ANTI-SEIZURE UNIT 3 Flashcards
What drug class is Phenytoin?
Hydantoin
What drug class is Valproic Acid?
Valproate
What drug class is Phenobarbital?
Barbiturate
What is Anti-seizure used treat?
Epilepsy/ Seizures
What is Epilepsy?
Seizure disorder
Abnormal electric discharges from cerebral
neurons
Characteristics
■ Loss of consciousness
■ Involuntary, uncontrolled movements
Cause
■ Unknown disruption in electrical brain functioning
■ Secondary to brain trauma or anoxia, infection, stroke
■ Isolated seizures due to fever, electrolyte, or acid–base
imbalance, alcohol, or drugs
Are anti-seizure drugs CNS depressants or CNS stimulants?
Depressants
What is the action of Anti-seizure
Antiseizure drugs
– Stabilize nerve cell membranes
– Suppress abnormal electric impulses in cerebral
cortex
Specific types of action
– Suppress sodium influx
– Suppress calcium influx
– Enhance action of GABA
Is Phynetoid an Anti-seizure Medication?
Yes
Phenytoin
Action
Decreases excitability in the brain
Uses
Prevent seizure
Therapeutic serum level
■ 10 to 20 mcg/mL
What is the therapeutic serum level of Phenytoin?
A. 10 -100 mcg/ml
B. 25-45 mcg/ml
C. 10-20 mcg/ml
D. 12-20 mcg/ml
C. 10-20 mcg/ml
Which of the following is a side EFFECT ON PHENYTOIN
A. BROWN -PINK/RED URINE
B. HYPOGLYCEMIA
C. GINGIVAL HYPERPLASIA
D. THROMBOCYTOPENIA
E. LEUKOPENIA
A. BROWN -PINK/RED URINE
C. GINGIVAL HYPERPLASIA
Side Effects
CNS - Headache, dizziness, slurred speech, confusion,
drowsy, depression
■ Gingival hyperplasia
■ Hyperglycemia
■ Urine discoloration – pink-red/brown color
Adverse Effects
Thrombocytopenia, leukopenia, suicidal ideation
■ Stevens-Johnson syndrome
What is the following an adverse effect Phenytoin
Thrombocytopenia, leukopenia, suicidal ideation
■ Stevens-Johnson syndrome
A healthcare provider has ordered Phenytoin for your pregnant client in her third trimester who is experiencing mild seizures. What priority action of the nurse is appropriate?
A. Contact the Health Care Provider, and hold the medication, it is not advised that pregnant women take Phenytoin.
B. Administer the Phenytoin to stop her mild seizure
C. Give a nursing dose due to stop her seizures
D. Administer the medication intravenously only
A. Contact the Health Care Provider, and hold the medication, it is not advised that pregnant women take Phenytoin.
Contraindications
– Pregnancy (teratogenic
DOES PHENYTOIN AFFECT PLATELET REGULATION AND BLOOD CLOTTING?
YES
Interactions
– Many
■ Decreased effects of anticoagulants & oral
contraceptives
■ Decreases folic acid and Vitamin K
■ Decreases absorption of calcium & vitamin D
Is Phenobaritbal an Antiseizure medication and what is its class?
YES, CLASS IS BARBITURATES
What is Status Eliepticus and what medication is used to treat it?
Status Epilepticus is defined as a seizure with 5 minutes or more of continuous clinical and/or electrographic seizure activity or recurrent seizure activity without recovery between seizures.
A SEIZURE THAT LASTS MORE THAN 5 MINUTES AN COMES BACK REPEATIDLY
PHENOBARBITAL BIG BOY
Phenobarbital
– Action
■ Decreases excitability of the brain
Use
■ Seizures, status epilepticus
Since Phenobarbital is the Big Boy of Anti Seizure medications , What adverse affect would you be more worried about as nurse, when administering Phenobarbital?
Respiratory Depression
Side effects/adverse reactions
CNS depression
Sedation, respiratory depression
Tolerance
Should Phenobarbital be stopped abruptly ?
A. No
B. Yes
Other important information
Cannot be stopped abruptly
Must use caution with other CNS depressants
Should you use other CNS depressant drugs with anti-seizure drugs?
A. Yes
B. No
B. No
Anti seizure medications are CNS Depressants, you will never use alcohol, caffeine, smoking, and other CNS depressants when a patient is taking Phenobarbital.
Is Valproic Acid a Antiseizure medication and what is its class?
Yes , Valproic Acid is an anti-seizure medication. The class is Valproate
Valproic acid
– Action
■ Depresses the excitability of the brain
– Use
■ Seizures
Which of the following drugs would be best to use on a pregnant woman who is experiencing seizures?
A. Phenobarbital
B. Phenytoin
C. Valproic Acid
D. Sumitriptan
C. Valproic Acid
Valproic Acid is the safest anti-seizure medication to use on a progeny woman who is having a seizure. It has the less side effects
What are the side effects of Valproic Acid? (Select all that apply)
A. Constipation
B. Diplopia
C.Dizziness
D. Pink/red - brown urine
E. Leukopenia
F. Gingival hyperplasia
B. Diplopia
C.Dizziness
Side effects
– Dizziness, drowsiness
– Insomnia, diplopia (double vision)
– Weakness, GI distress
Which of the following is an adverse effect of Valproic Acid?
A. Hepatic Toxicity
B. Constipation
C. Drowsiness
D. Urinary retention
A. Hepatic Toxicity
Adverse Reactions
– Hepatoxic
– Suicidal ideation
– Thrombocytopenia
A patient with a history of seizures and liver failure has been ordered Valproic Acid . What are the priority actions of the nurse?
A. Administer morphine along side valproic acid
B. Administer. nursing dose
C. Administer acetaminophen 5grams alongside Valproic Acid
D. Hold the medication contact the HCP, question order.
D. Hold the medication contact the HCP, question order.
Adverse Reactions
– Hepatoxic
– Suicidal ideation
– Thrombocytopenia
