Antiepileptics/anxiolytics/sedatives/hypontics

Question 1

epilepsy

Answer 1

Results in seizures
Unpredictable event involving abnormal activity of the brain cells that at times disturbs consciousness and motor or sensory function.

Question 2

hydantoins

Answer 2

Stabilize nerve membranes
Decrease conduction through nerve pathways
Metabolized in the liver, avoid alcohol

Phenytoin (Dilantin)
Fosphenytoin (Cerebyx)

Question 3

Phenytoin (Dilantin)

Answer 3

Narrow therapeutic index: levels should be 10-20 mcg/ml
IV loading dose: 15-20 mg/kg
IV: no faster than 50mg/min or may have bradycardia, cardiac arrest, hypotension, v-fib
onset 10-20 minutes
24 hour duration

Question 4

Phenytoin (Dilantin) SE

Answer 4

gingival hyperplasia, hyperglycemia, bad acne, rash over abdominal/chest area
take with food

Question 5

Cerebyx (fosphenytoin) SE

Answer 5

hyperglycemia, bradycardia, cardiac arrest, liver problems, rash

Question 6

barbiturates

Answer 6

Phenobarbital
Used for kids 
Depress cerebral cortex
Depress motor nerve output
Inhibit conduction thru RAS

Question 7

phenobarbital

Answer 7

Also used as sedative, hypnotic
Therapeutic range
Liquid form- tastes bad, put in apple juice or similar
Physical dependence can develop
No ETOH

Question 8

phenobarbital SE

Answer 8

CNS depression-drowsiness, lethargy; anticholinergic -constipation, dry mouth, blurred vision, urinary retention

Question 9

Carbamezepine (Tegretol)

Answer 9

used to treat partial seizures

also used for neuropathic pain

Question 10

Carbamezepine (Tegretol) SE

Answer 10

CNS depression, N/V/A
Hepatotoxic-LFTs
Clay colored stools, RUQ pain, dark urine, jaundice
Suppress bone marrow-watch CBC
rash, sedation, dizziness, blurred vision, nystagmus

Question 11

Carbamezepine (Tegretol) contraindications

Answer 11

bone marrow suppression

Question 12

summary points on antiepileptics

Answer 12

Watch CNS side effects
Monitor therapeutic levels
Hepatotoxicity- no ETOH
Dermatological effects (acne, rash)
Additional uses

Question 13

epileptic safety

Answer 13

Help them on the floor/ rails up (padded)
Never put anything in their mouth
Support airway
Time length, description of seizure (type)
Neuro assessment
Vitals
Possible injuries especially oral

Question 14

anxiolytics

Answer 14

prevent feeling of tension or fear

Question 15

sedatives

Answer 15

calm patient

Question 16

conscious sedation

Answer 16

when don’t need patient to be completely anesthetized; patient is awake enough to keep their own airway open; vitals signs remain normal, continuous 02/RR monitoring

Question 17

when would conscious sedation be used

Answer 17

Amnesia

Colonoscopy, bronchoscopy, endoscopy, dental procedures, nerve block, resetting bones

Question 18

sedatives/hypnotics drug class

Answer 18

benzodiazepines

Question 19

sundown syndrome

Answer 19

elderly patients get crazy, wild eyed, agitated at night

Question 20

benzodiazepine SE
Xanax (alprazolam)
 Versed (midazolam)
Ativan (lorazepam)
 Restoril (temazepam)

Answer 20

CNS depression, constipation, hypotension, urinary retention, blurred vision, urinary retention

Question 21

flumazenil (Romazicon)

Answer 21

antidote for benzodiazepines

low respirations and/or O2

Question 22

hypnotics

Answer 22

Induce sleep

Depress the CNS