Antiepileptic drugs (flashcards)

Question 1

what is status epilepticus?

Answer 1

Multiple seizures occur that last 5 minutes or longer of continuous or electrographic seizure activity or recurrent seizure activity without recovery between seizures
Result: hypotension, hypoxia, brain damage, and possibly death

Question 2

what drug is used for status epilepticus?

Answer 2

diazepam

Question 3

Serum concentrations of what drugs correlate better with seizure control and toxicity? PPPC

Answer 3

phenytoin, phenobarbital, carbamazepine, and primidone correlate better with seizure control and toxicity

Question 4

whats the pharmacological effects of the drugs?

Answer 4

Pharmacological effects:
Reduce nerve’s ability to be stimulated
Suppress transmission of impulses from one nerve to the next
Decrease speed of nerve impulse conduction within a neuron

Question 5

Antiepileptic drug indications?

Answer 5

Prevention or control of seizure activity
Long-term maintenance therapy for chronic, recurring seizures
Acute treatment of convulsions and status epilepticus

Question 6

what should you do if adverse effects occur in antiepileptic drugs?

Answer 6

Adverse effects often necessitate a change in medication.

Question 7

Antiepileptic Drugs: Contraindications

Answer 7

Drug allergy
Pregnancy

Sometime, prescribers weigh the fetal versus mother risk of maternal epilepsy and look to newer generation of drugs

Dilantin has shown congenital spinal malformations such as spina bifida

Question 8

what interacts with carbamazepine?

Answer 8

acetominophen

Question 9

what interacts with phenytoin?

Answer 9

increased free warfarin levels (bleeding )

Question 10

what interacts with valporic acid?

Answer 10

aspirin

Question 11

Many drugs have narrow therapeutic index so require lab drug monitoring such as? PPVC

Answer 11

phenytoin, valproic acid, phenobarbital, carbamazepine

Question 12

phenobarbital and primidone therapeutic effect levels?

Answer 12

serum drug levels of 15 to 40 mcg/mL

Question 13

adverse ffects of primidone and phenobarbital?

Answer 13

cardiovascular, central nervous system (CNS), gastrointestinal (GI), and dermatological reactions

Question 14

whats the therapeutic drug levels of phenytoin?

Answer 14

Therapeutic drug levels are usually 10 to 20 mcg/mL.

Question 15

whats the long term therapy adverse effects of phenytoin?

Answer 15

Long-term therapy adverse effects: lethargy, ataxia, mental confusion, gingival hyperplasia, acne, hirsutism, Dilantin facies, and osteoporosis (long term)

Question 16

how to administer phenytoin?

Answer 16

• Use NS, filter must be used.

Question 17

carbamazepine what is it?

Answer 17

Second most commonly prescribed antiepileptic drug in Canada after phenytoin
Autoinduction of hepatic enzymes

Question 18

ethosuximide what is it, adverse effects, contraindications and interactions?

Answer 18

Used in the treatment of uncomplicated absence seizures
Not effective for secondary generalized tonic-clonic seizures
Contraindication: known allergy
Adverse effects: GI and CNS effects
Drug interactions: hepatic enzyme–inducing drugs

Question 19

Gabapentin what is it, contraindications, adverse effects?

Answer 19

Believed to work by increasing the synthesis and synaptic accumulation of GABA between neurons
Contraindication: known drug allergy
Adverse effects: CNS and GI symptoms
Oral use only

Question 20

lamotrigine what is it, contraindications, adverse effects?

Answer 20

Also used for the treatment of bipolar disorder
Contraindications: drug allergy
Common adverse effects: relatively minor CNS and GI symptoms and possible Stevens-Johnson syndrome
Oral use only

Question 21

Valporic acid what is it, contraindications, adverse effects?

Answer 21

Also used for absence and myoclonic seizures
Contraindications: drug allergy, liver impairment
Common adverse effects: weight gain, hair loss
Interacts with aspirin to create toxic levels of valproic acid

Question 22

levetiracetam what is it, contraindications, adverse effects?

Answer 22

Adjunct therapy for focal seizures with and without secondary generalization
Contraindication: known drug allergy
Mechanism of action: unknown
Adverse effects: generally well tolerated, CNS effects
No drug interactions
Oral and injectable forms

Question 23

pregabalin what is it, contraindications, adverse effects?

Answer 23

Structurally related to GABA
Indication: focal seizures
Most common uses: adjunct therapy for neuropathic pain, postherpetic neuralgia
Contraindication: known drug allergy
Adverse drug reactions: primarily CNS related
Oral use only

Question 24

no grapefruit juice with what drug?

Answer 24

Carbamazepine