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;
8 Cards in this Set
- Front
- Back
|
A patient who has partial seizures has been taking phenytoin, Dilantin. But the patient has recently developed thrombocytopenia. The NP should contact the patients neurologist to discuss changing the patient's medication to |
Carbamazepine, tegretol. Evidence-based recommendations exist showing carbamazepine to be effective as monotherapy for partial seizures. Because this patient has developed a serious side effect of Dilantin, changing to Tegretol may be a good option. The other three drugs may be added to phenytoin or another first-line drug when drug-resistant seizures occur, but are not recommended as monotherapy |
|
|
A patient is newly diagnosed with generalized epilepsy. The NP will refer this patient to a neurologist and should expect this patient to begin taking |
Phenytoin, Dilantin. There is little good quality evidence to support the use of newer model therapy over older drugs. Phenytoin is the Prototype of many seizure medications and is usually tried first. Other drugs may be used if seizures are resistant to Dilantin or if side effects occur |
|
|
A patient who takes carbamazepine, Tegretol has been seizure-free for 2 years and asks the NP about stopping the medication. The NP should |
Order an electroencephalogram. EEG. Discontinuation of aeds may be considered in patients who have been seizure-free for longer than 2 years. An EEG should be obtained before the medication is withdrawn. The drug should be tapered to prevent status epilepticus, but only after a normal EEG is obtained. AED therapy is not lifelong and all patients. Patients should not stop AED medications abruptly, and these drugs are not used on an as needed basis |
|
|
A 12 month old child with severe developmental delays was recently treated in an emergency department for a febrile seizure and is seen by the NP for a follow-up visit. The child's parent asks if it is necessary to continue giving the child phenobarbital. The NP should tell the parent that |
Their child is at increased risk for seizures and should continue the phenobarbital. Although the American Academy of Pediatrics has concluded that the risks of long-term treatment with phenobarbital outweigh the potential benefits in most cases, continued treatment with this drug is used in children at greatest risk for future neurological problems, including children with febrile seizures before 18 months of age and children with neurological dysfunction or severe developmental delays |
|
|
A patient who is taking Dilantin for a newly diagnosed seizure disorder calls the NP to report a rash. The NP should |
Tell the patient to stop taking the phenytoin and contact the neurologist immediately. Phenytoin should be discontinued if skin rash appears because some rashes can be life-threatening. Rashes are not related to serum drug levels, so a Dilantin level is not indicated. Although some rashes are self-limiting, the patient should stop taking the drug until serious rashes are ruled out. Suggesting diphenhydramine is not correct until the severity of the rash is known |
|
|
A patient who takes valproic acid for seizure disorder is preparing to have surgery. The NP should order |
Coagulation studies. Valproic acid may cause thrombocytopenia and inhibition of platelet aggregation. Platelet count and coagulation studies should be done before therapy is initiated, at regular intervals, and before any surgical procedure is performed |
|
|
A 20-kg child takes valproic acid, Depakote For seizures and has had regular dose increases with a current dose of 250 mg twice-daily. The child continues to have one or two seizures each week along with significant drowsiness that interferes with school participation. The NP should contact a child's neurologist to discuss |
Adding Lamotrigine, Lamictal, to this child's drug regimen. Research suggests a combination of Lamotrigine and valproate to be the most effective regimen in patients with refractory epilepsy. Valproic acid dosing may be increased to a maximum of 60 mg/ kg/day unless side effects prevent further increase in dosage. The other drugs are not recommended |
|
|
A patient who takes carbamazepine, for a seizure disorder is seen by a NP for a routine physical exam. Acbc reveals a low white blood cell count. The NP should |
Order a WBC differential. A benign leukopenia associated with carbamazepine is common and is reversible and dose-related. A WBC differential should be performed before changing the drug regimen |
