Anticonvulsants

Question 1

Carbamazepine (Tegretol, Equetro)

Answer 1

Group:Anticonvulsant and mood-stabilizing
Mechanism:Stabilizes the inactivated state of Voltage-gated sodium channels, making fewer of these channels available to subsequently open
Indication:Bipolar, seizures, trigeminal neuralgia
Side Effects:Dizziness, vertigo, drowsiness, ataxia, CHF, aplastic anemia, thrombocytopenia, myelosuppression, diplopia, rash
Considerations:Obtain baseline urinalysis, BUN, liver function, CBC; shake, take with food, monitor I/O, supervise ambulation, multiple drug interactions, don’t discontinue abruptly

Question 2

Gabapentin (Neurontin)

Answer 2

Group: Anticonvulsant
Mechanism:Decrease flow of calcium and sodium across neuronal membranes
Indication:Post herpetic neuralgia pain, partial seizures, epilepsy, insomnia, bipolar
Side Effects:Increases appetite, ataxia, irritability, dizziness, fatigue
Considerations:Monitor weight and behavior changes, tolerance develops, don’t discontinue abruptly

Question 3

Lamotrigine (Lamictal)

Answer 3

Group:Anticonvulsant
Mechanism:Decrease flow of calcium and sodium across neuronal membranes
Indication:Partial seizures, epilepsy, depression, bipolar
Side Effects:Rash, diplopia, headaches, dizziness, drowsiness, ataxia, N/C, Stevens-Johnson syndrome
Considerations:Eat after meals, toxicity, tolerance develops, don’t discontinue abruptly

Question 4

Phenobarbital (Luminal)

Answer 4

Group:Anticonvulsant
Mechanism:Decrease flow of calcium and sodium across neuronal membranes
Indication:Partial seizures
Side Effects:Drowsiness, rash, GI upset, constricts pupils, respiratory depression, ataxia
Considerations:Monitor VS, no alcohol or hazardous activity, toxicity, withdrawal, tolerance develops, don’t discontinue abruptly

Question 5

Phenytoin (Dilantin)

Answer 5

Group:Anticonvulsant
Mechanism:Decrease flow of calcium and sodium across neuronal membranes
Indication:Status epileptics
Side Effects:Drowsiness, ataxia, nystagmus, blurred vision, hirsutism, lethargy, GI upset, gingival hypertrophy, red urine/sweat
Considerations:Give with water or meals, instruct in oral hygiene, increase vitamin D, tolerance develops, don’t discontinue abruptly

Question 6

Pregabalin (Lyrica)

Answer 6

Group:Anticonvulsant
Mechanism:Decreases release of neurotransmitters.
Indication:Partial seizures, anxiety, fibromyalgia, neuropathic pain
Side Effects:Dizziness, drowsiness, blurred vision, diplopia, ataxia, dry mouth
Considerations:Increased creatine kinase level, tolerance develops, don’t discontinue abruptly

Question 7

Topiramate (Topamax)

Answer 7

Group:Anticonvulsant
Mechanism:Decrease flow of calcium and sodium across neuronal membranes
Indication:Seizure, personality disorder
Side Effects:Ataxia, confusion, dizziness, fatigue, vision problems
Considerations:Increased risk for renal calculi, permanent eye damage

Question 8

Valproic Acid (Depakote, Valproate)

Answer 8

Group:Anticonvulsant, mood stabilizing
Mechanism:Decrease flow of calcium and sodium across neuronal membranes
Indication:Kid seizures, epilepsy, mood stabilizing, migraines
Side Effects:Sedation, tremor, ataxia, N/V, bleeding, GI upset
Considerations:Take with food, not soda, monitor platelets and liver, tolerance develops, don’t discontinue abruptly