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”

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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

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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)
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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
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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

“Some Friends Like Weed. Austin Reed Does Like Smoking.”

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