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64 Cards in this Set
- Front
- Back
What is the action of anticonvulsant meds?
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decreases flow of CA and NA across neuronal membranes
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Which anticonvulsnts should you give to tx partial seizures?
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partial seizures:
1. Luminal 2. Mysoline 3. Tegretol 4. Neurontin 5. Lamictal |
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Which meds should you give to tx generalized tonic-clonic seizures?
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tonic-clonic seizures:
1. Luminal 2. Mysoline 3. Tegretol |
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Which meds should you give to tx absence seizures?
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Zarontin
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Which meds should you give to tx status epilecticus?
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status epilecticus:
1. Valium 2. Ativan 3. Dilantin |
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4 potential side effects of anticonvulsant meds?
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1. cardiovascular depression
2. respiratory depression 3. agranulocytosis 4. aplastic anemia |
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What develops w/ long-term use of anticonvulsants?
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tolerance
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How should you discontinue anticonvulsant use?
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taper, do not d/c abruptly
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Which meds should be cautiously used w/ anticonvulsants? Why?
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MAOIs- lower the seizure threshold
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Meds from which 2 other classes can be used as anticonvulsants?
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1. barbiturates
2. benzodiazepines |
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What do older adults face when taking anticonvulsants?
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increased risk of adverse rxn
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Although Clonazepam (Klonopin) is used as an anticonvulsant, what med class is it from?
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Benzodiazepine
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What are 4 pt side effects of Clonazepam (Klonopin)?
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1. drowsiness
2. dizziness 3. confusion 4. resp. depression |
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teaching a/w clonazepam (klonopin)?
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1. do not d/c abruptly
2. avoid activities that require alertness |
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Typical IV push dose of Diazepam (Valium)?
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should not exceed 2 mg/min
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What is the impact of mixing Diazepam (Valium) w/ alcohol?
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it increases CNS depression
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What should you monitor ina pt who has just received diazepam (valium)?
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VS: have resuscitation equipment available if given IV
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What are 5 withdrawal sympstoms a/w stopping long-term use of diazepam (valium)?
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1. V
2. sweating 3. cramps 4. tremors 5. convulsions |
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5 potential side effects of Diazepam (Valium)?
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1. drowsiness, ataxia
2. hypOtension 3. tachycardia 4. resp depression |
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What is Fosphenytoin (Cerebyx) used to tx?
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tonic-clonic seizures & status epilecticus
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When should a pt contact his/her HCP when using Fosphytoin (Cerebryx)?
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if a rash devo
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Is Fosphenytoin highly protein-bound?
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yes
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5 pt side effects of Fosphenytoin (Cerebryx)
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1. Drowsiness
2. dizziness 3. confusion 4. leukopenia* 5. anemia* |
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2 side efects of Levetiracetam (Keppra)?
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1. dizziness
2. suicidal ideation* |
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What should a pt taking Keppra (Levetiracetam) avoid? (2)
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1. alcohol
2. driving & activities that require alertness |
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How should you administer Phenytoin sodium (Dilantin)?
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PO: w/ .5 glass of water or w/ meals::to MINIMIZE GI irritation
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What adverse effect can be caused by IV Phenytoin sodium (Dilantin), which precautions should you take?
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cardiac arrest: have resuscitation equip available
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Which substances should never be mixed w/ Phenytoin sodium (Dilantin)?
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1. any other drug
2. dextrose IV 3. alcohol (increases serum levels) |
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What should you inform pt taking phenytoin sodium (Dilantin) about?
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1. expect red-brown or pink discoloration of sweat and urine
2. oral hygiene 3. increase vitamin D intake & exposure to sun w/ long-term use |
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7 potential side effects of Dilantin?
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1. drowsiness, ataxia
2. nystagmus 3. blurred vision 4. hirsutism 5. lethargy 6. GI upset 7. gingival hypertrophy |
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When does the side effect of drowsiness diminish s/p Phenobarbital (Luminal)?
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after initial weeks of therapy
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What is an early side of Phenobarbital (Luminal) toxicity?
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nystagmus
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Does Phenobarbital (Luminal) result in tolerance and/or dependence?
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yes, w/ long-term use
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What should a pt taking Phenobarbital (Luminal) avoid?
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alcohol or hazardous activities
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What might sudden d/c of Phenobarbital (Luminal) lead to?
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withdrawal symptoms
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Which supplements should be given in pt on long-term use of Phenobarbital (Luminal)?
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folic acid!
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What impact might Phenobarbital (Luminal) have on older adults?
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decreased cognitive fxn
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6 s.e. of Phenobarbtial (Luminal)
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1. drowsiness
2. rash 3. GI upset 4. initially constricts pupils 5. resp. depression 6. ataxia |
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How long might the full therapeutic response of Primidone (Myosoline) take?
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up to 2 wk
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4 pt s.e. in pt taking Primidone (Myosol)
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1. drowsiness
2. ataxia 3. diplopia 4. N,V |
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When is magnesium sulfate given?
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to tx pregnancy-induced HTN
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Before each dose of mag sulfate, what should you monitor?
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knee jerks
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What should you monitor often during mgso4 admin?
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VS & IO
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5 s.e. of magneisum sulfate?
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1. flushing
2. sweating 3. exteme thirst 4. hypOtn 5. sedaton, confusion |
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What is the drug of choice in many seizure disorders fo young children?
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valproic acid (depakote)
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How should one take depakote (valproic acid)?
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w/ food, NOT w/ carbonated beverage
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What 3 labs need to be monitored in pt taking valproic acid (depakote)?
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1. plt
2. bleeding time 3. liver fxn tests |
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4 s.e. of valproic acid (depakote)
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1. sedation
2. tremor, ataxia 3. N,V 4. prolonged bleeding time |
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What should you monitor in a pt on Carbamazepine (Tegretol)?
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1. IO
2. CBC |
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What is a danger a/w carbamazepine (tegretol)
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multiple drug interactions
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What should you teach a pt on carbamazepine (tegertol)?
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1. supervise ambulation
2. take w/ meals 3. wear protective clothes r/t photosensitivity 4. multiple drug interactions |
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5 s.e. of carbamazepine (tegretol)
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1. myelosuppression
2. dizziness, drowsiness 3. ataxia 4. diplopia 5. rash |
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In pt taking Ethosuximide (Zarontin), what should you monitor for?
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1. behavior changes
2. weight changes (weekly weight) |
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3 s.e. of ethosuximide (zarontin)
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1. GI symptoms
2. drowsiness 3. ataxia, dizziness |
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What should you monitor for in a pt taking Gabapentin (neurontin)?
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1. weight change
2. behavioral change |
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What can Gabapentin (Neurontin) also be used to tx?
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postherpetic neuralgia
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5 s.e. of gabapentin (neurontin)
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1. increased appetite
2. ataxia 3. irritability 4. dizziness 5. fatigue |
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How should one take Lamotrigine (Lamictal)
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divided doses w/ meals or just after meals to decrease adverse effects
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6 s.e. of Lamotrigine (Lamictal)
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1. diplopia
2. headache 3. dizziness 4. drowsiness 5. ataxia 6. N,V |
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what life-threating event can happen with Lamotrigine (Lamictal) is mixed w/ valproic acid?
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life-threatening rash
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What is topiramate (topamax) used for?
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adjunct therapy for intractible partial seizures
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When should you stop topiramate (topamax) immediately?
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w/ eye problems: could lead to permanent damage
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What is a pt taking topiramate (topamax) at increased risk for?
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renal calculi
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5 s.e. of Topiramate (Topamax)
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1. ataxia
2. confusion 3. dizziness 4. fatigue 5. vision problems |