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69:252 Psychopharmacology > Anticonvulsants > Flashcards

Anticonvulsants Flashcards

1
Q

Anti-Mania medication (mood stabilizer medications)
Anticonvulsant medications **
Antipsychotic medication

A

Treatment of Bipolar Disorder

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2
Q

has been used since the mid 90’s, very common as an alternative to lithium

A

Valproic acid

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3
Q

doesn’t have FDA approval for mania but it is used extensively for resistant case of BPAD. It is quite sedating which is not always appreciated by the individual

A

Carbamazepine

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4
Q

Antipsychotic medication may be required short term – treat sx of psychosis or form some individuals – long term treatment to better control ______

A

mood

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5
Q

Rapid Tranquilization - ________ 5 to 10 mgs IM prn, Ativan 1 to 2 mgs. IM prn, Olanzapine 10 mgs IM (for aggression and/or severe insomnia)

A

Haloperidol

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6
Q

is disinhibiting – can cause increase in DSB

A

Lorazepam

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7
Q

most prevalent of the neurological disorders
characterized by recurrent seizures that are not caused by secondary sources

A

Epilepsy

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8
Q

Epilepsy affects about ___ % of the Canadian Population
Abnormal electrical activity

A

0.6

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9
Q

May include:
Loss of consciousness
Sensory disturbances
Chorea
Fainting
Temporary memory loss
Symptoms are dependent on the type of seizure
Broadly categorized as: Partial or Generalized

A

Symptoms of Epilepsy

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10
Q

jerky body movement

A

Chorea

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11
Q

bilateral

A

Generalized Seizure

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12
Q

involve one hemisphere

A

Partial Seizure

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13
Q

Infectious Disease
Trauma
Metabolic Disorders
Vascular Diseases
Febrile Incidents (common in pediatrics)
Neoplastic Disease
Withdrawal
Overdose

A

Secondary cause of seizure

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14
Q

Alteration in cell membrane permeability
Altered distribution of ions across neuronal cell membranes
Decreased inhibition of thalamic or cortical neuronal activity
Imbalances in neurotransmitters
Gamma Aminobutyric Acid (GABA)
Acetylcholine

A

Idiopathic Seizures – Potential Causes

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15
Q

seizures due to an unknown cause

A

Idiopathic

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16
Q

Drugs that potentiate GABA action
Drugs that suppress sodium influx
Drugs that suppress calcium influx

A

Anti-Seizure Medication - categorized by action

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17
Q

Drugs that Potentiate Gamma – Amino Butyric Acid (GABA)

These drugs can work by increasing the inhibitory effect of _____

Drugs Include:
Barbiturates
Benzodiazepines
GABA structural analogs
Sulfamate- substituted monosaccharides

A

GABA

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18
Q

Benzo-diazepine
diazepam
Valium
_____ mg

A

2-40 mg

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19
Q

Benzo-diazepine
lorazepam
Ativan
______ mg (max 6 mg/day)

A

0.5 – 4 mg

20
Q

These drugs work by delaying sodium ions from crossing the neuronal membranes
Neuronal activity is suppressed because Na+ channels are temporarily inactivated
This inhibits the release of neurotransmitters from the neuron
Drugs include:
Hydantoins
Iminostilbenes
Phenyltriazine Derivatives
Carboxyl Acid Derivatives

A

Drugs that Suppress Sodium Influx

21
Q

carbamazepine
Tegretol
300-1600 mg
4-12

A

Sodium Influx Suppressant

22
Q

Valproic Acid (VPA) /Divalproex
Epival, Depakene Syrup
750-3000 mg
50-100
(toxic – 150+)

A

Sodium Influx Suppressant

23
Q

These drugs work by delaying the entry of Calcium into the neurons by blocking low-threshold Ca2+ channels
Reduces the likelihood of an action potential occurring.
Drugs include:
Succinimides

A

Drugs that Suppress Calcium Influx

24
Q

Most _________ medications act as follows:
Absorption – GI Tract
Distribution – Widely & cross the placenta and enter breast milk
Metabolism - Liver
Excretion – Kidneys

A

anti-seizure

25
Q

If in community and person does not have a known seizure disorder call 911
In acute care – persons does not have a know seizure disorder call medical 25
Time seizure!
In most cases a benzodiazepine (ex lorazepam) is given if seizure is greater than 3 min (medical emergency if 5+ min)

A

First Aid for Seizures

26
Q

Most seizures are 1-3 min
A seizure 5+ minutes or more than one seizure within 5 minutes = status epilepticus
A seizure 10+ minutes is dangerous = ________ (can cause brain damage)

A

status epilepticus

27
Q

Causes:
Withdrawal of Barbiturates, Benzodiazepine, Alcohol
Brain trauma/tumors
Infections
Drug overdoses (cocaine)

A

status epilepticus

28
Q

Treatment:
Phenytoin – first line drug in treatment of
Status Epilepticus 10- 15 mg /kg
Phenobarbital – 20 mg/kg in single or divided doses
Diazepam – 5 mg/min IV Push or 5- 10 mg IM/IV as needed every 10- 15 minutes (20 mg PO for treatment in alcohol withdrawal)
Lorazepam – 2 mg/min IM or IV Push

A

status epilepticus

29
Q

Common Adverse Effects
CNS: drowsiness, dizziness, ataxia, diplopia & hypotension
GI: nausea, vomiting & indigestion
Other: vitamin deficiencies, hair loss or excessive hair growth
Serious Adverse Effects
CNS Depression (heartrate, respiratory rate, consciousness)
Agranulocytosis
Steven – Johnson Syndrome (lamotrigine)
Angioedema
Laryngospasm
Suicidal Ideation
Bone marrow suppression and hepatotoxicity (valproic acid)
Gingival hyperplasia (ethosuximide and phenotynin)

A

Anticonvulsant Medications

30
Q

Some common side effects that may occur in the first few _____ of taking seizure medicines include feeling tired, stomach upset or discomfort, dizziness, or blurred vision (diplopia)

A

weeks

31
Q

Contraindications
Hypersensitivity
Central Nervous System Depression
Phenobarbital - Severe uncontrolled pain

A

Anti-seizure medications

32
Q

Caution
Hepatic Dysfunction
History of Myocardial Infarction
Pregnancy & Breast Feeding

A

Anti-seizure medications

33
Q

CNS Depressants – increase the risk of life threatening CNS depression
Other anticonvulsants – may increase or decrease serum levels of each other
Hormonal Contraceptives – decrease effectiveness
Herbal – Gingko and Oil of Primrose – both increase the severity and likelihood of seizures

A

Drug Interactions for Anti-seizure medications

34
Q

_____ – Aspirin/Warfarin/ Alcohol

A

VPA (Valporic Acid)

35
Q

Carbamazepine – ______

A

Lithium

36
Q

risk cannot be ruled out

A

Category C

37
Q

positive evidence of risk

A

Category D

38
Q

Anti-seizure medication can have an impact on how children and youth learn and their _______

A

social development

39
Q

Children are more sensitive to their ______ effects

A

sedative

40
Q

Newborns (1 – 10 days of Age)
Respond best to _____ phenobarbital

A

IM

41
Q

Older children (2 months – 6 years of age)
Close monitoring is required as per ___ and ___

A

age; weight

42
Q

Age 10 – 14
Drug can be given at ______

A

normal adult dose

43
Q

are more susceptible to the adverse effects of the drugs

A

Older adults

44
Q

Dosages of all drugs may need to be reduced

A

Older adults

45
Q

Older adults need to be monitored very carefully for ____ effects

A

toxic

46
Q

Older adults should be strongly encouraged to wear a ______ bracelet to assist others in providing appropriate care

A

medic alert

69:252 Psychopharmacology (14 decks)

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