Anticonvulsants

Question 1

Facts about phenytoin

Answer 1

Blocks sodium channels

Careful with extravasation

Hepatic enzyme induction - resistant to Non depolarizers

May cause aplastic anemia

Question 2

Facts about valproic acid

Answer 2

Blocks Sodium channels

May cause thrombocytopenia

Hepatic enzyme inhibition -slows phenytoin metabolism

Question 3

Facts about carbamazepine

Answer 3

Sodium channel blocker

Hepatic enzyme induction - resistant to Non depolarizers

Useful in trigeminal neuralgia

Both aplastic anemia and thrombocytopenia

Question 4

Gabapentin facts

Answer 4

Excreted unchanged by kidneys

Inhibition of alpha 2 delta on Ca channels

No affect with liver

Can cause respiratory depression when combined with opioid

Do not stopped abruptly

Question 5

What is the MOA of anticonvulsants except gabapentin?

Answer 5

Blocks sodium channels

Gabapentin - blocks alpha2 delta on Ca channels

Question 6

Main treatment for Alzheimer’s disease?

Answer 6

Cholinesterase inhibitors

Question 7

Considerations for Alzheimer’s?

Answer 7

Plaque formation - cell death

Poor candidates for MAC or regional

Use short acting drugs

Glyco is the best since it does not cross the BBB

Question 8

Facts about Parkinsons

Answer 8

Imbalance of dopamine and Ach

-Increased GABA in thalamus
-Decreased dopamine in the basal ganglia

Question 9

Considerations for Parkinsons

Answer 9

Risk for autonomic instability , dysrhythmias and aspiration

Treat hypotension with phenyl and fluids

Don’t give phenothiazines, butyrophenones, or Reglan

Anticholinergics treat acute exacerbation

Question 10

How to prevent corneal abrasion ? treatment?

Answer 10

Horizontal eye tapes

Antibiotics and NSAIDS