Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
38 Cards in this Set
- Front
- Back
|
EPILEPSY:
What is going on... Most of the info processing of the brain occurs in what part... For a person to be Dx with epilepsy... |
-Abnormal firing of cerebral neurons as a result of brain dysfunction
-Cerebral cortex (fxns such as touch, hearing, vision, movement, thinking) -At least 2 seizures |
|
|
Classification of Seizure Types...
|
Partial seizures:
-Simple partial seizures -Complex partial seizures -Partial seizures secondarily generalized General seizures: -Generalized tonic-clonic (grand mal)seizures -Absence (petit mal) seizures -Tonic seizures -Atonic seizures -Conic and myoclonic seizures -Infantile spasms |
|
|
Partial Seizures:
Also called... Excessive electrical activity where... Simple Partial seizure: Pt may experience what... Key feature is... Complex Partial Seizure: What happens... Typically orginate where... So can be classified as... |
-Focal seizures
-In one cerebral hemisphere -Strange motor, sensory, or autonomic sensations -They are conscious, may just stare, then snap out of it -Preservation of consciousness -Loss of awareness. Pt seems dazed or confused and exhibits meaningless behaviors -Frontal or temporal lobe -Temporal lobe epilepsy |
|
|
Generalized Seizures:
Excessive elec activity where... Usually orginates where... What is common... Myoclonic... Atonic... Tonic... Clonic... Tonic-clonic (grand mal)... |
-Both hemispheres
-Thalamus or brainstem (so affects whole body) -Loss of consciousness -Brief shock-like muscle jerks generalized or restricted to one extremity -Sudden loss of muscle tone -Sudden stiffening of body/arms/legs -Rhythmic jerking movements of arms/legs w/out a tonic component -Tonic phase followed by clonic phase |
|
|
Absence (petit mal) Seizure:
Person appears how... Different types... How is status epilepticus defined... |
-Appears to blank out or daydreaming
-Simple Absence (primarily effects consciousness only) -Complex Absence -Atypical Absence (includes physical sx's like eye blinking or lip movements) -A seizure lasting longer than 30min, or 3 seizures w/out a NL period in between -May be fatal and requires intervention |
|
|
PHENYTOIN:
Brand names... First choice for what... Some efficacy in what... No effect on what... Type of dosing... Type of admin that is unpredicatible... Onset... Protein binding... Half life... It accumulates where... Metabolism/excretion... |
-Partial seizures and generalized tonic-clonic seizures
-Clonic, myoclonic, and atonic seizures -Infantile spasms or absence seizures -Oral dosing -IM -30min-1hr -90% -22-24hrs -In the brain, liver, muscle, and fat -Hepatic (also enterohepatic circulation; metabolite are inactive) -Renal (slow plasma clearance; dose dependent) |
|
|
Phenytoin:
Side effects... Contraindications... |
-Nystagmus
-Diplopia -Ataxia -Gingival Hyperplasia (once drug is stopped, this resolves) -Hirsutism (Unwarranted hair growth) -Hypersensitivity to Phenytoin -Hepatic dysfunction -Bradycardia -Elderly (need to dose adjust) -Condition w/ low serum albumin levels |
|
|
Phenytoin:
Toxicity results in what type of symptoms... Drug interactions are related to what... What drugs cause decreases in phenytoin... What drugs cause increases in phenytoin... Phenytoin may decrease levels of... |
-Unsteady gait
-Slurred speech -Confusion -Nausea -Hypothermia, Hypotension -Respiratory depression -Related to protein binding -phenobarbital,carbamazepine, clarithromycin, Ciprofloxacin (Drugs that induce the CP450 system) -Warfarin (short-lived) -Digitalis, theophylline and thyroid hormone |
|
|
CARBAMAZEPINE:
Effective at treating what types of seizures... Some efficacy in... Type of admin... Half life... Protein binding... Metabolism... Why is phenytoin superior at Tx'ing seizures than carbam... |
-Partial and generalized tonic-clonic seizures
-Trigeminal neuralgia (Reduces pain associated with trigeminal nerve) -Bipolar disorder (Mania) -Oral -36 hrs -70% -Hepatic (yields an active epoxide metabolite; also induces CP450) -it has a larger side effect profile |
|
|
Carbamazepine:
Side effects... Contraindications... Toxicity symptoms... |
-CV: arrythmias, bradycardia, chest pain
CNS: Manesia, anxiety, aseptic meningitis Derm: alopecia, altered skin pigmentation, exfoliative dermatitis GI: Abdominal pain, N/V -Hypersensitivity to Carbamazepine -Tricyclic antidepressants -Bone marrow depression -Diplopia -Ataxia -Dizziness -Idiosyncratic blood dyscrasias (avoid succinylcholine) -Aplastic anemia -Neuromuscular disturbances |
|
|
Carbamazepine:
Drug Interactions- What inhibits its clearance... Which drugs decrease its bld levels... Reduces levels of what...why... |
-Valproic acid
-Phenytoin and phenobarbital -Primidone, phenytoin, ethosuximide, valproic acid, clonazepam (b/c it induces CP450 sys) |
|
|
TOPIRAMATE:
Treats what kinds of seizures... Some efficacy on what... Type of admin... Protein binding... half life... Metabolism/excretion... |
-Partial and generalized tonic-clonic seizures (as a monotherapy)
-Lennox-Gestaut Syndrome (seizures in toddlers), West Syndrome (seizures in infants) and absence seizure (adjunct) -Migraine headaches (mono) -Oral -41% -21 hrs -Hepatic/renal |
|
|
Topiramate:
Side effects... Contraindications... Drug Interactions: Drugs that decrease its levels... Co-admin with any CSN depressant will... May increase levels of... |
-CNS: dizziness, somnolence, nervousness, altered memory, cognitive dysfunction
GI: nausea & wt loss Neuromuscular: paresthesia -Pts w/ hepatic, resp, or renal impairment -Phenytoin and Carbamazepine -Enhance sedative effects -Phenytoin |
|
|
PHENOBARBITAL:
Indications... |
-Partial seizures and generalized tonic-clonic seizures
-Not the drug of choice, 3rd line |
|
|
PRIMIDONE:
Indications... Type of admin... Protein binding... Half life... Metabolism/excretion... |
-Partial seizures and generalized tonic-clonic seizures (may be more effective than Phenobarbital)
-Complex partial seizures(Phenytoin and Carbamazepine are superior) -More effective than phenobarbitol -Oral (completely absorbed) -99% -6-8 hrs -Hepatic to pentobarbital (active) and PEMA -Renal |
|
|
Primidone:
Side effects... Contraindications... Drug interactions... |
-CNS: drowsiness (so given hs), vertigo, ataxia, lethargy, behavioral changes
-Dermatologic: rash -GI: N/V, anorexia (may be intolerable) -Pts with G6PD deficiency, NADH methemoglobin reductase deficiency -Same as phenobarbital. Primarily due to inducing effects on cyp450 enzyme |
|
|
Enterococcus (endocarditis):
Organism... DOC... Alternative... |
-Gram POSITIVE cocci
-Penicillin G or ampicillin w/ gentamicin or streptomycin -Vancomycin with gentamycin |
|
|
Uncomplicated UTI:
Organism... DOC... Alternative... |
-Enterococcus (Gram POSITIVE cocci)
-Ampicillin or amoxicillin -Nitrofurantoin, a fluroquinolone: fosfomycin |
|
|
Penicillinase producing staph aureus:
Organism... DOC... Alternative... |
-Staph aureus (Gram POSITIVE cocci)
-A penicillinase-resistant penicillin -A cephalosporin, vacomycin, amoxicillin-clavulanic acid |
|
|
Methicillin resistant staph aureus:
Organism... DOC... Alternative... |
-Staphylococcus aureus (MRSA) Gram POSITIVE cocci
-Vancomycin -Linezolid, trimethoprim-sulfamethoxazole |
|
|
Sterepococcus pneumonae:
Organism... DOC... Alternative... |
-Gram POSITIVE cocci
-Penicillin G -Ceftriaxone, cefotaxime |
|
|
Neisseria gonorrhoeae (gonococcus):
Organism... DOC... Alternative... |
-Gram NEGATIVE cocci
-Ceftriaxone, cefixime, ciprofloxacin -Cefotaxime, Penicillin G |
|
|
Neisseria meningitides (meningococcus):
Organism... DOC... Alternative... |
-Gram NEGATIVE cocci
-Penicillin G -Cefotaxime, chloramphenicol, a fluoroquinolone |
|
|
Bacillus anthracis (anthrax):
Organism... DOC... Alternative... |
-Gram POSITIVE bacilli
-Ciprofloxacin -Amoxacillin, doxycycline |
|
|
Clostridium difficile:
Organism... DOC... Alternative... |
-Gram POSITIVE bacilli
-Metronidazole -Vancomycin (PO) |
|
|
Escherichia coli:
Organism... DOC... Alternative... |
-Enteric Gram NEGATIVE bacilli
-Cefotaxime, ceftizoxime, cefepime -Ampicillin ± gentimycin, trimethoprim-sulfamethoxazole |
|
|
Enterobacter:
Organism... DOC... Alternative... |
-Enteric Gram NEGATIVE bacilli
-Imipenem -Trimethoprim-sulfamethoxazole |
|
|
Helicobacter pylori:
Organism... DOC... Alternative... |
-Enteric Gram NEGATIVE bacilli
-Tetracycline + metronidazole + PPI -Tetracycline + clarithromycin + PPI |
|
|
Klebsiella pneumoniae:
Organism... DOC... Alternative... |
-Enteric Gram NEGATIVE bacilli
-Cefotaxime, ceftizoxime -Imipenem, gentamycin |
|
|
Salmonella typhi:
Organism... DOC... Alternative... |
-Enteric Gram NEGATIVE bacilli
-Ceftriaxone, a fluoroquinolone -Trimethoprim-sulfamethoxazole |
|
|
H. Influenza (Meningitis, upper respiratory infection, bronchitis):
Organism... DOC... Alternative... |
-Gram NEGATIVE bacteria
-Cefotaxime, ceftriaxone, Trimethoprim-sulfamethoxazole -Cefuroxime, Chloramphenicol, Cefuroxime, a fluoroquinolone |
|
|
Vibrio cholerae (Cholera):
Organism... DOC... Alternative... |
-Gram NEGATIVE bacteria
-Tetracycline -Trimethoprim-sulfamethoxamide |
|
|
P. aeruginosa (UTI):
Organism... DOC... Alternative... |
-Gram NEGATIVE bacteria
-Ciprofloxacin -Levofloxacin, piperacillin |
|
|
Mycobacteria tuberculosis:
Organism... DOC... Alternative... |
-Isoniazid + rifampin + pyrazinamide ± ethambutol
-A fluoroquinolone, cycloserine |
|
|
Mycobacteria leprae (leprosy):
Organism... DOC... Alternative... |
-Dapsone + rifampin ± clofazimine
-Minocycine, levofloxacin |
|
|
Chlamydiae trachomatis (inclusion conjunctivitis):
Organism... DOC... Alternative... |
-Erythromycin
-A sulfonamide |
|
|
Chlamydiae trachomatis (pneumonia):
Organism... DOC... Alternative... |
-Erythromycin
-A sulfonamide |
|
|
Chlamydiae trachomatis (urethritis, cervicitis):
Organism... DOC... Alternative... |
-Doxycylcline or azithromycin
-Erythromycin, levofloxacin, amoxicillin |
