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Pharm > Anticonvulsants- epileptics (AEDs) > Flashcards

Anticonvulsants- epileptics (AEDs) Flashcards

1
Q

Epilepsy is a

A

seizure disorder

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2
Q

Characteristics of epilepsy

A
  1. Convulsive movements

2. loss of consciousness

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3
Q

Cause of epilepsy

A
  1. 75% are idiopathic (primary)
  2. secondary to brain damage
ex: 
trauma
anoxia 
infection
CVA
neoplasm
  1. isolated seizures due to acute changes
    fever

hypoglycemia
electrolyte imbalance (dec Na)
acid-base imbalance
ETOH / drug use

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4
Q

Suppress Na+ influx = hydantoins

A

phenytoin

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5
Q

side effect of phenytoin

A
  1. harmless pink-red urine
    warn the patient
    • Headache
    • dizziness
    • sedation
    • diplopia
    • nystagmus = oscillation of cornea vertically or horizontally while trying to focus
  • warn against fall, driving: sedation/drowsiness
avoid: 
herbs
CNS depressants (alcohol
    • dysrhythmia
    • bradycardia
    • hypotension
    • syncope
  2. gingival hyperplasia
    - frequent oral hygiene and dental checkups
  3. Hirsutism
    - returns to normal when drug is discontinued
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6
Q

Routes of phenytoin

A 
PO: 
shake suspension well for 2 minutes 
if not it will not work 
IV: 
Extravasation 
- purple glove syndrome - sloughing
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7
Q

when to take phenytoin

A

same time daily

do not discontinue abruptly

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8
Q

requirement of phenytoin

A

dose adjustment is required:
check serum levels
- toxicity
- hypotherapeutic

narrow therapeutic range

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9
Q

phenytoin decreases

A

decreases effect of oral contraceptives

warfarin

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10
Q

contraindication for phenytoin

A

pregnancy

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11
Q

phenytoin other considerations

A

diabetics must monitor hyperglycemia

blood dyscrasia
= abnormal size shape function

stop if rash develops=
may result in stephens-johnson syndrome

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12
Q

Suppress Ca++ influx

A

valproic acid

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13
Q

considerations of valproic acid

A
  1. dose adjustments is required
    check serum levels
    - toxicity
    - hypotherapeutic

= narrow therapeutic range

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14
Q

Side effects / adverse reactions of valproic acid

A 
1. CNS
dizziness
ataxia 
diplopia 
impaired cognition 
nervousness
  1. pancreatitis : self- limiting to chronic inflammation of the pancreas – caused by: alcohol use, cholelithiasis, autoimmune, drugs
    - abdominal pain
    - N/V
  2. thrombocytopenia
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15
Q

Promotion of GABA release

A

gabapentin

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16
Q

gabapentin secondary indications

A
  1. neuropathic pain = abnormal sensation without external source
  2. restless leg syndrome
  3. fibromyalgia
    phantom pain
    paresthesia

other uses are discussed in pain slides

17
Q

side effects of gabapentin

A
  1. monitor for drowsiness/dizziness
    confusion
    depression
    suicidal thoughts
  2. ataxia and FALL risk
  3. GI distress
    N/V
    diarrhea
    constipation
18
Q

enhance action of GABA

long acting barbiturates

A

phenobarbital

19
Q

phenobarbital indications

A
  1. antiepileptic
  2. sedative
  3. hypnotic
20
Q

phenobarbital contraindications

A
  1. pregnancy
  2. with other sedative-hypnotics
    - alcohol
    - opoids
21
Q

phenobarbital MOA

A

GABA stimulation- neurotransmitter

22
Q

side effects of phenobarbital

A
  1. respiration depression
  2. bradycardia
  3. ataxia (FALL) –> lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, abnormal eye movement
  4. dependence and tolerance–> wean off to avoid withdraw symptoms and seizure–> only for short term use
    2 weeks or less
  5. REM rebound –> vivid dreams and nightmares
  6. hangover effect
  7. skin eruption
  8. constipation
  9. paradoxical effects
  10. decreased effects of oral contraceptives
    use secondary method
23
Q

phenobarbital schedule

A

long acting schedule IV

24
Q

Enhance action of GABA

benzodiazepines

A

clonazepam

diazepam

lorazepam

25
Q

azepams primary prescribed for

A

treating acute status epilepticus

  • must be administered IV to achieve the desired response
  • due to tolerance other anticonvulsants
    need to be given or
    dose adjustments within 6 months
26
Q

clonazepam
diazepam
lorazepam
OVERDOSE REVERSAL AGENT

A

flumazenil

27
Q

MOA & schedule of

clonazepam, diazepam, lorazepam

A

GABA stimulation

Schedule IV

28
Q

indications of clonazepam, diazepam, lorazepam

A
  1. sedative
    - anxiolytic
    - preventing alcohol withdrawl symptoms (DT’s)
  2. epilepsy- antiepileptic
  3. spasms
    - centrally acting muscle relaxant
  4. insomnia
    - hypnotic
  5. anesthesia induction
    - sedative/hypnotic
29
Q

Other AED’s

A

cannabidiol CBD oil drop

30
Q

cannabidiol CBD oil drop - schedule

A

V = no risk of abuse

31
Q

cannabidiol CBD oil drop - indication

A
  1. two types of rare and severe epilepsy in patients two years of age and older
32
Q

cannabidiol CBD oil drop - side effects

A
  1. sleepiness
  2. sedation
  3. lethargy
  4. liver failure
  5. decreased appetite
  6. diarrhea
  7. rash
  8. weakness
  9. no euphoria
  10. no psychoactive

THC component

33
Q

other considerations - cannabidiol CBD oil drop

A

there are many other brands of CBD but unapproved by FDA

marijuana is schedule 1 compound

Pharm (7 decks)

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