A.Anticonvulsants

Question 1

Pathophysiology of epilepsy

Answer 1

Seizure disorder resulting from abnormal electrical charges from the cerebral neurons - characterized by a loss or disturbance of consciousness and convulsions ( involuntary paroxysmal muscular contractions

Question 2

Epilepsy

Answer 2

Neurological disorder with recurrent episodes of convulsive movements or other motor activity - loss of consciousness - sensory disturbances - other behavioral abnormalities

Question 3

Epilepsy cause and characteristics

Answer 3

-Seizure disorder- abnormal electric discharges from cerebral neurons -Characteristics: loss of consciousness, convulsive movements Cause: - unknown - secondary to trauma, anoxia, infection, stroke - isolated seizures due to fever , electrolyte , or acid-base imbalance

Question 4

Types of seizures

Answer 4

1. Generalized - grand mal ( tonic- clonic)- common - petit mal ( absence ) > 10 sec or less - children 2. Partial - psychomotor - repetitive behavior- chewing or swallowing motions - behavioral changes

Question 5

Antiepileptic drugs indications

Answer 5

• control seizure activity -status epilepticus ( Sz > 30 min, brain dmg > 60 min) - mood disorders ( bipolar disorder - manic / depression) - neuropathic pain ( migraines , diabetic neuropathy)

Question 6

Antiepileptic drugs

Answer 6

1. Hydantoins✨: phenytoin ( Dilantin)-longterm 2. Iminostilbene : carbamazepine ( tegretol)-longterm 3. Valproic acid ( depakote)- bipolar disorder 4. Benzodiazepines (stop seizure): clonazepam ( klonopin) - diazepam ( Valium)

Question 7

Phenytoin ( Dilantin ) Action

Answer 7

A: stabilizes cell membrane to limit seizures

Question 8

Phenytoin ( Dilantin ) Contraindications

Answer 8

Pregnancy- teratogenic

Question 9

Phenytoin ( Dilantin ) SE

Answer 9

Gingivitis - gingival hyperplasia - NYSTAGMUS ( invol. Movement of eye ball ) - HA, dizziness , slurred speech , decreases coordination, alopecia , diplopia (double vision), pink - red brown urine - thrombocytopenia, aplastic anemia

Question 10

Valproic acid ( depakote) SE

Answer 10

-ataxia ( elderly) - thrombocytopenia - heptatotoxicity

Question 11

Valproic acid ( depakote) Interactions

Answer 11

Barbiturates- additive effect ( increased cns depression )

Question 12

Carbamazepine ( tegretol ) SE

Answer 12

-BONE MARROW SUPPRESSION - dysrhythmias

Question 13

Carbamazepine ( tegretol ) Interactions

Answer 13

• several drugs with - can lead to toxicity - other bone marrow depressants - additive effect

Question 14

Lamotrigine ( lamictal)

Answer 14

SE- rash, ataxia - interactions: other anticonvulsants

Question 15

Antiepileptics : nursing process

Answer 15

1. Assessment: - document type of seizure seen - assess Liver Function Tests, CBC -CRITICAL ASSESSMENT: drug levels $ LFTs 2. Diagnoses: - risk for injury

Question 16

Antiepileptic drugs General nursing interventions

Answer 16

• WARN PATIENT NOT to discontinue abruptly - take drug same time everyday - avoid certain herbs , alcohol, and other CNS depressants - monitor serum drug levels and liver function tests - safety : protect from environmental hazards , driving

Question 17

Phenytoin nursing interventions

Answer 17

• need 🌟frequent oral hygiene and dental check ups - warn females taking oral contraceptives to use additional contraception - monitor glucose level in diabetics - warn if harmless publish / brown urine

Question 18

Drugs for status epilepticus

Answer 18

• benzodiazepines: A. Diazepam ( Valium) B. Lorazepam ( Ativan) C. Midazolam ( versed) …. followed by fosphenytoin– Cerebyx ( IV form of Dilantin)

Question 19

Ataxia

Answer 19

failure of muscular coordination; irregularity of muscular action.

Question 20

Benzodiazepines main purpose

Answer 20

stop seizure quickly, then Atavan then Valium

Question 21

Antiepileptic drugs Action

Answer 21

• decrease nerve response to electrical stimulation -decrease speed of seizure -decrease speed of electrical impulses through the nerves