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30 Cards in this Set

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  • Back
What are the three parts of the central nervous system?
brain
spinal cord
multiple neurotransmitters
What does the blood brain barrier do?
Restricts the entry of some drugs and large particles to the brain.
What are some exceptions that do cross the blood brain barrier?
lipid soluble drugs
Drugs with specific transport systems
What are some examples of things that cross the blood brain barrier?
water
alcohol
oxygen
carbon dioxide
glucose
gases
What type of things that restricted entry into the blood brain barrier?
protein bound drugs
highly ionized drugs
What does the restrictions and exceptions about the blood brain barrier implicate to the nurse?
If there is a problem in the brain, we need to use a drug that will cross the barrier.
What are three adaptations of the CNS to prolonged drug exposure?
Increased theraputic effects
Decreased side effects
Tolerance and Physical dependence
What are drugs for epilepsy called?
Antieleptic drugs
What is going on in the brain of an epileptic patient?
The neurons of the CNS have excessive excitability.
What is the difference between a seizure and a convulsion?
A seizure is general type of epileptic event and convulsions are a physical manifest of seizures.
What are the two types of seizures?
partial(focal) seizures
generalized seizures
How many people are effected by seizures?
2.3 million
What are the mechanisms of action of antieplieptic drugs?
They suppress the discharge of neurons from the focal area and the propagation of seizures from the focal area to other areas.
What does the suppression of sodium influx do?
Prolongs channel inactivation
What does the suppression of calcium influx do?
blocks calcium transport
decreases electrical generation
What does potentiation of GABA do?
It decreases excitability
What is one of the goals of drugs for epilepsy?
To reduce seizures and promote near to normal life for patient.
How do the maximize treatment but decrease side effects?
Increase dosage gradually until seizures are controlled or adverse effects become unacceptable.
Is treatment for epilepsy short term or long term? Is this an acute or chronic condition?
Treatment is usually long term. Epilepsy is a chronic condition.
What are two examples of Hydantoins?
Dilantin, Cerebyx
What do the hydantoins do?
inhibit sodium channels to suppress action potential and stabilize cell membrane excitability
Are hydantoins selective?
Yes. They are only affective against hyperactive neurons
What are hydantoins indicated for?
Partial and generalized tonic-clonic seizures
What is the theraputic index for hydantoins?
10-20 micrograms
What is unique about the half life of hydantoins?
The half life increases with dosage.
What are some of the side effects of hydantoins on the brain?
sedation
drowsiness
dizziness
lowered attention span
blurred vision
What do nurses need to know about hydantoins on the heart?
Cardiac dysrhythmias are known with IV route
What is a key side effect of hydantoins?
gingival hyperplasia
What percent of hydantoin patients experience gingival hperplasia?
20
What are some contraindications for hydantoin users?
oral contraceptives
warfarin
steroids
diazepam
alcohol
pregnancy