Wk 11 Antiseizure Flashcards Preview

Pharmacology > Wk 11 Antiseizure > Flashcards

Flashcards in Wk 11 Antiseizure Deck (40):
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1. What is the difference between the dose for an anxiolytic effect and the dose for a hypnotic effect?

Anxiolytic effect with low doses.
Hypnotic effect with high doses.

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2. How do benzodiazepines work?

They bind to the GABA receptor-chloride channel complex and inhibit cell excitability.

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3. What are the three main indications for benzodiazepines?

Anxiety, insomnia, seizures

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4. Can most benzodiazepines be safely administered during pregnancy?

No

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5. Name two major adverse effects of benzodiazepines?

CNS depression, anterograde amnesia. Sedation may decrease over time.

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6. What type of drug-drug interaction do benzodiazepines have on CNS depressants?

Potentiation

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7. What significant withdrawal symptoms may occur with rapid discontinuation of benzodiazepines?

Panic, paranoia, delirium, hypertension, muscle twitching, and seizures

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8. What is the antagonist for a benzodiazepine?

Flumazenil (Romazicon)

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9. Describe the type of stressors for which benzodiazepines are given.

They are to help with significant stressors only, not eliminate all stress from life.

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10. Barbiturates bind to what receptors?

GABA receptor-chloride channel complex and inhibit cell excitability.

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11. How do barbiturates affect the clearance of other drugs?

Increase drug clearance

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12. What effect does barbiturates have on oral contraceptives?

Increase their clearance which increase the chance of pregnancy

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13. What two physiologic functions do barbiturates depress?

CNS function and respirations

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14. Who should not be prescribed barbiturates due to the seriousness of overdose?

Suicidal patients

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15. Which class of drugs requires medically-supervised detoxification?

Barbiturates

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16. What signs make up the classic triad for barbiturate toxicity?

Respiratory depression, coma, pinpoint pupils (miosis)

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17. Abrupt withdrawal from barbiturates may result in what?

Death

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18. Buspirone (BuSpar) is solely used for what indication?

Anxiety

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19. An advantage of BuSpar is that it does not enhance the _____________.

CNS depression of benzodiazepines, alcohol, and barbiturates.

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20. Zolpidem (Ambien), eczoplicone (Lunesta), and trazadone (Desyrel) have an advantage over other hypnotics in that they do not interfere with what?

REM sleep

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21. Which significant daytime effect of Benadryl precludes its use for sleep?

Daytime somnolence

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22. List at least four anticholinergics effects.

Decreased salivation, decreased lacrimation, urinary retention, dry defecation, blurred vision, photophobia, tachycardia

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23. Why is trazadone (Desyrel) given only at night?

Significant sedation

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24. Name the five mechanisms of action of antiepileptic drugs (AEDs).

Delays recovery of sodium channels to reduce firing, blocks calcium channels to reduce firing, promotes potassium movement out of the neurons for repolarization, blocks glutamate receptors to prevent excitation, and potentiates GABA to decrease excitability.

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25. How should a competent prescriber stop an AED?

Slowly titrate off one drug at a time while keeping a seizure frequency chart.

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26. Name adverse effects of AEDs.

Depression, suicide, and CNS depression.

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27. What types of seizures are affected by phenytoin (Dilantin)?

All except absence.

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28. What is the mechanism of action for phenytoin (Dilantin)?

Slows recovery of sodium channels in hyperactive neurons.

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29. Name common adverse effects of phenytoin (Dilantin) at normal dosage.

Mild sedation and nausea, gum hyperplasia, rash, bleeding in neonates.

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30. When giving phenytoin (Dilantin) IV, how do you administer it?

No faster than 50mg/min and flush afterwards with normal saline. Also recommend flushing prior to dose administration to clear IV tubing.

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31. Name the contraindications for phenytoin (Dilantin)?

Bradycardias and heart blocks.

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32. What pregnancy category is phenytoin (Dilantin)?

Category D

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33. What would you tell a woman who is taking phenytoin (Dilantin) and oral contraceptives?

Phenytoin (Dilantin) reduces the blood levels of oral contraceptives. Use backup contraception.

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34. What seizures are affected by carbamazepine?

Tonic-clonic, partial, and complex partial seizures.

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35. What is the mechanism of action for carbamazepine (Tegretol)?

Delays recovery of sodium channels.

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36. How does carbamazepine (Tegretol) influence hepatic metabolism?

Carbamazepine (Tegretol) induces (speeds up) hepatic metabolism of other drugs.

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37. What pregnancy category is carbamazepine (Tegretol)?

Category D

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38, What antiepileptic drug should not be used during pregnancy? Why? What preventative measure is recommended?

Valproic acid. Causes neural defects and lowers IQs. Take folic acid 5 mg daily in case becomes pregnant.

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39. What organ dysfunctions may be precipitated by valproic acid?

Hepatotoxicity and pancreatitis.

Hepatotoxicity and pancreatitis.

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40. What is the first drug recommended for acute seizure management? Why?

Lorazepam (Ativan). Lasts 72 hours.