ANTI-SEIZURE UNIT 3

Question 1

What drug class is Phenytoin?

Answer 1

Hydantoin

Question 2

What drug class is Valproic Acid?

Answer 2

Valproate

Question 3

What drug class is Phenobarbital?

Answer 3

Barbiturate

Question 4

What is Anti-seizure used treat?

Answer 4

Epilepsy/ Seizures

Question 5

What is Epilepsy?

Answer 5

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

Question 6

Are anti-seizure drugs CNS depressants or CNS stimulants?

Answer 6

Depressants

Question 7

What is the action of Anti-seizure

Answer 7

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

Question 8

Is Phynetoid an Anti-seizure Medication?

Answer 8

Yes

Phenytoin
 Action
 Decreases excitability in the brain
 Uses
 Prevent seizure
 Therapeutic serum level
■ 10 to 20 mcg/mL

Question 9

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

Answer 9

C. 10-20 mcg/ml

Question 10

Which of the following is a side EFFECT ON PHENYTOIN
A. BROWN -PINK/RED URINE
B. HYPOGLYCEMIA
C. GINGIVAL HYPERPLASIA
D. THROMBOCYTOPENIA
E. LEUKOPENIA

Answer 10

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

Question 11

What is the following an adverse effect Phenytoin

Answer 11

Thrombocytopenia, leukopenia, suicidal ideation
■ Stevens-Johnson syndrome

Question 12

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

Answer 12

A. Contact the Health Care Provider, and hold the medication, it is not advised that pregnant women take Phenytoin.

Contraindications
– Pregnancy (teratogenic

Question 13

DOES PHENYTOIN AFFECT PLATELET REGULATION AND BLOOD CLOTTING?

Answer 13

YES

Interactions
– Many
■ Decreased effects of anticoagulants & oral
contraceptives
■ Decreases folic acid and Vitamin K
■ Decreases absorption of calcium & vitamin D

Question 14

Is Phenobaritbal an Antiseizure medication and what is its class?

Answer 14

YES, CLASS IS BARBITURATES

Question 15

What is Status Eliepticus and what medication is used to treat it?

Answer 15

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

Question 16

Since Phenobarbital is the Big Boy of Anti Seizure medications , What adverse affect would you be more worried about as nurse, when administering Phenobarbital?

Answer 16

Respiratory Depression

Side effects/adverse reactions
 CNS depression
 Sedation, respiratory depression
 Tolerance

Question 17

Should Phenobarbital be stopped abruptly ?
A. No
B. Yes

Answer 17

 Other important information
 Cannot be stopped abruptly
 Must use caution with other CNS depressants

Question 18

Should you use other CNS depressant drugs with anti-seizure drugs?
A. Yes
B. No

Answer 18

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.

Question 19

Is Valproic Acid a Antiseizure medication and what is its class?

Answer 19

Yes , Valproic Acid is an anti-seizure medication. The class is Valproate

Valproic acid
– Action
■ Depresses the excitability of the brain
– Use
■ Seizures

Question 20

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

Answer 20

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

Question 21

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

Answer 21

B. Diplopia
C.Dizziness

Side effects
– Dizziness, drowsiness
– Insomnia, diplopia (double vision)
– Weakness, GI distress

Question 22

Which of the following is an adverse effect of Valproic Acid?
A. Hepatic Toxicity
B. Constipation
C. Drowsiness
D. Urinary retention

Answer 22

A. Hepatic Toxicity

Adverse Reactions
– Hepatoxic
– Suicidal ideation
– Thrombocytopenia

Question 23

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.

Answer 23

D. Hold the medication contact the HCP, question order.

Adverse Reactions
– Hepatoxic
– Suicidal ideation
– Thrombocytopenia