antiepileptic: chapter 15

Question 1

what is the drug of choice for the immediate treatment of status epilepticus

Answer 1

diazepam

Question 2

mechanism of action of antiepileptic drugs

Answer 2

alter the movement of sodium, potassium, calcium, and magnesium which leads to more stabilized and less responsive cell membranes

Question 3

how do antileptic drugs make nerve excitement more difficult

Answer 3

increase threshold activity in the motor cortex

Question 4

how do antileptic drugs suppress nerve impulse transmission

Answer 4

limit the spread of the seizure from its origin

Question 5

how does GABA correspond with seizures? explain how antiepileptic drugs effect this

Answer 5

antiepileptic drugs enhance GABA. normal GABA levels leads to less seizures

Question 6

what are the 4 common drugs used to treat focal, secondary general, and generalized tonic-clonic seizures

Answer 6

carbamazepine, phenobarbitol, primidone, phenytoin

Question 7

in addition to the 4 common drugs, which drug is common for the treatment of secondary general and generalized tonic-clonic seizures

Answer 7

lamotrigine

Question 8

which types of seizures can valporic acid be used to treat

Answer 8

generalized tonic-clonic, myoclonic

Question 9

what is the only drug that can be used to treat absence seizures

Answer 9

ethosuximide

Question 10

key adverse effect of phenobarbitol and primidone

Answer 10

paradoxical restlessness

Question 11

5 adverse effects of phenytoin

Answer 11

nystagmus, ataxia, gingival hyperplasia, acne, hirutism, dilantin facies

Question 12

3 adverse effects of valporic acid

Answer 12

gi upset, weight gain, hepatotoxicity

Question 13

3 adverse effects of carbamazepine

Answer 13

visual change, rash, abnormal gait

Question 14

2 adverse effects of gabapentin

Answer 14

visual and speech changes, edema

Question 15

2 adverse effects of pregabalin

Answer 15

peripheral edema, blurred vision

Question 16

2 adverse effects of lamotrigine

Answer 16

skin rashes, vision changes

Question 17

2 adverse effects of levetiracetam

Answer 17

behavioural changes, incoordination

Question 18

1 adverse effect of ethosuximide

Answer 18

abdominal pain

Question 19

what is a key interaction of phenytoin

Answer 19

increase the levels of free warfarin and bleeding risk

Question 20

key interaction of carbamazepine

Answer 20

increase hepatic metabolism of acetaminophen and toxicity risk

Question 21

key interaction of valporic acid

Answer 21

when combined with aspirin it will increase the levels of free valporic acid and toxicity risk

Question 22

what drug class is phenobarbitol and primidone

Answer 22

barbiturate

Question 23

3 contraindications for the use of phenobarbitol and primidone

Answer 23

porphyria, liver or kidney impairment, respiratory illness

Question 24

contraindication for the use of phenytoin

Answer 24

heart issues involving bradycardia or blockage of electrocardiac function

Question 25

what is a long term consequence of phenytoin

Answer 25

osteoprosis

Question 26

4 signs of phenytoin toxicity

Answer 26

nystagamus, ataxia, dysarthria, encephalopathy

Question 27

what are 2 considerations for iv administration of phenytoin

Answer 27

you can only use NS, you must use a filter

Question 28

what drug class is carbamazepine

Answer 28

iminostilbene

Question 29

what drug class is phenytoin

Answer 29

hydantoin

Question 30

contraindication for carbamazepine

Answer 30

bone marrow suppression

Question 31

explain autoinduction of liver enzymes

Answer 31

the drug stimulates the production of enzymes that enhances its own metabolism which leads to lower than expected drug concentrations

Question 32

which drug is associated with autoinduction of liver enzymes

Answer 32

carbamazepine

Question 33

what drug class is ethosuximide

Answer 33

succinimide

Question 34

mechanism of action of gabapentin

Answer 34

increase synthesis and accumulation of gaba between neurons

Question 35

mechanism of action of pregabalin

Answer 35

affect calcium channels in the cns

Question 36

what adverse effect can lamotrigine cause

Answer 36

drug reaction with eosinophilia and systemic symptoms (DRESS)

Question 37

what symptoms are required for the classification of DRESS

Answer 37

fever, rash, and one internal organ involvement which is usually the liver

Question 38

2 contraindications for valporic acid

Answer 38

liver impairment, urea cycle disorder

Question 39

2 general nursing considerations for the administration of antiepileptics

Answer 39

- take with 180-240ml of water and food | - avoid juice, milk, and carbonated beverages

Question 40

what cannot be administered alongside carbamazepine

Answer 40

grapefruit

Question 41

what is the most common adverse effect of levetiracetam

Answer 41

sleepiness due to cns depression