10 Meds: Anticonvulsants

Front 1

What is the action of anticonvulsant meds?

Back 1

decreases flow of CA and NA across neuronal membranes

Front 2

Which anticonvulsnts should you give to tx partial seizures?

Back 2

partial seizures:
1. Luminal
2. Mysoline
3. Tegretol
4. Neurontin
5. Lamictal

Front 3

Which meds should you give to tx generalized tonic-clonic seizures?

Back 3

tonic-clonic seizures:
1. Luminal
2. Mysoline
3. Tegretol

Front 4

Which meds should you give to tx absence seizures?

Back 4

Zarontin

Front 5

Which meds should you give to tx status epilecticus?

Back 5

status epilecticus:
1. Valium
2. Ativan
3. Dilantin

Front 6

4 potential side effects of anticonvulsant meds?

Back 6

1. cardiovascular depression
2. respiratory depression
3. agranulocytosis
4. aplastic anemia

Front 7

What develops w/ long-term use of anticonvulsants?

Back 7

tolerance

Front 8

How should you discontinue anticonvulsant use?

Back 8

taper, do not d/c abruptly

Front 9

Which meds should be cautiously used w/ anticonvulsants? Why?

Back 9

MAOIs- lower the seizure threshold

Front 10

Meds from which 2 other classes can be used as anticonvulsants?

Back 10

1. barbiturates
2. benzodiazepines

Front 11

What do older adults face when taking anticonvulsants?

Back 11

increased risk of adverse rxn

Front 12

Although Clonazepam (Klonopin) is used as an anticonvulsant, what med class is it from?

Back 12

Benzodiazepine

Front 13

What are 4 pt side effects of Clonazepam (Klonopin)?

Back 13

1. drowsiness
2. dizziness
3. confusion
4. resp. depression

Front 14

teaching a/w clonazepam (klonopin)?

Back 14

1. do not d/c abruptly
2. avoid activities that require alertness

Front 15

Typical IV push dose of Diazepam (Valium)?

Back 15

should not exceed 2 mg/min

Front 16

What is the impact of mixing Diazepam (Valium) w/ alcohol?

Back 16

it increases CNS depression

Front 17

What should you monitor ina pt who has just received diazepam (valium)?

Back 17

VS: have resuscitation equipment available if given IV

Front 18

What are 5 withdrawal sympstoms a/w stopping long-term use of diazepam (valium)?

Back 18

1. V
2. sweating
3. cramps
4. tremors
5. convulsions

Front 19

5 potential side effects of Diazepam (Valium)?

Back 19

1. drowsiness, ataxia
2. hypOtension
3. tachycardia
4. resp depression

Front 20

What is Fosphenytoin (Cerebyx) used to tx?

Back 20

tonic-clonic seizures & status epilecticus

Front 21

When should a pt contact his/her HCP when using Fosphytoin (Cerebryx)?

Back 21

if a rash devo

Front 22

Is Fosphenytoin highly protein-bound?

Back 22

yes

Front 23

5 pt side effects of Fosphenytoin (Cerebryx)

Back 23

1. Drowsiness
2. dizziness
3. confusion
4. leukopenia*
5. anemia*

Front 24

2 side efects of Levetiracetam (Keppra)?

Back 24

1. dizziness
2. suicidal ideation*

Front 25

What should a pt taking Keppra (Levetiracetam) avoid? (2)

Back 25

1. alcohol
2. driving & activities that require alertness

Front 26

How should you administer Phenytoin sodium (Dilantin)?

Back 26

PO: w/ .5 glass of water or w/ meals::to MINIMIZE GI irritation

Front 27

What adverse effect can be caused by IV Phenytoin sodium (Dilantin), which precautions should you take?

Back 27

cardiac arrest: have resuscitation equip available

Front 28

Which substances should never be mixed w/ Phenytoin sodium (Dilantin)?

Back 28

1. any other drug
2. dextrose IV
3. alcohol (increases serum levels)

Front 29

What should you inform pt taking phenytoin sodium (Dilantin) about?

Back 29

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

Front 30

7 potential side effects of Dilantin?

Back 30

1. drowsiness, ataxia
2. nystagmus
3. blurred vision
4. hirsutism
5. lethargy
6. GI upset
7. gingival hypertrophy

Front 31

When does the side effect of drowsiness diminish s/p Phenobarbital (Luminal)?

Back 31

after initial weeks of therapy

Front 32

What is an early side of Phenobarbital (Luminal) toxicity?

Back 32

nystagmus

Front 33

Does Phenobarbital (Luminal) result in tolerance and/or dependence?

Back 33

yes, w/ long-term use

Front 34

What should a pt taking Phenobarbital (Luminal) avoid?

Back 34

alcohol or hazardous activities

Front 35

What might sudden d/c of Phenobarbital (Luminal) lead to?

Back 35

withdrawal symptoms

Front 36

Which supplements should be given in pt on long-term use of Phenobarbital (Luminal)?

Back 36

folic acid!

Front 37

What impact might Phenobarbital (Luminal) have on older adults?

Back 37

decreased cognitive fxn

Front 38

6 s.e. of Phenobarbtial (Luminal)

Back 38

1. drowsiness
2. rash
3. GI upset
4. initially constricts pupils
5. resp. depression
6. ataxia

Front 39

How long might the full therapeutic response of Primidone (Myosoline) take?

Back 39

up to 2 wk

Front 40

4 pt s.e. in pt taking Primidone (Myosol)

Back 40

1. drowsiness
2. ataxia
3. diplopia
4. N,V

Front 41

When is magnesium sulfate given?

Back 41

to tx pregnancy-induced HTN

Front 42

Before each dose of mag sulfate, what should you monitor?

Back 42

knee jerks

Front 43

What should you monitor often during mgso4 admin?

Back 43

VS & IO

Front 44

5 s.e. of magneisum sulfate?

Back 44

1. flushing
2. sweating
3. exteme thirst
4. hypOtn
5. sedaton, confusion

Front 45

What is the drug of choice in many seizure disorders fo young children?

Back 45

valproic acid (depakote)

Front 46

How should one take depakote (valproic acid)?

Back 46

w/ food, NOT w/ carbonated beverage

Front 47

What 3 labs need to be monitored in pt taking valproic acid (depakote)?

Back 47

1. plt
2. bleeding time
3. liver fxn tests

Front 48

4 s.e. of valproic acid (depakote)

Back 48

1. sedation
2. tremor, ataxia
3. N,V
4. prolonged bleeding time

Front 49

What should you monitor in a pt on Carbamazepine (Tegretol)?

Back 49

1. IO
2. CBC

Front 50

What is a danger a/w carbamazepine (tegretol)

Back 50

multiple drug interactions

Front 51

What should you teach a pt on carbamazepine (tegertol)?

Back 51

1. supervise ambulation
2. take w/ meals
3. wear protective clothes r/t photosensitivity
4. multiple drug interactions

Front 52

5 s.e. of carbamazepine (tegretol)

Back 52

1. myelosuppression
2. dizziness, drowsiness
3. ataxia
4. diplopia
5. rash

Front 53

In pt taking Ethosuximide (Zarontin), what should you monitor for?

Back 53

1. behavior changes
2. weight changes (weekly weight)

Front 54

3 s.e. of ethosuximide (zarontin)

Back 54

1. GI symptoms
2. drowsiness
3. ataxia, dizziness

Front 55

What should you monitor for in a pt taking Gabapentin (neurontin)?

Back 55

1. weight change
2. behavioral change

Front 56

What can Gabapentin (Neurontin) also be used to tx?

Back 56

postherpetic neuralgia

Front 57

5 s.e. of gabapentin (neurontin)

Back 57

1. increased appetite
2. ataxia
3. irritability
4. dizziness
5. fatigue

Front 58

How should one take Lamotrigine (Lamictal)

Back 58

divided doses w/ meals or just after meals to decrease adverse effects

Front 59

6 s.e. of Lamotrigine (Lamictal)

Back 59

1. diplopia
2. headache
3. dizziness
4. drowsiness
5. ataxia
6. N,V

Front 60

what life-threating event can happen with Lamotrigine (Lamictal) is mixed w/ valproic acid?

Back 60

life-threatening rash

Front 61

What is topiramate (topamax) used for?

Back 61

adjunct therapy for intractible partial seizures

Front 62

When should you stop topiramate (topamax) immediately?

Back 62

w/ eye problems: could lead to permanent damage

Front 63

What is a pt taking topiramate (topamax) at increased risk for?

Back 63

renal calculi

Front 64

5 s.e. of Topiramate (Topamax)

Back 64

1. ataxia
2. confusion
3. dizziness
4. fatigue
5. vision problems