AED- Patient Care

Question 1

When providing AEDs what should be monitored?

Answer 1

1. Frequency
2. Comorbidity
3. Cost Access
4. Toxicity
5. Blood levels
6. ADE
7. Compliance
8. First aid

Question 2

What is MC issue with AEDs in compliance risks?

Answer 2

Seizure if 1st drug stopped too abruptly.

1. Start new drug LOW slow
2. When at min. effect, SLOWLY tape down other drug

Question 3

Mr. Happy has not had a seizure since 2017? He wants to know if he can stop?

Answer 3

1. NO seizure >2y
2. Controlled on mono-therapy
3. Normal neurologic and EEG exam
4. Risk 61% change of seizure free vs benefits
5. TAPER slowly for 1-3mo by 1/3

Question 4

What is main goal to DEC ADE?

Answer 4

Titrate slow and low. Don’t add another med until 1st is MAX

Question 5

Ms. Brook 23y h/o absence seizure what risk need to be discussed?

Answer 5

1. Teratogencity- VALPROATE***
2. DEC effect if used with contraceptives
3. DEC fertility
4. Monotherapy
5. Folic ACID supp

Question 6

Which ADE may cause cleft palate?

Answer 6

Carbamazepine, PHenytoin, Topiramate

Question 7

Which ADE may cause congenital cognitive impairment and cardiac malformations?

Answer 7

**Phenobarbital. Lamotrigine

Question 8

What are the MC Cat C RX?

Answer 8

**OXC, GBP, LEV

Question 9

When should AEDs be taken off if planning birth?

Answer 9

6 months b4 conception, TAPER Slowly. Lowest dose. DX testing

Question 10

Which are known to transfer in breast feeding?

Answer 10

LTG, PRIM, LEV, GBP, TPA

Question 11

For Geriatrics on AEDs what should be considered?

Answer 11

1. Accurate wt monitored,
2. INC sedative and cardiorespiratory ADEs.
3. FX risk.
4. DI,
5. Comorbidity