Intracranial (Antiseizure)

Question 1

hydantoins

Answer 1

phenytoin, fosphenytoin

• stabilize nerve cells throughout the CNS
• influence ionic channels in cell membrane; decrease excitability and hyperexcitability to stimulation

Treats: seizures, specifically status epilepticus (last longer)

Contraindications: birth defects, older adults/debilitated patients (may respond adversely to CNS depression), coma, depression, psychoses, other CNS depressants, alcohol, primrose (cause seizures), ginko (adverse effects)

Adverse effects: constipation, anorexia, cardiac arrhythmias, changes in BP, urinary retention, loss of libido

• monitor heart rate/rhythm

Question 2

barbiturates

Answer 2

phenobarbitol

• inhibit impulse conduction in the RAS

Contraindications: birth defects, older adults/debilitated patients (may respond adversely to CNS depression), coma, depression, psychoses, other CNS depressants, primrose, ginko, alcohol, warfarin (decreased effectiveness)

Adverse Effects: depression, anorexia, cardiac arrhythmia, changes in BP, urinary retention, loss of libido, withdrawal syndrome

• Causes decreased synthesis of Vitamin K and D

Question 3

inhibitory neurotransmitter GABA

Answer 3

valproic acid

• reduces abnormal electrical activity in the brain
• increase GABA activity at inhibitory receptors

Contraindications: pregnancy, phenobarbital/diazepam (potential toxicity, increased serum levels), phenytoin (seizures, toxicity),

Adverse reactions: hyperammonemia, liver toxicity, thrombocytopenia, paresthesias

-patients should be well hydrated due to risk of renal calculi development