Anticonvulsants & Antiepileptics Flashcards
1
Q
Phenytoin
A
- Suppress Na influx
- PO, IV
- PO: shake well for 2 min
- IV: in-line filter; monitor for extravasation - Side effects: harmless pink-red urine, headache, dizziness, sedation, diplopia, nystagmus, dysrhythmia, bradycardia, hypotension, syncope, gingival hyperplasia, hirsutism
- FALL RISK
- Contraindications: pregnancy
- Nursing: warm against falls & driving
- Decreases effectiveness of oral contraceptives & warfarin
- Diabetics need to monitor for hyperglycemia
- Blood dyscrasia & monitor for rash (Stevens-Johnson)
- Has narrow therapeutic range
- Do not discontinue abruptly
“Please Hang Grandmas Purple Hair Down Stairs With Others”
“Don’t Need No Hot Guys”
2
Q
Valproic Acid
A
- Suppress Ca influx
- Side effects: dizziness, ataxia, diplopia, impaired cognition, nervousness, pancreatitis (abd pain, N/V), thrombocytopenia
- Contraindication: pregnancy & children <2 years old
- Narrow therapeutic range
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3
Q
Gabapentin
A
- Promotes GABA release
- Secondary indications: neuropathic pain, restless leg syndrome, fibromyalgia, phantom pain & paresthesia
- Side effects: ataxia & fall risk, angioedema, GI distress (N/V, diarrhea, constipation)
- Monitor for dizziness/drowsiness, confusion, depression, suicidal thoughts
GABA = GI, ataxia, blundering (falls), angioedema
4
Q
Phenobarbital
A
- Enhance action of GABA; long acting barbiturate
- Indication: anti-epileptic, sedative, hypnotic
- NO REVERSAL AGENT (usually replaced by benzos)
- Narrow therapeutic window; easy to overdose
- Side effects: respiratory depression, bradycardia, ataxia, dependence & tolerance, REM rebound (vivid dreams & nightmares), hangover effect, skin eruption, constipation, paradoxical effects (anxiety)
- Decreases the effects of oral contraceptives
- Contraindications: pregnancy & with use of other sedative-hypnotics (alcohol, opioids)
5
Q
Clonazepem, Diazepam & Lorazepam
A
- Enhance action of GABA
- Usually prescribed to treat acute status epilepticus
- Must be administered IV to achieve desired response
- Dose adjust every 6 monthsv
- Benzos Break Seizure IVP
6
Q
Cannbidiol
A
- CBD oil drop
- Schedule V (marijuana is schedule I)
- Indication: 2 types of rare & severe epilepsy in patients 2 years or older
- Side effects: sleepiness, sedation, lethargy, liver failure, decreased appetite, diarrhea, rash, weakness, no euphoria, no psychoactive
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