T3-Antiseizure Medications-MJ Flashcards Preview

Pharm I > T3-Antiseizure Medications-MJ > Flashcards

Flashcards in T3-Antiseizure Medications-MJ Deck (68):
1

If you have a seizure does that mean its epilepsy?

No, just because you have one doesn't mean its epilepsy

2

What is epilepsy?

Chronic, recurrent seizures

3

Do all seizures involve convulsions?

No

4

What is epilepsy caused by?

Hyperexcitable neurons (focus)

5

A ____ is a cluster of neurons that cause the seizure. Several clusters are called ____.

Focus, foci

6

T or F: If the seizure is occurring (hyperexcitable neurons) in a certain lobe, the functions of that lobe is what is shown in the seizure.

True; If it's in the temporal lobe, we can expect to see the client having visual problems and seeing wild colors

7

What does it mean if it is a generalized seizure?

BOTH hemispheres are invoved

8

What are the 6 different types of generalized seizures?

Tonic-clonic
Absence
Atonic
Myoclonic
Status epilepticus
Febrile seizures

9

What generalized seizure is this?
-Major convulsions
-Period of muscle rigidity
-Synchronous muscle jerks

Tonic-clonic (grand mal)

10

Tonic-clonic: What characteristic of this seizure is the tonic phase? What is the clonic phase?

Tonic- muscle rigidity
Clonic-Synchronous muscle jerks

11

Tonic-clonic: These seizures often cause _____, but not ____.

Cause urination, but not defection

12

Tonic-clonic: How are convulsions preceded?

Loud cry, cause by forceful expiration of air across the vocal cords

13

Tonic-clonic: What are these seizures accompanied by?

Marked impairment of consciousness and are followed by period of CNS depression (postictal state)

14

Tonic-clonic: How long does this seizure last?

90 seconds or less

15

What is the other name for absence seizures? What are they characterized by?

Petit Mal; characterized by loss of consciousness for a brief time (10-30 sec)

16

What do absence seizures usually involve?

Mild, symmetric motor activity (eye blinking)

17

Can absence seizures occur with no motor activity at all?

Yes

18

The patient may experience ____ of absence attacks a day.

Hundreds

19

What patients do absence seizures occur primarily in?

Children and usually cease during the early teen years

20

What are atonic seizures characterized by?

Sudden loss of muscle tone

21

Atonic seizures: If seizure activty is limited to the muscles of the neck, "____" occurs. However, if the muscles of the limbs and trunk are involved, a "____" can occur.

"Head drop"
"Drop attack"

22

Atonic seizures: Which causes the patient to suddenly collapse--head drop or drop attack?

Drop attack

23

What age group are atonic seizures most often in?

Children

24

What seizure consists of sudden muscle contraction that lasts for just 1 SECOND?

Myoclonic

25

Myoclonic: What is it when seizure activity is limited to one limb?

Focal myoclonus

26

Myoclonic: What is it called when seizure activity involves the entire body?

Massive myoclonus

27

What seizure is defined as a seizure that persists for 15-30 minutes or longer or a serious of recurrent seizures during which the patient does not regain consciousness?

Status epilepticus (SE)

28

There are several SE, which can be life-threatening?

Generalized convulsive SE

29

What age group are febrile seizures associated with?

Children ages 6 months to 5 years

30

How do febrile seizures generally manifest as?

Generalized tonic-clonic convulsions of short duration

31

T or F: Children who have febrile seizures are at high risk of developing epilepsy later in life.

FALSE; they are NOT at high risk for developing epilepsy later in life

32

What are some treatment methods for treating seizures?

Block sodium channels
Promote GABA activity
"Other"

33

Why do we want to promote GABA when treating seizures?

GABA are the brakes! They slow things down in the brain. They will tell the hyper excitable neurons to SLOW DOWN

34

What are the challenges with most drugs in preventing seizures?

1. Narrow therapeutic index
2. Lots of interactions
3. Neurosensory side effects
4. Compliance

35

Challenges in preventing seizures: Talk about the neurosensory side effects.

These involves the senses and the mind (pretty unpleasant--sedation, incoordination, double or blurred vision, N/V)

*Effects all similar to what? Alcohol

36

Challenges in preventing seizures. Talk about compliance.

When seizure drugs aren't working its because the client isn't taking the meds like they should or maybe not even taking them at all. It is important to reinforce the importance of the drug regiment with seizure drugs!

37

Do seizure meds work immediately. Explain.

No, just because they started the drug doesn't mean its the "right fit" for them. Getting seizure control takes some time. Patient education!!!

38

What are the 4 main anti-seizure drugs?

Phenytoin
Valproic acid
Lamotrigine
Levetricetam

39

What are the challenges with phenytoin?

Protein binding
CYP interactions
Saturable metabolism

40

Is it hard to keep phenytoin levels effective?

Yes

41

What is the range for phenytoin levels?

10-20 mcg/mL

42

What are the side effects of phenytoin?

1. GINGIVAL HYPERPLASIA (the big one we will continually be tested on)
2. Hirustism
3. Hepatoxicity (what is J.A.U.N.D.I.C.E?)
4. Vitamin D and folic acid deficiency

43

What is important patient education when teaching the patient about the possible side-effects of gingival hyperplasia?

Good oral hygiene

44

What is purple glove syndrome the result of?

Giving phenytoin through an IV and it infiltrates (IV comes out of vein into interstitial tissue)

*A lot of hospitals now only will let you give this drug through a CENTRAL line, not peripheral)

*This purple glove syndrome can lead to amputations!

45

What is mild phenytoin toxicity?

Nystagmus

46

What is moderate phenytoin toxicity?

Slurred speech, ataxia

47

What is severe phenytoin toxicity?

Confusion, lethargy, coma, seizure

48

Is it important to teach the patient the different levels of phenytoin toxicity?

Yes; they need to know so they can be apart of the early symptom watch!

We want them to come to the doctor with a nystagmus instead of it get too late and they go into coma!

49

What are some of the side-effects of Valproic acid?

Hair loss
Weight gain
Hepatotoxicity (know J.A.U.N.D.I.C.E)

50

Is valproic acid teratogenic?

Yes, highly!

51

What can valproic acid and pregnancy cause?

Neural tube defects--spina bifida

52

Valproic acid and IQ of the child: what happens?

The IQ of the child may decrease

53

If a woman at child bearing years had tired other seizure methods and valproic acid was the only one that worked, what should our patient education be?

Tell her to take extra folic acid and be sure to use effective contraceptive methods

54

What are the side-effects of lamotrigine?

1. Neurosenory
2. STEVEN-JOHNSONS

55

Why do we need to start Low and go sLow with Lamotrigine?

Give a low dose, give it slowly to reduce possible steven johnson

56

Why do we LOVE LEVEtiracetam?

1. Few neurosensory side effects
2. WIDE therapeutic range
3. Few interactions

57

What are the side effects of levetiracetam?

Agitation/aggression (rare)
Depression (rare)

58

Which anti-seizure drug has a side effect of gingival hyperplasia?

Phenytoin

59

Which anti-seizure drug has a side effect of Steven Johnson?

Lamotrigine

60

Which anti-seizure drug has a WIDE therapeutic range?

Levetiracetam

61

Which anit-seizure drug is highly teratogenic?

Valproic acid

62

Which anti-seizure drug has a really narrow therapeutic range and levels have to be monitored?

Phenytoin

63

Which anti-seizure may cause spina bifida when taking during pregnancy?

Valproic acid

64

Which anti-seizure drug has few neurosensory side effects and few interactions but has rare side effects for agitation, aggression, &/or depression?

Levetiracetam

65

Which anti-seizure drug has neurosensory side effects?

Lamotrigine

66

Which anti-seizure drugs have hepatotoxicity as side-effects?

Phenytoin and Valproic acid

67

Which anit-seizure drug has side-effects for hirutism and vitamin D and folic acid deficiency?

Phenytoin

68

Which anti-seizure drug has side effects for hair loss and weight gain?

Valproic acid