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NURS 252 (Pharmacology 2) > Antiepileptic Drugs > Flashcards

Antiepileptic Drugs Flashcards

1
Q

What is a seizure?

A

A brief episode of abnormal electrical activity in the nerve cells of the brain, which may or may not lead to a convulsion

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2
Q

What is a convulsion?

A

Involuntary spasmodic contractions of any or all voluntary muscles throughout the body, including skeletal, facial, and ocular muscles

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3
Q

What is epilepsy?

A

Chronic, recurrent patterns of seizures

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4
Q

What is primary epilepsy and what is it AKA?

A

Idiopathic
Cause cannot be determined, roughly 50% if epilepsy cases

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5
Q

What is secondary epilepsy and what is it AKA?

A

Symptomatic
Distinct cause is identified

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6
Q

What are the 2 classifications of epilepsy excluding unclassified seizures?

A

Generalized onset seizures
Both hemispheres, tonic-clonic seizures, atonic seizures AKA drop attacks
Focal Onset seizures
Localized or focal region, simple complex, secondary generalized tonic-clonic

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7
Q

What is the drug of choice for immediate treatment of status epilepticus?

A

Diazepam

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8
Q

What are the goals of therapy for antiepileptic drugs?

A

Controlling or preventing seizures while maintaining a reasonable quality of life
Titrate to lowest possible dose that controls seizures

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9
Q

T/F: Antiepileptic drug therapy is short term

A

False; It is usually lifelong

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10
Q

T/F: Multiple drug therapy is started before single-drug therapy is tried

A

False: Single-drug therapy is started before Multiple-drug therapy is tried

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11
Q

Serum concentrations of _____, _______, ________, and ________ correlate better with seizure control and toxicity than _________, ________, and ________.

A

Phenytoin, phenobarbital, carbamazepine, primidone
Valproic acid, ethosuximide, and clonazepam

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12
Q

What are the 4 classes of antiepileptic drugs?

A

Barbiturates
Hydantoins
Iminostilbenes plus valproic acid
2nd and 3rd gen antiepileptics

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13
Q

What are the drug effects of antiepileptic drugs?

A

Reduce nerve’s ability to be stimulated
Suppress transmission of impulses from one nerve to the next
Decrease speed of nerve impulse conduction within a neuron

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14
Q

What are the indications of antiepileptic drugs?

A

Prevention or control of seizure activity
Long-term maintenance therapy for chronic seizures
Acute treatment of convulsions and status epilepticus

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15
Q

What can long term therapy of phenytoin cause?

A

Gingival hyperplasia, acne, hirsutism and dilantin facies

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16
Q

What are the contraindications of AEDs?

A

Pregnancy

17
Q

What are the interactions of AEDs?

A

Phenytoin: Antibiotics, antifunfals, SSRI’s reduce clearance and increase toxicity, warfarin
Carbamazepine: Increased metabolism of acetaminophen resulting in reduced efficacy
Valproic acid: Asprin displaces it from protein binding resulting in increased levels and toxicity risk

18
Q

What 4 drugs have a narrow therapeutic index and require lab drug monitoring?

A

Phenytoin, valproic acid, phenobarbital, carbamazepine

19
Q

What is phenobarbital and primidone? (AE, CI, TE)

A

AE: Sedation
CI: Porphyria, liver or kidney impairment, respiratory illness
TE: 15 - 40 mcg/mL

20
Q

What are the therapeutic levels of phenytoin?

A

10 - 20 mcg/mL

21
Q

What are some considerations regarding IV admin of phenytoin?

A

20 gauge or larger venous catheters
Diluted in NS
Filter must be used

22
Q

What is the second most commonly prescribed AED in canada after phenytoin?

A

Carbamazepine

23
Q

What is Ethosuximide? (ID, CI, AE, IE)

A

ID: Uncomplicated absence seizures
CI: Allergy
AE: GI and CNS effects
IE: Hepatic enzyme-inducing drugs

24
Q

What is Lamotrigine?(ID, CI, AE, Forms)

A

ID: Bipolar disorder
CI: Allergy
AE: Minor CNS and GI symptoms and possible Stevens-Johnson syndrome
Oral use only

25
Q

What is valproic acid? (ID, CI, AE, IE)

A

ID: Myoclonic seizures
CI: Allergy, Liver impairment
AE: Weight gain, hair loss
IE: Aspirin

26
Q

What is levetiracetam? (ID, CI, AE, Forms)

A

ID: Focal seizures with and without secondary generalization
CI: Allergy
AE: CNS effects
Oral and injectable forms

NURS 252 (Pharmacology 2) (23 decks)

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