(g) What are the pregnancy-associated physiological changes on antiseizures drug metabolism? Do you advise therapeutic drug monitoring for the antiseizure drugs listed in question (e)? (3 marks) 

(h) After delivery of the baby, Jessie keeps taking the same dose of the antiseizure drug because she is worried of sleep deprivation and seizure recurrence. Is she at risk of antiseizure drug overdose and why? (2 marks) 

(i) Jessie is concerned about antiseizure drug exposure to her newborn baby if she breastfeeds him. What is your advice? (1 mark)