Anticonvulsants Flashcards

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1
Q

What is the preparation steps for the team?

A

Self, team, environment, patient

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2
Q

What things should you do first when a fitting patient arrives?

A
ABCDE
Secure airway 
High flow
Glucose 
IV access
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3
Q

What drugs would you use to treat a fitting patient?

A

Buccal midazolam (up to 2 doses)
Rectal diazepam (esp infants)
Lorazepam
Phenytoin (need to know about allergy, pregnant) - if patient on phenytoin you can give phenobarbital or IV levetiracetam

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4
Q

What side effect are you most concerned about in anti-epileptic medication?

A

respiratory depression

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5
Q

What is better? Lorazepam or diazepam

A

Lorazepam - 1-3 min onset when IV, shorter acting effects, less resp depression
Diazepam - 1-5 action, variable response

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6
Q

What are some common anaesthetic drugs?

A

propofol, thiopentone, ketamine

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7
Q

What are some possible causes of status epilepticus?

A

febrile convulsions

epilepsy, haemorrhagic stroke, hypoglycaemia, hypoxia, alcohol intoxication

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8
Q

What are some medical complications of status epilepticus?

A

injury, hypoxia, hyperthermia, hypoglycaemia

long term - epilepsy, encephalopathy, focal neurological defects

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9
Q

What are some features of early alcohol withdrawal?

A

under 24 hours = autonomic hyperactivity

Shakes, insomnia, anxiety, hyperreflexia, sweating, tachycardia, tachypnoea, GI upset

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10
Q

How would you treat alcohol withdrawal?

A

Refer to alcohol liason service
Go home and drink if possible
Give 2-3 days chlordiazepoxide
consider social issues

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11
Q

What are the features of delirium tremens?

A

48-72h severe autonomic hyperactivity and altered sensorium

  • above hyperthermia
  • disorientation
  • agitation
  • hallucinations
  • seizures
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12
Q

What is the mortality of delerium tremens if untreated?

A

30%

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13
Q

How do you manage delerium tremens?

A

fluid replacement
IV pabrinex
GABA replacement

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14
Q

How would you assess alcohol dependence when conscious?

A

CAGE, AUDIT, ADLs

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