Antiseizure

Question 1

What is our Hydantoin

Answer 1

Phenytoin

Question 2

Phenytoin (Hydantoins)

Action

Answer 2

affects ion channels to reduce excitability to stimulation

Question 3

Phenytoin (Hydantoins)

Indication

Answer 3

seizures

and those with seizures who need less sedating meds

Question 4

Phenytoin (Hydantoins)

Pharmacokinetics of therapeutic range

Answer 4

therapeutic serum level: 10-20mcg/mL

Question 5

Phenytoin (Hydantoins)

Contra/Cautions

Answer 5

allergy
caution in elderly/debilitated
impaired renal/liver function
depression or psychoses (can be worsened)

Question 6

Phenytoin (Hydantoins)

Adverse Effects

Answer 6

CNS depression, confusion, lethargy
HTN
severe liver toxicity
bone marrow suppression
urinary retention
loss of libido

Question 7

Phenytoin (Hydantoins)

Drug-Drug

Answer 7

Alcohol - increase CNS effects and decreases seizure threshold

Question 8

What are the Barbiturates

Answer 8

Phenobarbital
Primidone (PO only)

Question 9

What are the Benzodiazepines

Answer 9

“-azepam”
Clonazepam
Diazepam

Question 10

Barbiturate

Half-life

Answer 10

100 hours

Question 11

Benzodiazepine

Half-life

Answer 11

18-50 hours

Question 12

Barbiturates & Benzodiazepines

Action

Answer 12

stabilize nerves by decreasing excitability in the ion channels

Question 13

Barbiturates & Benzodiazepines

Indications

Answer 13

epilepsy

status-epilepticus: phenobarbital

Question 14

Barbiturates & Benzodiazepines

Contra/Cautions

Answer 14

allergy
caution in elderly/debilitated
impaired renal/liver function
depression or psychoses (can be worsened)

Question 15

Barbiturates & Benzodiazepines

Drug-Drug

Answer 15

Alcohol - increase CNS depression

Question 16

Barbiturates & Benzodiazepines

Adverse Effects

Answer 16

CNS: CNS depression/confusion/drowsiness
CV: arrhythmia, HTN
Other: urinary retention, loss of libido, physical dependence/withdrawal

Question 17

What are our Succinimides

Answer 17

“-suximide”
Ethosuximide
Methsuximide

Question 18

Succinimide

Indication

Answer 18

Absence seizures

Question 19

Succinimides

Action

Answer 19

suppress abnormal activity in brain specifically associated with absence seizures

Question 20

Succinimides

Contra/Cautions

Answer 20

known allergy
pregnancy/lact
renal/hepatic disease

Question 21

Succinimides

Adverse effects

Answer 21

CNS depressant effects
bone marrow suppression (pancytopenia)
steven-johnson syndrome

Question 22

Succinimides

Drug-Drug

Answer 22

Primidone- decreases primidone levels

Question 23

What are the other drugs for absence seizures

Answer 23

“-amide”
acetazolamide
zonisamide

valproic acid

Question 24

Acetazolamide & Zonisamide

Action

Answer 24

alters electrolyte movement to stabilize the nerve membrane

Question 25

Valporic Acide | Action

Answer 25

reduces abnormal activity in the brain and increases GABA activity at inhibitory receptors

Question 26

Acetazolamide/Zonisamide/Valporic Acid | Contra/cautions

Answer 26

known allergy | hepatic/renal impairment

Question 27

Acetazolamide/Zonisamide/Valporic Acid | Adverse effects

Answer 27

liver toxicity | CNS depression/suppression

Question 28

Acetazolamide/Zonisamide/Valporic Acid | Drug-Drug

Answer 28

Phenytoin: break through seizures can occur

Question 29

Drugs for partial seizures

Answer 29

"-azepine" carbamazepine oxcarbazepine Gabapentin Lamotrigine Levetiraxetam Topiramate

Question 30

Partial Seizure Drugs | Action

Answer 30

Directly: alters sodium/calcium channels Indirectly: increases activity of GABA (a inhibitory neurotransmitter)

Question 31

Partial Seizure Drugs | Contra/caution

Answer 31

known allergy severe hepatic/renal dysfunction bone marrow suppression

Question 32

Partial Seizure Drugs | Adverse effects

Answer 32

most are CNS related liver toxicity and failure potential for increased suicidality

Question 33

Partial Seizure Drugs | drug-drug

Answer 33

CNS depressants and alcohol carbamazepine: consult a drug guid hormonal contraceptives: decrease contraceptive effect and increases metabolism of anticonvulsant

Question 34

Antiseizure Agents | Nursing process - assessment

Answer 34

description of seizure (onset, duration, generalized: aura/recovery?) vitals, CNS, muscle strength, EEG, renal/hepatic labs

Question 35

Antiseizure Agents | Nursing diagnoses

Answer 35

acute pain r/t CNS effects disturbed thought process r/t CNS effects impaired skin integrity r/t CNS effects risk for injury r/t CNS effects risk for infection r/t bone marrow suppression deficient knowledge

Question 36

Antiseizure Agents | Implementation

Answer 36

give with food monitor CBC before and during discontinue drug slowly counseling for women of child bearing age safety measures prepare to d/c if: marrow suppression, unusual depression, personality changes