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77 Cards in this Set
- Front
- Back
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A siezure can be defined as a symptom of an abnormal and excessive _________ discharge in the ______.
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electrical
brain |
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What is the most common cause of recurring and chronic seizures?
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Epilepsy
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Epileptic seizures are generally iodiopathic? T or F
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TRUE.
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The common causes of seizure activity are: head injuries, brain tumors, ____ and ____
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Temperature elevations and poisoning (alcohol or drugs)
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What is the MOST frequent cause of a seizure?
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Failure to take medications to control previously diagnosed seizure activity.
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Seizures can be grouped into two broad categories
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Generalized and Focal
...based on clinical presentation and EEG. |
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What sort of treatment options are available for the individual suffering from seizure disorders?
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Medication for epileptic seizures.
Surgery and dietary treatment are sometimes used to control symptoms. |
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What is the goal for treatment?
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To supress or reduce the number of seizures.
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Anticonvulsants work by ______ or ______ the abnormal discharges of the CNS.
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Depressing or slowing
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How are pts usually started on their medications?
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2 STEPS:
- P arenteral therapy - O ral therapy when seizure activity under control. |
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The 4 Major Classes of Anticonvulsants are:
1. Barbituates __________ 2. Hydantoins 3. Succinimides |
Benzodiazepines
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What determines the type of anticonvulsant that the pt would take?
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Trial and error, mostly.
Where one drug fails? Another might work |
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Barbituates are CNS stimulants? T or F
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FALSE
They are depressants and used for their sedative effect on the brain. |
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Barbituates act primarily on the _____. They _______ nerve impulses that go to the cerebral cortex.
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Brainstem
Reduce |
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What sort of affect do barbituates have on the respiratory system?
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They depress it.
They slow the activity of nerves and muscles. |
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BARBITUATES
What does it mean when a barbituate is said to raise the seizure threshold? |
The level of electrical activity that must be produced before a seizure will occur is raised.
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BARBITUATES
Barbituates are: a. short-acting b. long-acting c. Intermediate-acting d. A, C e. A, B, C |
Answer: e. A, B, C
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Long-acting barbituates are typically used to control and prevent seizures of which type?
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M iscellaneous seizures (caused by tetanus, fever & drugs)
E pilepticus, status. (sometimes) G rand Mal seizures |
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What is status epilepticus?
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A series of grand mals occuring one after another.
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Elders and weakened pts tend to be more sensitive to barbituates? T or F
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TRUE.
'Hangover', confusion and delirium also more likely. Elder --> Low Dose. |
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BARBITUATES
In an adverse reaction, elders tend to experience worsening brain disorder symptoms. T or F |
TRUE.
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BARBITUATES
S/S of Adverse Reactions? |
- H epatitis w/Jaundice
- U nusual bleeding/bruising. - U ticaria (hives) - P aradoxical restessness/excitement |
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BARBITUATES
What may happen to the platelet count of pt experiencing an adverse reaction to barbituates? |
It will decrease.
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BARBITUATES
An increased tolerance or withdrawal symptoms upon D/C'ing barbituates anticonvulsants can always be considered normal in a pt. T or F |
FALSE.
Pt could be experiencing an adverse reaction. |
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BARBITUATES
S/S of an Overdose? |
S low, shallow respirations
T achycardia S hock C oma |
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BARBITUATES
A pt showing signs of areflexia may be experiencing: a. Nothing. b. an adverse reaction c. an overdose d. a common symptom |
C.
An Overdose. |
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BARBITUATES
Death tends to result from ______. |
Cardiorespiratory failure.
The drug will overly depress the CNS. |
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BARBITUATES
What sort of effect does the barbituate have on anticoagulants, cortifosteroids and digitalis preparations? Why? |
They reduce their activity because they increase metabolism.
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BARBITUATES
MAO I's decrease the depressant effect of barbituates? T or F |
FALSE.
The increase the effect. |
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When barbituates are mixed with alcohol, antihistamines, benzodiazepines, methotrimeprazine, narcotics and tranqs, an ______ effect is produced.
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Additive
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BARBITUATES
What is the generic name for Luminal Phenobarbital? |
Phenobarbital.
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BARBITUATES
It is ok to administer barbituates to a pt in pain? T or F |
FALSE.
Barbituates tend to worsen pain |
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BARBITUATES
Barbituates may be given to pt's with a history of abuse and addiction? |
FALSE.
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BARBITUATES
Why should you exercise caution when giving barbituates parentally? |
Injecting into an artery or tissue may cause serious ischemia. Gangrene could also result.
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BENZODIAZEPINES
Benzodiazepones are CNS depressants? T or F |
TRUE
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BENZODIAZEPINES
Benzodiazepines act on the _____ and ________ system of the brain, suppressing the electiical discharge. |
Hypothalmus and limbic
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BENZODIAZEPINES
Benzodiazepines treat ______ motor seizures. |
Minor
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What sort of anticonvulsant is used to treat Lennox-Gastaut syndrome?
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Benzodiazepines
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BENZODIAZEPINES
Name 3 Benzodiazepines that are approved for use as anti-convulsants? |
GENERIC TRADE
Clonazepam Klonapin Clorazepate Tranxene Diazepam Valium |
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BENZODIAZEPINES
Diazepam is administed by what route? |
Intravenously.
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Which benzodiazepine is the drug of choice for status epilepticus?
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Diazepam.
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Clonazepam is used to treat grand mal seizures in elders? T or F
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FALSE
It's used to treat petit mal seizures in children. |
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By which route is clonezepam administered to children?
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Orally
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Chronic use of this benzodiazepine may result in impaired physical or mental function in the developing child.
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Clonazepam
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Clorazeoate is used with oher anti-epileptics to control ______ seizures.
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Partial
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Benzodiazepines are also given to pt's who have failed to respond to this anticonvulsant.
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Succinimides
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BENZODIAZEPINES
A flushed pt with low b/p, sob, blurred vision, sweating and confusion could be suffering from: a. an overdosage. b. an adverse reaction. c. a common side effect |
B. Adverse Reaction.
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BENZODIAZEPINES
S/S of Adverse Reaction |
Paradoxical reaction
Anorexia Bitter taste and dry mouth Heartburn Burning eyes ....and itchy skin with a rash |
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BENZODIAZEPINES
A pt who appears tired, weak comes down the hall. They appear to be somewhat confused and have an unsteady stance. This pt is demonstrating signs of: a. an overdosage. b. an adverse reaction. c. a common side effect |
a. Overdosage.
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BENZODIAZPINES
Somesimes, a combination of benzodiazepines and other anti-convulsants can provoke additional seizures. T or F |
TRUE
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BENZODIAZEPINES
Benzodiazepines can be used during pregnancy? T of F |
F
They may produce neonatal depression and congenital malformations |
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BENZODIAZEPINES
Which pts should be carefully monitored while on Benzodiazepines? |
- Geriatrics
- Weak Patients - Children - Pt's with decreased liver function |
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What does the liver do to benzodiazepines?
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Changes benzodiazepines into long-acting forms.
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The pt taking benzodiazepines is at increased R/F.
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- increased sedation
- liver damage |
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Why would the pt taking benzodiazepines experience increased sedation?
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The drug remains in the body longer.
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If stopped too quickly, benzodiazepines can produce this type of seizure?
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Status Epilepticus
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A pt with a respiratory problem and taking benzodiazepines has been noticed drooling.
Is this abnormal? |
Not necessarily.
Benzodiazepines may cause drooling or increased secretions in pt's with abnormal respiratory problems. |
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What is the onset of action for the benzodiazepines? ___ to ___ minutes with effects that last __ to __ hours.
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- 30 to 60 minutes
- 7 to 8 hours |
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Hydantoines act primarily on the ___ ____ where they stop the seizure activity by increasing or decreasing ___ ___ movement along the cortex during the generation of nerve impulses
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- Motor Cortex
- Sodium ion |
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Hydantoins treat which type of seizure?
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Grand Mal and psycho motor seizures
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Hydantoins are sometimes used to treat status epilepticus, migraine and trgeminal neuralgia? T or F
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True.
They also treat nonepileptic psychotic patients. |
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You notice a pt staring forward with slurred speech, low b/p and unresponsive pupils. This could be signs of:
a. Common Side Effects b. Adverse Reactions c. Overdose. |
C. Overdose.
They pt may also have 'nystagmus' (twitchy eyeballs) |
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What special recommendations should be given for hydantoine oral suspension and PO-route drugs?
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Shake well and don't freeze.
Chewable tablets should not be used for once a day treatment. |
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What type of administration route is dangerous with hydantoine?
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SubQ or perivascular injections.
...because of high alkalinity of the solution. |
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When given by IV route, Hydantoins must be administered very slowly
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TRUE
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Pts taking hydantoins at R/F for toxicity. Why?
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They metabolize the drug at higher rates and are R/F:
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Good oral hygiene should be emphasized for hydantoins. Why?
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Gingival hyperplagia.
Gum overgrowth is a typical findng with us of hydantoins. |
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Nystagmus, lupus erythematosus, gingival hyperplagia, hepatitis with jaundice and lymph node hyperplasia are the s/s of an adverse reaction for which anticonvusalnt?
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Hydrantoin.
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In PO hydrantoin therapy, a capsule labeled 'prompt' means what?
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The capsule is to be given 2-3x a day.
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In Hydrantoin oral therapy, a capsule labeled 'extended' means that the capsule should be given ____.
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Once a day.
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Name two hydantoins medications?
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GENERIC TRADE
Fosphenytoin Cerebyx Phenytoin Dilantin |
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Succinimides _____ the seizure threshhold in the cortex and basal ganglia.
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Elevate
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Succinimides control this type of seizure
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Petite Mal
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Succinimides + other anti-convulsant can result in either an increases __________ or an increased ______.
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1. Sex drive
2. frequency of grand mal seizures. |
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S/S of Succinimide Adverse Reaction
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Systemic lupus erythematosus
Mental slowness. Blood cell changes. Muscular Weakness. |
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A pt taking succinimides has what appears to be pink urine. This is:
a. normal. b. an infection c. an adverse reaction d. a common side effect |
A. Normal.
Succinimides may make urine appear pink, red or reddish-brown. |
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Name a Succinimide drug.
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GENERIC TRADE
Phensuximide Ethosuximide Zarontin |
