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Pharmacology Test 2 > Seizure DRUGS > Flashcards

Seizure DRUGS Flashcards

1
Q

Benzodiazepines for seizures

-Indications

A

Absence seizures and myoclonic seizures

  1. One of the MOST widely prescribed classes
    - used also for: Anxiety, skeletal muscle spasms, and alcohol withdrawal symptoms

Tolerance may develop quickly

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2
Q

Benzodiazepines for seizures

-Risks and Contraindications

A

Monitor for drug abuse potential (Schedule IV)
Pregnancy Category D
Contraindicated in NARROW-ANGLE GLAUCOMA

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3
Q

Benzodiazepines for seizures

-Side effects and OD

A
  1. Respiratory depression may result w/ other CNS depressants
  2. Common side effects include dizziness, drowsiness
  3. for overdose give FLUMAZENIL (ROMAZICON)
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4
Q

Benzodiazepines for seizures

-Prototype drug

A

Diazepam (Valium)

  1. Mechanism:
    - Similar to that of barbiturates but safer
  2. Primary Use:
    - Short-term seizure control
  3. Adverse effects:
    - Drowsiness and dizziness
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5
Q

Examples of Benzodiazepines

A
  1. Clonazepam (Klonopin)
  2. Clorazepate (Tranxene)
  3. Lorazepam (Ativan
  4. Diazepam (Valium)
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6
Q

Barbiturates for seizures

-Overview

A
  1. Low margin for safety
  2. High potential for dependence
  3. Profound CNS depression
  4. Effective against all major seizure types EXCEPT absence seizures
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7
Q

Barbiturates for seizures

-What type of seizure they DO NOT treat?

A

Barbiturates are not effective against absence seizures

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8
Q

Examples of Barbiturates

A
  1. Phenobarbital (Luminal)
  2. Amobarbital (Amytal)
  3. Secobarbital (Seconal)
  4. Pentobarbital (Nembutal)
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9
Q

Barbiturates for seizures

-Prototype Drug

A

Phenobarbital (Luminal)

  1. Mechanism:
    - Changing the action of GABA
  2. Primary Use:
    - Controlling seizures
  3. Adverse effects
    - Dependence, drowsiness, vitamin deficiencies, laryngospasm
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10
Q

Barbiturates for seizures

-Monitor?

A
  1. Monitor Pt condition
  2. Liver and kidney function
  3. Pregnancy Category D
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11
Q

Barbiturates for seizures

-Patient Teaching

A
  1. Use Reliable contraception
  2. Immediately report pregnancy
  3. Report excessive signs of bleeding
  4. Report drowsiness and bone pain
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12
Q

Hydantoins for Seizures

-Overview

A
  1. Useful for all types of epilepsy except ABSENCE SEIZURES

2. Provides effective seizure Suppression w/out abuse potential or CNS depression associated w/ barbiturates

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13
Q

Hydantoin and Phenytoin-like Drugs

-Monitor??

A
  1. Monitor serum-drug levels and signs of toxicity
  2. Blood dyscrasias and bleeding disorders
  3. liver and kidney function
  4. Fatal hepatotoxicity can occur
  5. Watch for GINGIVAL HYPERPLASIA
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14
Q

Hydantoin and phenytoin-like drugs

-contraindications

A
  1. Pt’s w/ hypersensitivity to hydantoin products

2. Rash, seizures due to hypoglycemia, sinus bradycardia, and heart block

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15
Q

Hydantoin and phenytoin-like drugs

-Patient Teaching

A
  1. Immediately report heart block, hypoglycemia, or pregnancy
  2. Immediately report unusual bleeding
  3. Routine labs for liver and kidney function
  4. Report signs of toxicity
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16
Q

Hydantoins

-Prototype Drug

A

phenytoin (Dilantin)

  1. Mechanism
    - Desensitize sodium channels
  2. Primary Use
    - Treats all types of seizures except absence seizures
  3. Adverse Effects:
    - CNS depression, Gingival hyperplasia, skin rash, cardiac dysrhythmias, Hypotension
17
Q

Examples of Hydantoins

A
  1. Phenytoin (Dilantin) –MOST COMMON

2. Fosphenytoin (Cerebyx)

18
Q

Hydantoin and newer drugs

-Overview of mechanism

A
  1. Delay an influx of sodium ions across membrane
  2. Sodium movement determines action potential
  3. Sodium channels are not blocked; they are just desensitized
19
Q

Phenytoin-Like Drugs

-Prototype Drug

A

Valproic Acid (Depakene)

  1. Mechanism:
    - Desensitize sodium channels
  2. Primary Use:
    - ABSENCE SEIZURES
  3. Adverse effects:
    - Limited CNS depression, Visual disturbances, ataxia, vertigo, headache
  4. Additional Adverse Reactions:
    - GI effects, Hepatotoxicity, pancreatitis
20
Q

Examples of Phenytoin-Like Drugs

A
  1. Carbamazepine (Tegretol) - tonic-clonic and partial seizures
  2. Felbamate (Felbatol)
  3. Lamotrigine (Lamictal)
  4. Valproic acid (Depakene, Depakote) –absence seizures
  5. Zonisamide (Zonegran)
21
Q

Phenytoin-like Drugs

-Carbamazepine (Tegretol)

A

Used for Tonic-clonic and partial seizures

22
Q

Phenytoin-like Drugs

-Valproic acid (Depakote, Depakene)

A

Used for absence seizures

23
Q

Phenytoin-like Drugs

-Patient Teaching

A
  1. Avoid alcohol, OTC drugs, and herbal meds
  2. Avoid Nicotine
  3. Avoid driving and hazardous activities
  4. Rebound seizures if discontinued abruptly
  5. Take w/ food
24
Q

Succinimides for Seizures

- Overview

A
  1. Suppress seizures by delaying calcium influx into neurons
  2. Generally ONLY effective against ABSENCE SEIZURES
  3. Ethosuximide (Zarontin) -MOST COMMON prescribed drug in this class
25
Q

Succinimides for Seizures

- Indications

A
  1. Do not abruptly withdraw med
  2. Use w/ caution w/ antiseizure meds, phenothiazines, and antidepressants
  3. Pregnancy Category C
26
Q

Succinimides for Seizures

- Prototype drug

A

Ethosuximide (Zarontin)

  1. Mechanism
    - Suppress calcium influx
  2. Primary Use:
    - ABSENCE SEIZURES
  3. Adverse effects
    - drowsiness, dizziness, lethargy
27
Q

Succinimides for Seizures

- RARE BUT SERIOUS SIDE EFFECTS

A
  1. systemic lupus erythematosis
  2. leukopenia
  3. Aplastic anemia
  4. Stevens-Johnson syndrome
28
Q

Examples of Succinimides

A
  1. Ethosuximide (Zarontin)
  2. Methsuximide (Celontin)
  3. Phensuximide (milontin)
29
Q

Succinimides for Seizures

- Patient Teaching

A
  1. Immediately report mood changes and SUICIDAL THOUGHTS
  2. Avoid driving and hazardous activities
  3. Do not suddenly stop taking
  4. Take w/ food
  5. Report symptoms of fever or sore throat
  6. Report weight loss and anorexia
30
Q

Newer GABA-related Drugs

A
  1. Gabapentin (Neurontin)
  2. Pregabalin (Lyrica)
  3. Tiagabine (Gabitril)
  4. Topiramate (Topamax)

Pharmacology Test 2 (10 decks)

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