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45 Cards in this Set
- Front
- Back
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What is the mechanism of action for anti epileptic drugs? |
Suppress discharge of neurons within a seizure focus & suppress propagation of seizure activity from the focus to other areas of the brain |
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What are the 4 basic mechanisms of anti epileptic drugs? |
-suppression of sodium influx -suppression of calcium influx -antagonism of glutamate -potentiation of GABA |
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True/False: choice of epileptic drug depends on type of seizure the patient is experiencing |
True |
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What is used for dosage adjustment in anti epileptic drugs? |
Monitoring plasma drug levels; can aid in determining cause of lost seizure control, monitoring patient adherence & identify cause of toxicity |
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What drug inhibits Na channels that inhibit spread of seizure activity in the motor cortex? |
Phenytoin (Dilantin) |
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True/False: Dilantin is used for all types of seizures besides absence |
True; often with generalized, tonic/clonic & status |
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What type of administration is not recommended for Dilantin? |
IM-painful, erratic absorption, crystallizes causing necrosis |
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True/False: if a rash occurs with Dilantin, d/c the drug |
True-hypersensitive |
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What are some common side effects with Dilantin? |
-hirsutism -drowsy -ginger hyperplasia -folic acid deficiency -hyperglycemia |
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True/False: Females should use another form of birth control while on Dilantin |
True; decreases effectiveness of oral contraceptives |
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What are some things the nurse should teach the patient in regards to Dilantin? |
-reduce drug gradually -metabolized in urine -excreted in urine (alkaline urine enhances excretion) |
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What class of anti epileptic drugs potentiates effect of GABA & is used for generalized, tonic/clonic seizures? |
Barbiturates (Phenobarbital) |
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True/False: barbiturates are not the drug of choice for children |
True; can cause intellectual decline in school aged children |
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What are some side effects of barbiturates? |
-drowsiness (most common) -lethargy -dizziness -bronchospasm (esp with IV) -dependency with LT use -male impotence |
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True/False: common adverse effect of barbiturates are hematologic depression |
True |
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What epileptic drug blocks Na channels, suppresses Ca influx, and increases GABA? |
Valproic Acid |
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True/False: valproic acid treats absence, tonic/clonic, and myoclonic seizures |
True |
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What is a common adverse effect of valproic acid? |
Possible fatal hepatoxicity-watch for decreased appetite, malaise, N, abd pain, jaundice |
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What delays neuronal discharge around seizure foci by acting on Na channels? |
Carbamazepines (Tegretol) |
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True/False: tegretol is the number one choice for partial seizures and is also used for bipolar disorder |
True |
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What should be included in teaching for tegretol? |
S/S of blood abnormalities (fever, sore throat, pallor, weakness, infection, easy bruising, and petechiae) |
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What should the nurse monitor for while the patient is on tegretol? |
-hematologic toxicity (bone marrow suppression, aplastic anemia) -CV ( crackles, water retention, dependent edema) -skin (Stevens johnson syndrome) |
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What is the drug of choice for absence seizures in children and adults? |
Ethosuximide (Zarontin) |
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True/False: the nurse should check for allergies to yellow dye 5 for zarontin |
True |
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What are the side effects for zarontin? |
N, V, blood dyscrasias (penias, anemias) |
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What other drugs can be given with Primidone (Mysoline)? |
Phenytoin & Carbamazepine- never Phenobarbital |
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What are some serious adverse effects of Mysoline? |
-psychosis -leucopenia -thrombocytopenia -systemic lupus erythematosus |
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What class of anti epileptic drugs are useful as adjunctive & in status epilepticus? |
Benzodiazepines |
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What is restricted to acute treatment of status epilepticus and tonic/clonic seizures? |
Diazepam (Valium)- give repeatedly |
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What benzo can be given IV during status epilepticus & can be used for long term treatment? |
Clonazepam (Klonopin) |
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What should be checked when Lorazepam (Ativan) is given IV for status epilepticus? |
Physical dependence, baseline VS, decreased HR, RR, BP |
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What anti epileptic drug is indicated for mono tx & adjunctive tx of partial seizures that blocks Na channels? |
Oxcarbazepine (Trileptal) |
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True/False: the most common adverse effect of Trileptal is Stevens Johnson syndrome |
True |
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What should the nurse caution the patient about using with trileptal? |
Na wasting diuretics (lasix, thiazides) |
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What anti epileptic drug is used as adjunctive tx in partial, generalized, tonic/clonic seizures for those older than 2 years of age? |
Lamotrigine (Lamictal); also used for partial seizures for those greater than 16 years old |
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True/False: lamictal blocks sodium and calcium channels and decreases release of glutamate |
True |
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What anti epileptic drug can be used for prophylaxis of migraines with an unknown mechanisms of action? |
Gabapentin (Neurotin) |
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What should the nurse educate the patient in regards to neurotin? |
Avoid driving or hazardous activities until confident they are not mentally impaired |
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What anti epileptic drug can be used for fibromyalgia & the most common adverse effect is weight gain? |
Pregabalin (Lyrica) |
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True/False: levetiracetam (Keppra) is unique and different from all over AEDS however exact action is unknown |
True |
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What is Keppra used for? |
Adj tx in myoclonic greater than 2 years of age, partial onset in greater than 4 years of age, and primary generalized tonic/clonic greater than 6 years of age |
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What anti epileptic drug can be used for treatment of migraine with adverse effects of anorexia and weight loss? |
Topiramate (Topamax) |
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True/False: tiagabine (gabitril) is generally well tolerated with asthenia being a common adverse effect |
True; blocks uptake of GABA |
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What anti epileptic drug is contraindicated with sulfonamide drugs? |
Zonisamide (Zonegran) |
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True/False: zonegran blocks calcium and sodium channels and should not be used in pregnancy or breast feeding |
True |
