Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

343 Pharm Exam 5 > Chapter 19 : Antiseizure Drugs > Flashcards

Chapter 19 : Antiseizure Drugs Flashcards

1
Q

What does seizure mean?

A

Brief episode of abnormal electrical activity in nerve cells of the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does epilepsy mean?

A

Chronic, recurrent pattern of seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are 3 common generalized seizure types?

A

Tonic clonic ( grand mal )
Absense ( petit mal )
Psychomotor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is tonic-clonic ( gland mal )?

A

Most common
Generalized altering muscle spams and jerkiness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is absence (petit mal)?

A

Brief loss of consciousness (10secs or less)
Usually occurs in children
( day dreaming stare )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is psychomotor?

A

Repetitive behavior
- chewing or swallowing motions
- behavior changes
Motor seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 2 functions of antiseizure drugs?

A

Stabilizes nerve cell membranes
Suppress abnormal electric impulses in cerebral cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 3 specific types of action any anti seizure drug?

A

Suppress sodium influx
Suppress calcium influx
Enhance action of GABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Antiseizure drugs usually is better with what?

A

Another seizure medication
Like adding on

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the goal of therapy?

A

To control or prevent seizures while maintaining a reasonable quality of life

To minimize adverse effects and drug induced toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Antiseizure drugs usually are a what time drug?

A

Life long

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Usually we start off what with these drugs?

A

Low dose is started

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Notes
If low dose is not effective
Increase dosages
If not we use multiple drug therapy

Serum drug concentrations must be measured
- therapeutic drugs monitoring

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Patients who are seizure free for 1-2 years ___be able to what for antieplieptic therapy?

A

May be able to discontinue
( to see what happens )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Patients who have a seizure, usually what happens to their driving status?

A

They get suspended for 6 months
Then their doctors are able see if their able to drive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Indications for antiseizure drugs
Prevention or control of seizure activity
Long term maintenance therapy for chronic, recurring seizures

Acute treatment of convulsions and status epilepticus

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Sometimes antiseizure drugs can be used to treat what other 2 conditions?

A

Migraine management
Pain control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the 4 antiseizure drugs we will be talking about?

A

Hydrantoins ( phenytoin )
Phenobarbital ( barbiturate )
Benzodiazepines
Valproate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the action of an hydantoins ( phenytoin )?

A

Inhibits sodium influx and stabilize cell membranes

Reduces repetitive neuronal firing

Limits seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is super important to note about hydantoins (phenytoin)?

A

It’s highly protein bound
Narrow therapeutic window

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the syndrome with hydantoins (phenytoin)?

A

Purple glove syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do we get purple glove syndrome?

How do we give it?

What do we do prior to this medication administration?

A

Potent vasoconstrictor

Give in central line or PICC line, never in hands or IM

Dilute

( this vasoconstriction can cause tissue damage and loss of limb )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the 6 hydantoins side effects?

A

Gingival hyperplasia
Osteoporosis
Fatal hepatotoxicity
Nephrotoxicity
CV side effects
Teratogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is gingival hyperplasia?

A

Overgrowth of the gum tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

So since hydantoins causes gingival hyperplasia, what do we usually have to tell them?

A

Extreme dental care
Brushing and flossing extreme

26
Q

Why does hydantoins cause osteoporosis?

A

Decreases the absorption of vitamin D

27
Q

Since hydanotoins causes hepatotoxicity and nephrotoxity, what type of tests will we do?

A

Bun creatinine
LFTS

28
Q

Hydanotojns has some form of suicidal ideation, so we what?

A

Warn patients & screens for that

29
Q

What are the 3 CV hydantoins side effects?

A

Hypotension
Bradycardia
Ventricular fibrillation

30
Q

So to avoid CV side effects, what are we going to do?

A

Administer it very very slowly
Because it causes cardiovascular collapse

31
Q

2 Big messages for hydantoins regarding females is what?

A

That they need to have 2 forms of birth control because it decreases its effectiveness

No pregnancy because it’s teratogenic

32
Q

What are the 2 decrease effect medications that phenytoin causes?

A

Anticoagulants
Oral contraceptives

33
Q

Notes
Increase effect with cimetidine
INH - tb drug

Decrease effects with folic acid
Calcium
Antacids
Sucralfate
Cisplatin

A
34
Q

What are the foods that are decreased with phenytoin? (3)

A

Folic acid
Calcium
Vitamin D

35
Q

Phenobarbital ( barbiturate )

A
36
Q

Phenobarbital ( barbiturate ) is typically used for who?

A

A pregnant person who has a seizure disorder

37
Q

How long does it take for Phenobarbital ( barbiturate ) to work?

A

2-3 weeks to reach therapeutic levels

So educate patients that it may take a while to work

38
Q

What is the biggest clinical manifestation of Phenobarbital ( barbiturate )?

A

Respiratory depression

39
Q

Phenobarbital ( barbiturate ) has a high physical dependence rate so what do we tell them?

A

Slowly wean off the medication

40
Q

If you go cold turkey of Phenobarbital ( barbiturate ) what happens?

A

Fetal withdrawal symptoms = death

41
Q

We want to educate patients to avoid what while on Phenobarbital ( barbiturate )?

A

Alcohol

42
Q

Notes
Phenobarbital ( barbiturate )
Elderly : may have greater sedation, altered excretion

A
43
Q

Benzodiazepines

A
44
Q

What are the 3 Benzodiazepines medications?

A

Clonazepam
Clorazepate
Diazepam

45
Q

Benzodiazepines usually used more for who?

A

Status epilepticus
( a seizure that won’t stop )

46
Q

How does Benzodiazepines work?

A

Relax the muscules and interrupt that neuro muscular stimulation

47
Q

Benzodiazepines how do we give it? Route?

A

IM or IV

48
Q

Benzodiazepines can cause what massive clinical manifestation?
And how would we prevent it?

A

Cardiovascular collapse
- don’t give it with bradycardia & hypotension

Causes life threatening tachycardia
- very careful

49
Q

Notes
Clonazepam
Treats absense & myoclonic seizures
Tolerance may occur in 6 months

Clorazepate
Treated partial seizure

Diazepam
Treats status epliepticus
IV for status
Short term effect
- antiseizure medication must be given during or immediately after the administration of diazepam

A
50
Q

Valproate

A
51
Q

What is valproate medication?

A

Valproic acid

52
Q

What are the side effects of valproate?

A

Dizziness
Drowsiness’s
Weakness
Insomnia
Diplopia
GI Distres
Suicidal ideation
Thrombocytopenia

53
Q

Antiseizure drugs & pregnancy

A
54
Q

Most antiseizure drugs are teratogenic, what the one medication that is the expection ?

A

Phenobarbital ( barbiturate )

55
Q

Antiseizure drugs tend to inhibit what vitamin?

And how does it affect pregnancy?

A

K

Infant hemorrhage soon after birth

56
Q

Typically how would we avoid this infant hemorrhage with anti seizure drugs?

A

Since vitamin K tends to be inhibited
- so we usually give it a few days before birth or at delivery injection

57
Q

If a patient is trying to get pregnant
And since anti seizure drugs decrease the loss of ____
We usually recommend to take extra ____ supplements

A

Folic acid ( folate )

58
Q

Nursing implications notes
IV forms - follow manufactures instructions, give slowly, observe for skin damage

Teach patients to journal their response to medication

Wear medic alter bracelet

Do not discontinue suddenly

Follow driving recommendation

Teach patients that therapy is long term and possibly life long

Teach females of childbearing age to use reliable contraception

Teach good dental hygiene and regular dental visits with hydantoins

Take medications as directed

A
59
Q

Practice question 1
Before administrating a daily dose of phenytoin, what is the most important for the nurse to do?

  1. Maintains the patient on bed rest
  2. Check phenytoin levels
  3. Monitor intake and output
  4. Monitor renal function tests
A
  1. Check phenytoin levels
60
Q

Practice question 2
A patient was discharged 3 days ago on phenytoin therapy for seizure disorder. The patient comes to the emergency department experiencing seizures. What will be of most value to determine the etiology of the returned seizures?

  1. A ct scan
  2. EEG
  3. Serum phenytoin levels
  4. Serum electrolytes
A
  1. Serum phenytoin levels
61
Q

Practice question 3
When assessing a patient taking phenytoin therapy for seizure disorder, which indicates an adverse reaction to this therapy?

A. Thrombocytopenia
B. Leukocytosis
C. Gingival atrophy
D. Hypoglycemia

A

A. Thrombocytopenia

343 Pharm Exam 5 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions