Pharm - Antiepileptic drugs Flashcards
(32 cards)
Medications used to control epilepsy and convulsions
Antiepileptics/Anticonvulsants
Evidence indicates these drugs alter the movement of sodium, potassium, calcium, and magnesium ions resulting in more stabilized and less responsive cell membranes
Antiepileptics
CNS dysfunction that can cause symptoms ranging from momentary sensory disturbances to convulsive seizures
Epilepsy
Excessive stimulation of the neurons in the brain, leading to a brief episode of abnormal neuron activity.
Seizure
A more severe seizure characterized by involuntary spasmodic contractions of any or all voluntary muscles throughout the body, including skeletal, facial, and ocular muscles.
Convulsion
Primary (idiopathic) epilepsy
No identifiable cause
Characterized by neuronal activity that originates simultaneously in the grey matter of both hemispheres. Several subtypes.
Generalized onset seizures
Begin with muscular contractions throughout the body (tonic) and progress to alternating contraction and relaxation (clonic phase). Involve spasms of upper trunk with flexion of the arms
Tonic-clonic seizures
originate in localized or focal region (1 lobe) of the brain
Focal onset seizures
A subtype of generalized onset seizures that involves a brief loss of awareness but without loss of consciousness or spasmodic eye blinking.
Simple focal seizures
level of consciousness reduced but not completely lost
Focal onset seizure
Multiple seizures occur that last for 5 minutes or longer of continuous clinical or electrographic or both without recovery (returning to baseline)
Status epilepticus
A metabolic process by which a drug stimulates production of enzymes that enhance its own metabolism. Leads to reduction in therapeutic drug concentration
Autoinduction
A patient is experiencing temporary lapses in consiousness that last only a few seconds. Her teachers have said she “daydreams too much.” What type of seizure can this be classified as?
a)Simple
b)Generalized
c)Complex
d)Partial
b) generalized
Which condition is a life threatening emergency in which patients typically do not regain consciousness?
a) status epilepticus
b) tonic-clonic seizures
c) epilepsy
d) primary epilepsy
a) status epilepticus
Which of the following is true about the intravenous infusion of phenytoin (Dilantin)? Select all.
a) phenytoin is injected quickly
b) phenytoin is injected slowly
c) the injection of phenytoin is followed by an injection of sterile saline
d) phenytoin must not be infused continuosly
e) phenytoin is mixed with D5W (5% dextrose and water) for the infusion
b, c, d
The nurse administers phenobarbital to a patient. What priority clinical manifestation should the nurse monitor as a possible adverse effect of this therapy?
a) constipation
b) gingival hyperplasia
c) drowsiness
d) dysrhythmias
c) drowsiness
A patient with a history of epilepsy experiences status epilepticus. What medication can the nurse expect to prepare for this condition?
a) phenobarbital
b) diazepam (Valium)
c) valproic acid (Depakene)
d) phenytoin (Dilantin)
b) diazepam (valium)
A patient who is experiencing neuropathic pain tells the nurse that the health provider is going to start him on a new med that is generally used to treat seizures. The nurse anticipates that which drug will be ordered?
a) phenobarbital
b) phenytoin (Dilantin)
c) gabapentin (Neurontin)
d) lamotrigine (Lamictal)
c) gabapentin
Phenytoin (Dilantin) is prescribed for a patient. The nurse checks the patient’s current list of medications and notes that interactions may occur with which drugs or drug classes? (select all)
a) loop diuretics
b) warfarin (Coumadin)
c) sulphonamide antibiotics
d) corticosteroids
e) oral contraceptives
a, b, c
A patient is unable to take oral meds and has received a loading dose of phenytoin (Dilantin) intravenously. The orders call for him to receive phenytoin 5mg/kg per day in three divided doses. The medication comes in a vial containing 50mg/mL. The patient weighs 90kg. How many mL of medication will be drawn up for each dose?
How many mG will the patient receive each day? For each dose?
3mL
450 mg/day
150mg/dose
When teaching a patient about taking their antiepileptic meds, what is important to educate on ?
-Treatment is long term and usually lifelong (not a cure)
-Take same time each day
-Do not crush, chew, or open extended forms
-This med should not be discontinued abruptly
-Follow driving recommendations
-Keep a journal to monitor therapeutic response, seizure occurrence, and adverse effects.
What is important when administering Dilantin IV?
-Diluted in NS only!
-Filter must be used
-Saline flush
-Slow IV directly into large vein (20 gauge or larger) venous catheter
Treatment for status epilepticus
Diazepam (Valium)
