DONE: Drugs: Anticonvulsants > Seizures Flashcards
(127 cards)
0
Q
What three disease process treatment medications are discussed in this lecture?
A
Myasthenia Gravis (MG)
Seizures
Parkinson’s Disease (PD)
1
Q
What therapeutic classification of medication is used to treat Amyotrophic Lateral Sclerosis (ALS)?
A
Rilotec
Study Tip: These medications are not discussed in this lecture but they are discussed in Lecture II.
2
Q
What therapeutic classification of medication is used to treat Increased Intracranial Pressure (IICP)?
A
Osmotic Diuretics Ex. Mannitol
Corticosteroids
Barbiturates
Anticonvulsants
Study Tip: These medications are not discussed in this lecture but they are discussed in Lecture II.
3
Q
What therapeutic classification of medication is used to treat both a CVA and TPA?
A
Anticoagulants > Ex. Warfarin / Heparin
Platelet Inhibitors > Ex. Aspirin / Plavix
Study Tip: These medications are not discussed in this lecture but they are discussed in Lecture II.
4
Q
What therapeutic classification of medication is used to treat infections R/T Encephalitis?
A
Antibiotics - Emergent to start ASAP Pain meds Antivirals Antipyretics
Study Tip: These medications are not discussed in this lecture but they are discussed in Lecture II.
5
Q
What therapeutic classification of medication is used to treat infections R/T Meningitis?
A
Antibiotics - Emergent to start ASAP Pain meds Antivirals Antipyretics Study Tip: These medications are not discussed in this lecture but they are discussed in Lecture II.
6
Q
What therapeutic classification of medication is used to treat Multiple Sclerosis (MS)?
A
Non-Interferons
Interferons
Study Tip: These medications are not discussed in this lecture but they are discussed in Lecture II.
7
Q
50% of _______are idiopathic which means that the Drs don’t know what causes them. The other 50% are caused secondary to trauma, anoxia, infection, and CVAs.
A
Seizures
Study Tip: These all cause some damage to brain.
8
Q
_______ are caused by abnormal, sudden, excessive discharge of electrical activity within the brain. All these neurons are firing and sending impulses to other parts of the brain.
A
Seizures
9
Q
Define Epilepsy?
A
Chronic Seizure Activity
10
Q
______ is a chronic condition. There is no cure. Some procedures can interrupt pathways of the brain you could call that somewhat of a cure but it is still a chronic condition.
A
Epilepsy
11
Q
Genetic factors Trauma Tumors Circulatory Disorders Metabolic Disorders Toxicity Infections These can cause what neurological disorder?
A
Seizures
12
Q
What are the two types of Seizures?
A
Generalized & Partial
13
Q
No loss of consciousness.
What type of seizure is this?
A
Simple partial seizure
14
Q
Twitching Paralysis Visual disturbances Aura These are the clinical manifestations of what neurological disorder?
A
Simple Partial Seizure
15
Q
When symptoms start in one area of the body and then spread this is also known as __________.
A
Jacksonian Seizures
16
Q
Sometimes a patient will have an _____ before a seizure this means they have unusual sensations and they help to identify when they are about to have a seizure.
A
aura
Study Tip: This is what is felt before the seizure.
17
Q
Altered levels of consciousness.
What type of seizure is this?
A
Complex partial seizure
18
Q
A patient with this type of seizure can have some of the same clinical manifestations as simple partial. A patient having this type of seizure can’t interact with the environment.
A
Complex Partial Seizure
Study Tip: This is because of loss of consciousness.
19
Q
Automatism, Lip smacking Awkward Gait Repetitive hand movements Fear Anxiety Hallucinations Déjà vu feeling These are the clinical manifestations of what neurological disorder?
A
Complex Partial Seizure
20
Q
A _________ seizure involves the entire body.
A
generalized
21
Q
If brain activity is normal what happens is you have an electrical impulse that is sent to other parts of the brain. If there are too many impulses the brain will kind of put a _______ on it and will prevent it from being sent to other parts of the brain. In people with ______ those bursts of activity from the cortex are not modulated.
A
damper
epilepsy
22
Q
Electrical impulses originating in the cerebral cortex and going on to deeper brain structures and it’s not being forwarded from there is considered _______ brain activity.
A
Normal
23
Q
Electrical impulses originating in the cortex and going down in to the deeper areas of the brain and then being sent on so they are just firing all over the brain is considered ______ brain activity.
A
Abnormal
24
_______ is a problem in the brains wiring and it can be a really devastating condition to have.
Epilepsy
25
Seizure medications are also called ________ these are used to depress abnormal neuronal discharges and prevent the spreading of electrical activities that the brain is not suppressing on own, so its not __________ the cause its just preventing a seizure from occurring.
anticonvulsants
| eliminating
26
This is used to depress abnormal neuronal discharges and prevent the spread of seizures to adjacent neurons.
Anticonvulsants
Study Tip: These medications prevent seizure, and do NOT eliminate the cause.
27
Anticonvulsant drugs generally act by stabilizing nerve cell membranes and preventing abnormal electric impulses from the seizure _______ to other cortical areas.
These drugs generally act by stabilizing _______ membranes and that makes them __________.
focus
nerve cell
CNS depressants
28
```
Diplopia
Drowsiness
Double vision
Ataxia
Slowed mental processes
What therapeutic classification of medication has these side effects?
```
Anticonvulsants
Study Tip: Slowed mental processes means it's probably not safe for these patient's to operate a car.
29
Most of these medications work by preventing ______ influx or ______ influx or by increasing ______ which is the chief inhibitory neuro transmitter so it gives the brain more of this substance and inhibits transmission.
sodium
calcium
GABA
30
What is the chief inhibitory neurotransmitter released during a seizure?
GABA
31
What does GABA mean?
Gamma-Amino Butyric Acid
32
Begin with a single dose of the medication. The dosing depends on the patient's age, weight, type of seizures, how often seizures are occurring, and what the cause of the seizure was. The nurse will start with this dose and increase it until the desired effect happens or the degree of side effects become worse than the benefits that the patient is achieving.
This is the principle drug therapy for what therapeutic classification of medications?
Anticonvulsants
33
______ levels of anticonvulsant drugs need to be monitored. There are many drugs that should be monitored. It is up to the RN to be AWARE of the levels that need to be monitored for each medication.
Serum
34
Therapeutic ranges that’s what it’s called when a drug is supposed to be say between 1.0 and 2.0 of the blood serum level of the drug, with anticonvulsants these ranges are only used as a guide. Patient might need a therapeutic level of ______ to be effective or therapeutic. If the patient’s seizures are well controlled but the drug level was LESS than the therapeutic range it’s okay it means we titrated/adjusted the dose to give the desired effect to control seizures.
2.5
35
Many of the newer anticonvulsant drugs on the market don’t need to have the therapeutic drug levels monitored because the range is so big that it isn’t essential. A ______ range is harder to keep a blood level within that range.
NARROW
36
If the seizure control isn’t achieved with a single drug we might need to change the _______, the _______, or we might add another _______. About a third of patients require combination therapy.
dosage
timing
drug
37
When giving a woman an anticonvulsant medication what 4 indications must be taken into consideration that can affect seizure activity?
```
Hormonal fluctuations
Puberty
Menstruation
Pregnancy
Menopause
```
Study Tip: This is very IMPORTANT.
38
Some of the anticonvulsants have _________ effects so pregnant women can’t take them, this is another thing to keep in mind.
teratogenic
39
A single dosage of anticonvulsant drug is based on the patient's age, weight, type, frequency, and cause. The nurse will increase the dose to achieve therapeutic range or until toxic side effects occur. Some patient's may need a __________ regimen.
combination
40
What are the 4 therapeutic classifications of anticonvulsants?
Hydantoins
Barbiturates
Valproates
Benzodiazepines
41
What is the name of the most commonly used Hydantoin therapeutic classification of anticonvulsant medication?
Phenytoin / Dilantin
Study Tip: Remember the “toin” > HYDANTOIN. This medication is covered in-depth in this exam.
42
What is the name of the most commonly used Barbiturate therapeutic classification medication?
Phenobarbital / Luminal
Study Tip: Remember the “barbital” > BARBITURATE. This medication is covered in-depth in this exam.
43
What is the name of the most commonly used Valproate therapeutic classification of anticonvulsant medication?
Valproic Acid / Depakote
44
What are the 3 names of the most commonly used Benzodiazepine therapeutic classification of anticonvulsant medication?
Diazepam / Valium
Lorazepam / Ativan
Clonazepam / Klonopin
Study Tip: Remember the “PAM”. This medication is covered in-depth this exam.
45
What is the name of the most commonly used mood stabilizer for anticonvulsant medication therapy?
Carbamazepine / Tegretol
Study Tip: This medication is covered in-depth in this exam.
46
What is the name of the most commonly used analgesic adjunct and mood stabilizer for anticonvulsant medication therapy?
Gabapentin / Neurontin
47
What is the name of the most commonly used adjunct treatment for anticonvulsant medication therapy?
Lamotrigine / Lamictal
48
What is the name of the most commonly used pyrrolidines for anticonvulsant medication therapy?
Levetiracetam / Keppra
| Study Tip: This medication is covered in-depth in this exam.
49
What is the name of the most commonly used analgesic therapeutic classification of anticonvulsant medication?
Pregabalin / Lyrica
Study Tip: This medication is covered in-depth in this exam.
50
When we are treating ACUTE seizure, if someone has just had a seizure or if someone had a recurrence of seizures we use Benzodiazepines, so the nurse will administer?
Valium and Ativan
REMEMBER: This is the medication therapy for an Acute Seizure.
51
What are two other types of Benzodiazepines besides Ativan and Valium?
Clonapine and Tranzine.
| REMEMBER: This is the medication therapy for an Acute Seizure.
52
Benzodiazepines do have multiple uses, in addition to being used for antiseizure medications they are also used for ______, _______, used ________, and also for patients who are _________.
```
Sedatives
Hypnotics > sleeping medications
Preoperatively
Anxious
REMEMBER: This is the medication therapy for an Acute Seizure.
```
53
Valium is the drug choice for _______ and this is clinically manifested as a continuous seizure without a pause, or back to back seizures with hardly any pause in between, or 3rd category any seizure over ______ mins in length.
Status Epilepticus
5-10 mins
REMEMBER: This is the medication therapy for an Acute Seizure.
54
During a status Epilepticus the nurse would administer the Valium IV every _____ minutes up to a total of _____ mg PRN. And then after that we can give it every ____ hours PRN.
10-15 minutes
30 mg
2-4 hours
REMEMBER: This is the medication therapy for an Acute Seizure.
55
This medication depresses the Central Nervous System while potentiating the action of GABA?
Valium
REMEMBER: This is the medication therapy for an Acute Seizure.
56
Onset _____ mins
Peak _____ mins
Duration 15-60 mins
In status Epilepticus the anticonvulsant effect duration is _____ minutes.
What anticonvulsant medication have this mode of action?
Valium
1-5 mins
15-30 mins
15-20 mins
Study Tip: THIS IS IMPORTANT!!
REMEMBER: This is the medication therapy for an Acute Seizure.
57
Onset 1-5 mins
Peak 15-30 mins > this is WHY the nurse will give it every 10-15 mins.
As soon as the _______ reaches peak levels we are going to administer another dose. Why?
Valium
TO KEEP THAT THERAPEUTIC DRUG LEVEL UP!!!
REMEMBER: This is the medication therapy for an Acute Seizure.
58
We really want to control seizures because if the seizure goes on for too long something and a ________ can occur and cause the patient’s brain to not get oxygenated because of the hypoxia and obviously that is a very bad thing.
hypoxic brain injury
Study Tip: Hypoxic brain injury is a diagnostic term that encompasses a complex constellation of pathophysiological and molecular injuries to the brain induced by hypoxia.
59
__________ is also used to control status epilepticus, Valium is the drug of choice but This medication can be used also.
Lorazepam / Ativan
REMEMBER: This is the medication therapy for an Acute Seizure.
60
If giving _________ IV the nurse cannot exceed ____mg a minute so if you are giving it IV push, you must give it slowly. A dose of ____ needs to be given over ____ mins and a maximum of ______ can be given. That can also be repeated in _____ mins.
```
Lorazepam / Ativan
2 mg
4 mg
2-5 mins
8 mg
10-15 mins
```
REMEMBER: This is the medication therapy for an Acute Seizure.
Study Tip: You can NOT give medications IV push in Block 2.
61
The onset is _____ mins
The peak is _____ mins
The duration is 8-12 hours
What anticonvulsant medication has this mode of action?
15-30 mins
15-20 mins
Lorazepam / Ativan
REMEMBER: This is the medication therapy for an Acute Seizure.
62
This medication is going to cause Central Nervous System depression and also potentiate and increase the effects of GABA. What anticonvulsant medication has these pharmacodynamics?
Lorazepam / Ativan
| REMEMBER: This is the medication therapy for an Acute Seizure.
63
What are alternate uses for the benzodiazepine Diazepam / Valium?
Anti-Anxiety
Sedative/Hypnotic
Skeletal Muscle Relaxants (affects the CNS)
REMEMBER: This is the medication therapy for an Acute Seizure.
64
What are alternate uses for the benzodiazepine Lorazepam / Ativan?
Anesthetic adjuncts
Anti-Anxiety
Sedatives/Hypnotics
REMEMBER: This is the medication therapy for an Acute Seizure.
65
__________ can be given via IV administration for alternative treatment of acute seizures / status epilepticus.
Benzodiazepines
REMEMBER: This is the medication therapy for an Acute Seizure.
66
______ is the principal INHIBITORY neurotransmitter of the brain. Medication is given to control this neurotransmitter during an acute seizure.
GABA
Study Tip: At the end of the axon of the nerve, the electrical impulse stimulates the release of the neurotransmitter GABA, which inhibits another electrical impulse in another nerve fiber produce a depression of electrical activity in the brain.
67
These acute seizure medications depress the CNS and enhance GABA which is a major inhibitor of neurotransmission in the brain.
What medication has these pharmacodynamics?
Benzodiazepines
Study Tip: Depression of the CNS and the enhancement of GABA causing anti-convulsant and skeletal muscle relaxation effects.
68
```
Dizziness
Drowsiness
Lethargy
Blurred vision
Hypotension
Respiratory depression
What therapeutic classification of medication has these side effects?
```
Benzodiazepines
Study Tip: Remember these are CNS depressants.
REMEMBER: This is the medication therapy for an Acute Seizure.
69
Obviously if you are giving these acute treatment _________ via IV to your patient that is having seizures or status epilepticus this is someone that you are going to have to be monitoring blood levels VERY VERY closely. Follow up with the patient frequently after administering these medications.
Benzodiazepines
| REMEMBER: This is the medication therapy for an Acute Seizure.
70
After the benzodiazepine medications are administered we have to provide a follow up with anticonvulsants that have a _______ duration.
Longer
REMEMBER: This is the medication therapy for an Acute Seizure.
71
After treating an acute seizure with a short acting medication we would give something like ______ or _______ during or immediately after administering the _______ or _______ to prevent future seizures.
Phenytoin or Phenobarbital - Chronic
Valium or the Ativan - Acute
REMEMBER: This is the medication therapy for long term control of seizures.
72
While administering the medications needs to control a patient presenting with an immediate seizure the nurse must give the short course of action medication FIRST, which is the _______, then SECOND they will administer the ________. We are going to have to give a THIRD medication which is the _________ after that one that is going to maybe take longer to start having an effect, but it will also going to LAST longer.
Ativan
Valium
Phenytoin or Phenobarbital
Study Tip: Valium is the drug of choice it’s going to work hopefully but it is NOT going to last long.
73
Phenytoin / Dilantin ends in 'toin which lets you know that it's therapeutic classification is ______. This is a long term seizure therapy medication.
Hydantoin
74
This medication prevents partial and generalized tonic-clonic seizures. What is the name of this medication?
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
75
_________ was the very first anticonvulsant used to treat seizures, discovered in 1938 and it is still the most common drug.
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
76
________ has the least toxic side effects of any of the antiepilepsy drugs, it has a small amount of generalized sedation and it’s not addictive.
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
Study Tip: There are some other medications that are Phenytoin medications that end in 'toin but Dilantin is the one you will see most often.
77
```
Drug Classification:
Hydantoin > Drugs end in “TOIN”
Therapeutic Effects/Uses:
Prevent partial and generalized tonic-clonic seizures.
What is the name of this medication?
```
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
78
Drug binds to sodium channels on the cell which suppresses sodium influx, prolonging the channel inactivation, thus preventing the neuron from firing (prevents repetitive neuronal firing). What medication have these pharmacodynamics?
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
79
PO: Onset _____ hrs
IV: Onset within minutes and up to _______ hour so IV medication will work VERY VERY quickly!
What medication have this mode of action?
0.5-2 hrs
1 hr
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
80
This medication can alternatively work as an anti-dysrhythmic because it increases the electrical stimulation threshold in the heart which makes it more difficult for the SA and AV nodes to fire slowing the heart rate so the nurse must monitor the HEART via EKG. What anticonvulsant medication is this?
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
81
```
Headache
Diplopia
Dizziness
Hypotension
Nausea
Dark Urine
Hypotension > could be BAD, the rest aren’t serious.
What medication has these side effects?
```
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
82
What is Diplopia?
Double vision which is a side effect of Phenytoin / Dilantin
83
Gingival Hyperplasia:
The nurse must monitor for bleeding gums.
What medication has these adverse effects?
Phenytoin / Dilantin
Study Tip: This will probably be on State Boards IMPORTANT.
REMEMBER: This is the medication therapy used for long term control of seizures.
84
Bone Marrow Suppression
| What medication has these adverse effects?
Phenytoin / Dilantin
Study Tip:
Therapy with hydantoin anticonvulsants should be administered cautiously in patients with preexisting blood dyscrasias and/or bone marrow depression. Bone Marrow Depression occurs related to Low Blood Count caused by Blood Dyscrasias.
REMEMBER: This is the medication therapy for long term control of seizures.
85
Thrombocytopenia: What does that word mean? Thrombo-cyto-penia, take the word apart. The blood clotting cells are low.
What medication has these adverse effects?
Low Platelets. Increases your patient's ______ risk.
Phenytoin / Dilantin
Bleeding
REMEMBER: This is the medication therapy for long term control of seizures.
86
Leukopenia: This is decreased white blood cells.
| What medication has these adverse effects?
Phenytoin / Dilantin
Study Tip: This develops into thrombocytopenia.
REMEMBER: This is the medication therapy for long term control of seizures.
87
Stevens-Johnson Syndrome: It is very rare, it’s a very serious disorder of the skin and mucus membranes. It often begins with several days of flu like symptom and then the mucus membrane and skin become inflamed, painful-red, and the skin starts to die and the top layer sheds. People that are seen with this look like they have burns over their entire body, it’s extremely painful and can be fatal. What medication has these adverse effects?
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
88
Facial swelling
Tongue swelling
Hives
Skin pain
Red or Purple skin rash that spreads
Blisters on the skin and mucus membranes Shedding of the skin
What medication has these adverse effects?
Phenytoin / Dilantin
- These are the clinical manifestations of Steven-Johnson Syndrome.
Study Tip: As the nurse you maybe just have to comfort them and hope that they recover.
REMEMBER: This is the medication therapy for long term control of seizures.
89
This medication is also used as an anti-dysrhythmic so DO NOT give this medication if the patient is in heart block. Remember it also blocks the sodium channels in cardiac tissues so it can cause big problems for someone who is already in heart block.
What medication has this nursing intervention?
Phenytoin / Dilantin
Study Tip: THIS IS IMPORTANT
REMEMBER: This is the medication therapy for long term control of seizures.
90
The nurse know that this medication decreases the effectiveness of birth control pills so they might want to try a different method. This medication can also have teratogenic effects which means it can cause birth defects. This medication can cross into breast milk and be fed to an infant inadvertently.
What medication has this nursing intervention?
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
91
The nurse knows that this medication can increase or decrease the absorption of many other medications because it is VERY VERY PROTEIN bound, it fights other medications, and it actually REMOVES AND REPLACES other medications on the protein surface.
What medication has this nursing intervention? What are the most common anticoagulants that this medication can displace?
Phenytoin / Dilantin
Coumadin / Warfarin and Aspirin /ASA
REMEMBER: This is the medication therapy for long term control of seizures.
92
If a medication is not bound to ______ it circulates freely in the blood or binds to other molecules in the blood.
Protein
93
If a medication such as ________ is bound to a protein, and they get kicked off the protein by another Phenytoin / Dilantin with a stronger protein bond, the previous medication on the protein begins circulating in the blood. Since there is more free drug circulating in the blood than there is supposed to be that increases the blood level which means it is going to have a bigger SYSTEMIC effect. This will increase the patient's _______ risk.
Coumadin or Aspirin
Bleeding
REMEMBER: This is the medication therapy for long term control of seizures.
94
Initially when a patient is on Phenytoin / Dilantin with Coumadin / Warfarin the protein binding increases the effect of the anticoagulant medication but then decreases the effect so if someone is on Phenytoin / Dilantin you really have to closely monitor the ______ blood levels.
APTT
REMEMBER: This is the medication therapy for long term control of seizures.
95
Phenytoin / Dilantin can increase blood glucose. What should the nurse monitor?
Blood sugar
| Symptoms of hyperglycemia
96
There are a lot of side effects with what long term seizure therapy medication?
Phenytoin / Dilantin
97
The nurse must monitor the patient's serum drug levels because it has a very narrow therapeutic range.
What is the normal therapeutic range?
What medication has this nursing intervention?
10-20 mcg/mL
Phenytoin / Dilantin
Study Tip: This is IMPORTANT!
REMEMBER: This is the medication therapy for long term control of seizures.
98
```
The nurse must monitor:
CBC levels
Platelet counts
Liver function tests
Renal function tests
What medication has this nursing intervention?
```
Phenytoin / Dilantin
Study Tip: The nurse will monitor platelet count to make sure the patient doesn't develop any adverse effects of the medication which includes Thrombocytopenia. This means there is a decrease in the number of platelets, the platelet count is usually included in the CBC.
REMEMBER: This is the medication therapy for long term control of seizures.
99
________ can cause liver and kidney issues which is why you are monitoring the platelet level in a patient taking Phenytoin / Dilantin.
Thrombocytopenia
REMEMBER: This is the medication therapy for long term control of seizures.
100
Warm these specific IV medications to room temperature. What medication has this nursing intervention?
Phenytoin / Dilantin
Study Tip: This is so that the precipitates in the fluid will dissolve.
REMEMBER: This is the medication therapy for long term control of seizures.
101
Only mix _______ medication with NS If you mix it with any other IVF you are going to get a precipitate and it makes it very difficult to administer via IV.
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
102
This medication can also cause hyperglycemia so you need to monitor your diabetic patients.
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
103
This nurse must educate the patient that the medication may cause drowsiness especially when driving.
Patient must wear an ID card or bracelet.
Necklaces and bracelets are more durable.
They should ALWAYS carry it.
What medication has this patient teaching as a nursing interventions?
Phenytoin / Dilantin
Study Tip: Anytime any type of patient has a disorder that can cause them to fall down in public or anywhere the patient should carry this.
REMEMBER: This is the medication therapy for long term control of seizures.
104
The nurse must educate the patient to take the medication at same time each day as directed. The patient may take this medication with food.
Take with food to avoid GI irritations.
Avoid taking with milk and antacids which will decrease the absorption of the medication.
What medication has this patient teaching as a nursing interventions?
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
105
The nurse should educate the patient to avoid alcohol and avoid OTC medications until discussed with healthcare provider.
What medication has this patient teaching as a nursing interventions?
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
106
People think certain medications are not harmful since they are OTC like _____, but this can cause issues with blood clotting and GI bleeds. They cause a lot of problems, another example is ______ which destroys your liver. Both are OTC medications but they are extremely dangerous. We need to educate people about them.
Aspirin
Tylenol
REMEMBER: This is the medication therapy for long term control of seizures.
107
The nurse needs educate the patient on maintaining good dental hygiene because of the side effects of Gingival Hyperplasia.
What medication has this patient teaching as a nursing interventions?
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
108
The nurse needs to educate diabetic patient's to monitor their blood sugar closely which means they need to check it more times a day than they normally do because of the side effect of the increased blood sugar.
What medication has this patient teaching as a nursing interventions?
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
109
The nurse will need to educate female patients that they need to use additional non-hormonal methods of contraception because taking this medication at the same time will make the birth control pills not as effective.
What medication has this patient teaching as a nursing interventions?
Phenytoin / Dilantin
REMEMBER: This is the medication therapy for long term control of seizures.
110
You might see this anticonvulsant medication given in the hospital for long term treatment of seizures and many hospitals just give the generic drug which is called ________.
Phenobarbital / Luminal
REMEMBER: This is the medication therapy for long term control of seizures.
111
```
Drug Class:
Barbiturates
Therapeutic Effects/Uses
Prevent tonic-clonic and partial seizures
Status Epilepticus
What anticonvulsant medication is this?
```
Phenobarbital / Luminal
REMEMBER: This is the medication therapy for long term control of seizures.
112
Increases the activity of GABA
| What medication has this pharmacodynamics?
Phenobarbital / Luminal
REMEMBER: This is the medication therapy for long term control of seizures.
113
Therapeutic range: 15-40 mcg/mL
This range is little bit wider than the medication _______ but still pretty narrow.
What medication have this Mode of Action?
Phenytoin / Dilantin
Phenobarbital / Luminal
REMEMBER: This is the medication therapy for long term control of seizures.
114
```
Sedation
Ataxia
Dizziness
Mood changes
Hypotension
Respiratory depression
Increased tolerance to medication
This is because of CNS depression.
You can build up a tolerance to medications.
What anticonvulsant mediation has these side effects?
```
Phenobarbital / Luminal
REMEMBER: This is the medication therapy for long term control of seizures.
115
This medication also has teratogenic effects which means it can cause birth defects if taken by a pregnant woman.
What anticonvulsant mediation has these side effects?
Phenobarbital / Luminal
REMEMBER: This is the medication therapy for long term control of seizures.
116
There are less teratogenic effects in ______ than in Dilantin, and if someone is going to have their previous medication discontinued it needs to be done gradually or we can cause the patient to go into a seizure.
Phenobarbital / Luminal
REMEMBER: This is the medication therapy for long term control of seizures.
117
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Drug Class:
– Iminostilbene
Therapeutic Effects/Uses:
– Refractory seizures
What anticonvulsant medication is this?
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Carbamazepine / Tegretol
Study Tip: So we have a patient who has these seizures that we’ve been trying the medications on and they are just NOT working.
REMEMBER: This is the medication therapy for long term control of seizures.
118
What does a refractory seizure mean?
Anything refractory including a seizure means it is not responding to treatment.
119
So the nurse might add ______ medication to Dilantin therapy or Phenobarbital therapy if this patient is having refractory seizures.
Carbamazepine / Tegretol
REMEMBER: This is the medication therapy for long term control of seizures.
120
This medication is used to treat long term Tonic-Clonic and Partial Seizures.
Carbamazepine / Tegretol
REMEMBER: This is the medication therapy for long term control of seizures.
121
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___________ medication is used to treat
Seizures
Bipolar disease
Trigeminal neuralgia
Neurogenic pain
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Carbamazepine / Tegretol
REMEMBER: This is the medication therapy for long term control of seizures.
122
Decreases synaptic transmission in the CNS by affecting sodium channels in neurons.
What medication have this Pharmacodynamics?
Carbamazepine / Tegretol
REMEMBER: This is the medication therapy for long term control of seizures.
123
The nurse must maintain the blood level in the therapeutic range:
5-12 mcg/mL That’s not very big range so you have to watch it.
What medication have this Nursing Intervention?
Carbamazepine / Tegretol
REMEMBER: This is the medication therapy for long term control of seizures.
124
Possible toxicity if taken with this fruit ________ juice. This is something that anyone on medication should not take, neither the fruit nor the juice. This fruit will either increase or decrease the effects of the medication, it just seems to mess with your medications.
What medication has this food interaction?
Grapefruit
Carbamazepine / Tegretol
REMEMBER: This is the medication therapy for long term control of seizures.
125
Drug Class:
Pyrrolidines
Therapeutic Effects/Uses:
Complex partial & tonic-clonic seizures.
This medication is used as both adjunctive and monotherapy. It can be adjunctive or added on to other medications, used as a secondary helper medication or it can be the only medication given. Seen given ALONE often.
What anticonvulsant medication is this?
Levetiracetam / Keppra
REMEMBER: This is the medication therapy for long term control of seizures.
126
This medication prevents the propagation of seizure activity. It appears to work by inhibiting burst firings without effecting normal neuronal excitability. It prevents that excitability that happens when electrical impulses are firing without that control.
What medication have this Pharmacodynamics?
Levetiracetam / Keppra
REMEMBER: This is the medication therapy for long term control of seizures.
