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Chapter 4 > Anti-epileptic medication > Flashcards

Anti-epileptic medication Flashcards

1
Q

What factors are considered when prescribing ant-epileptic medication?

A

type of seizure
age
sex
co-morbidities

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2
Q

how often is it given for adults and for children?

A

usually twice a day

children: given higher doses or more frequent doses as their metabolism is more rapid.

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3
Q

Which AED have a long half-life? How often are they given?

A

Lamotrigine
phenytoin
phenobarital

given ONCE AT NIGHT

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4
Q

Which three categories are anti-epileptic medication placed into?

A

Category 1: Patient must stick to the same brand:

  • carbamazepine
  • phenytoin
  • phenobabital

Category 2:

  • lamotrigine
  • valproate
  • zonisamide

Category 3: doesn’t matter what brand

  • levetiracetam
  • gabapentin
  • pregabalin
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5
Q

What should pts avoid doing?

A

avoid abrupt withdrawal

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6
Q

Can the categories be used with one another?

A

yes, but monotherapy is preferred.

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7
Q

What are the rules and regulations of patients on AED?

A
  • Must only drive if only seizure free for one year
  • if pts are experiencing seizures, it should only be sleep seizures not wake seizures for 3 years
  • if pt does get a seizure (if single episode or first episode) cannot drive for 6 months
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8
Q

if pt is pregnant is there a risk of teratogenicity when taking AED?

A

Yes especially in the 1st trimester or pts taking two or more AED.
valproate has the highest risk

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9
Q

Why are routine injections of vitamin K given at birth?

A

to minimise the risk of neonatal haemorrhage particularly in those who have been associated with anti-epileptic medication

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10
Q

For any newly diagnosed tonic-clonic seizure, what is first line?

A

Sodium valproate

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11
Q

For a generalised tonic-clonic seizure, what is first line?

A

Sodium valproate

Carbamazepine

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12
Q

For an absence seizure, what is first line?

A

Sodium valproate or

ethosuximide

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13
Q

For a focal seizure, what is first line?

A

Lamotrigine

but for newly diagnosed, its carbamazepine

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14
Q

For a person with atonic/tonic seizure what is first line?

A

Sodium valproate

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15
Q

For pregnancy, if a pt has been diagnosed with epilepsy, what is first line?

A

Oxycarbazepine

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16
Q

For pregnancy, if pt has been diagnosed with general tonic clonic seizures, what is first line?

A

lamotrigine

17
Q

Whats the therapeutic range of carbamazepine?

A

4-12mg/L

18
Q

Patients on carbamazepine may experience blood disorders, what are the signs of these symptoms?

A

Blood disorders - so sore throat, fever, unexplained bruising - may have bone marrow suppression - make sure patient is aware

19
Q

What are the toxicity S/E of carbamazepine?

A
  • blood disorders
  • skin disorders
    anti-epileptic hypersensitivity disorders
  • hepatic disorders
  • blurred vision
  • drowsiness
  • hyponatraemia
20
Q

What is the route of elimination of carbamazepine?

A

hepatic

21
Q

What category is carbamazepine in? Whats the most important factor about this category?

A

Category 1. patient must stick to the same brand.

22
Q

What can lamotrigine cause?

A

Bone Marrow Supression

Both laMotrigine and cabarbaMazepine cause bone Marrow supression

23
Q

What is status epilepticus?

A

a pt starts to have a seizure one after the other without regaining consciousness in between them

24
Q

What do you do if a patient experiences status epilepticus?

A

put pt in recovery position
given oxygen
hyperglycaemia must be corrected (if they do have it)
if its due to alcohol intake - give thiamine
if they are pyridoxine deficient - give pyridoxine

25
Q

if a pt does get a seizure for more than FIVE minutes, what is given to the patient?

A
  • IV lorazepam
26
Q

If unable to resuscitate the patient what would you give?

A

diazepam rectal solution or midazolam oromucosal solution via buccal cavity?

27
Q

if seizure lasts for more than 25 minutes, what would you give?

A

phenytoin or phenobarbital

28
Q

if seizure lasts for more than 45 minutes what would you give?

A

anaesthesia with thiopental, midazolam

29
Q

if patients have febrile convulsions, what would you give?

A

paracetamol

Chapter 4 (13 decks)

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