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Pharmacology Exam #1 > Antiseizure Agents > Flashcards

Antiseizure Agents Flashcards

(39 cards)

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1
Q

What seems to cause seizures?

A

Abnormal neurons sensitive to stimulation or prone to over-responsiveness

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2
Q

What are primary seizures?

A

Seizures with no underlying cause

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3
Q

What are secondary seizures?

A

Seizures because of a primary cause (ie. head injury, overdose, fever)

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4
Q

What is a tonic-clonic seizure?

A

dramatic contractions/relaxations of muscles (spasms)

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5
Q

What is an absence seizure?

A

abrupt, brief loss of consciousness
Looks like daydreaming, absent stare

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6
Q

What is Status Epilepticus?

A

Most dangerous of seizures
Repeated seizures lasting longer than 5 minutes

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7
Q

Considerations for use of Antiepileptic Agents
In Children

A
  • Can affect learning and development
  • More sensitive to sedating effects
  • May need to switch doses/meds as they get older
  • They often need LARGER doses since they metabolize the drug faster
  • Parents need support and education
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8
Q

Considerations for use of Antiepileptic Agents
In Adults

A
  • Regular, routine care
  • Monitor for adv. effects
  • Medic Alert Bracelet
  • DO NOT breastfeed while taking => causes heavy sedation in infants
  • Fetal abnormalities => use barrier contraception, weigh risk vs benefit in pregnancy
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9
Q

Considerations for use of Antiepileptic Agents
In Older Adults

A
  • More susceptible to adv. effects
  • LOWER dose needed to do to impaired metabolism
  • CNS effects => need for safety precautions
  • Renal or hepatic impairment => inc. risk of toxicity
  • Monitor serum levels closely
  • Medic alert Bracelet
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10
Q

Anti-Seizure

Hydantoins
Drug Name

A

Phenytoin

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11
Q

Anti-Seizure

Hydantoins
Mechanism of Action

A

Stabilizes the nerve membranes by blocking channels in the cell membrane or altering recepter sites
* Decreases excitability and hyperexcitability to stimulation

(less sedating than barbituates)

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12
Q

Hydantoins
Indication

A

Seizures

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13
Q

Anti-Seizure

Hydantoins
Contraindications

A

Absolute:
* Allergy

Cautions:
* Elderly or debilitated patients
* Impaired renal or hepatic funtion
* Depression or pyschoses

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14
Q

Anti-Seizure

Hydantoins
Adverse Effects

A
  • CNS depression (confusion, lethargy)
  • Cardiac Arrhythmias
  • Hypotension
  • Severe liver toxicity
  • Bone Marrow suppression
  • Urinary Retention
  • Loss of libido
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15
Q

Anti-Seizure

Barbituates and Benzodiazepines
Adverse Effects

A
  • SIGNIFICANT CNS depression (confusion, lethargy, fatigue)
  • Cardiac Arrhythmias, changes in BP
  • Urinary Retention
  • Loss of libido
  • Physical dependence and withdrawal
  • Black Box Warning: Opiods & Benzodiazepines together can results in: Profound sedation, respiratory depression, coma, death
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16
Q

Anti-Seizure

Hydantoins
Drug Interactions

Study These Flashcards
A

Alcohol (CNS depressant)
(also lowers seizure threshold)

17
Q

Anti-Seizure

Barbituates & Benzodiazepines
Drug Interactions

Study These Flashcards
A

Alcohol (CNS depressant)
(also lowers seizure threshold)

Same as hydantoins

18
Q

Anti-Seizure

Barbituates
Drug Names

Study These Flashcards
A
  • Phenobarbital
  • Primidone
19
Q

Anti-Seizure

Benzodiazepines
Drug Names

Study These Flashcards
A

“-azepam”
* Clonazepam
* Diazepam

20
Q

Half Life of Barbituates and Benzodiazepines

Study These Flashcards
A

Barbituates: Up to 100 hours
Benzodiazepines: 18-50 hours

Not for long term use, low lipid solubility

21
Q

Anti-Seizure

Barbituates & Benzodiazepines
Mechanism of Action

Study These Flashcards
A

Same as hydantoin

Stabilizes the nerve membranes by blocking channels in the cell membrane or altering receptor sites
* Decreases excitability and hyperexcitability to stimulation

22
Q

Barbituates & Benzodiazepines
Indication

23
Q

Anti-Seizure

Barbituates & Benzodiazepines
Contraindications

Study These Flashcards
A

Absolute:
* Allergy

Cautions:
* Elderly or debilitated patients
* Impaired renal or hepatic funtion
* Depression or pyschoses

Same as hydantoins

24
Q

Anti-Seizure

Succinimides
Drug Names

Study These Flashcards
A

“-suximide”
* Ethosuximide
* Methsuximide

25
# Anti-Seizure **Succinimides** MOA
Suppress the abnormal electrical activity in the brain
26
**Succinimides** Indications
* Seizures * Most commonly used for absence seizures
27
# Anti-Seizure **Succinimides** Contraindications
**Absolute:** * Allergy **Cautions:** * Renal or hepatic disease
28
# Anti-Seizure **Succinimides** Adverse Effects
* CNS depressant effects * Bone Marrow suppression * Stevens-Johnson Syndrome
29
# Anti-Seizure **Succinimides** Drug Interactions
**Primidone** *Barbituate.... decreases primidone levels*
30
# Anti-Seizure **GABA Modulators** Drug Names
* Valproic Acid * Divalproex
31
# Anti-Seizure **GABA Modulators** MOA
* Reduces abnormal electrical activity in brain * Increases GABA levels in the brain
32
**GABA Modulators** Indication
Seizures
33
# Anti-Seizure **GABA Modulators** Contraindication
**Absolute:** * Allergy **Cautions:** * Hepatic or renal impairment
34
# Anti-Seizure **GABA Modulators** Adverse Effects
* CNS Depression * Liver Toxicity * Pancreatitis * DRESS: Drug reaction with eosinophilia and systemic symptoms (severe hypersensitivity => in the mucus membranes => organs)
35
# Anti-Seizure **GABA Modulators** Drug Interactions
Other anti-seizure drugs *(risk of toxicity and risk of breakthrough seizures)*
36
What are the **OTHER** drugs to treat seizures?
* **Carbamazepine** *(Bloack Box warning for severe skin reactions, ADE: agranulocytosis, aplastic anemia, blood dyscrasias)* * **Lamotrigine** *(Black Box warning for serious skin reactions)* * **Levetiracetam** * **Topiramate** *(serious skin reactions)*
37
**Antiseizure Agents** Nursing Assessment
**History:** * Contraindications and Cautions **Physical:** * Skin * Vital Signs * CNS * Muscle strength * Abdominal * Urine output **Labs:** * ECG, renal & hepatic function tests, CBC
38
**Antiseizure Agents** Nursing Conclusions
* Impaired comfort (GI,CNS) * Altered Thought Process (CNS effects) * Impaired skin integrity (skin reactions) * Injury Risk (CNS) * Infection Risk (bone marrow) * Knowledge Deficit
39
**Antiseizure Agents** Interventions/Patient Teaching
* Administer with food * Monitor CBC before and during * Protect from infection * Prepare to discontinue drug *(skin rash, bone marrow suppression, unusual depression, personality changes)* * Discontinue drug slowly * Counseling to women of childbearing age * Provide safety measures * Patient Teaching (Medic alert bracelets, no alcohol/cns depressants)

Pharmacology Exam #1 (10 decks)

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