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Pharm Final > Antiseizure > Flashcards

Antiseizure Flashcards

1
Q

What is our Hydantoin

A

Phenytoin

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2
Q

Phenytoin (Hydantoins)

Action

A

affects ion channels to reduce excitability to stimulation

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3
Q

Phenytoin (Hydantoins)

Indication

A

seizures

and those with seizures who need less sedating meds

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4
Q

Phenytoin (Hydantoins)

Pharmacokinetics of therapeutic range

A

therapeutic serum level: 10-20mcg/mL

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5
Q

Phenytoin (Hydantoins)

Contra/Cautions

A

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

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6
Q

Phenytoin (Hydantoins)

Adverse Effects

A 
CNS depression, confusion, lethargy
HTN
severe liver toxicity
bone marrow suppression
urinary retention
loss of libido
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7
Q

Phenytoin (Hydantoins)

Drug-Drug

A

Alcohol - increase CNS effects and decreases seizure threshold

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8
Q

What are the Barbiturates

A 
Phenobarbital
Primidone (PO only)
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9
Q

What are the Benzodiazepines

A

“-azepam”
Clonazepam
Diazepam

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10
Q

Barbiturate

Half-life

A

100 hours

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11
Q

Benzodiazepine

Half-life

A

18-50 hours

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12
Q

Barbiturates & Benzodiazepines

Action

A

stabilize nerves by decreasing excitability in the ion channels

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13
Q

Barbiturates & Benzodiazepines

Indications

A

epilepsy

status-epilepticus: phenobarbital

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14
Q

Barbiturates & Benzodiazepines

Contra/Cautions

A

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

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15
Q

Barbiturates & Benzodiazepines

Drug-Drug

A

Alcohol - increase CNS depression

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16
Q

Barbiturates & Benzodiazepines

Adverse Effects

A

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

17
Q

What are our Succinimides

A

“-suximide”
Ethosuximide
Methsuximide

18
Q

Succinimide

Indication

A

Absence seizures

19
Q

Succinimides

Action

A

suppress abnormal activity in brain specifically associated with absence seizures

20
Q

Succinimides

Contra/Cautions

A

known allergy
pregnancy/lact
renal/hepatic disease

21
Q

Succinimides

Adverse effects

A

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

22
Q

Succinimides

Drug-Drug

A

Primidone- decreases primidone levels

23
Q

What are the other drugs for absence seizures

A

“-amide”
acetazolamide
zonisamide

valproic acid

24
Q

Acetazolamide & Zonisamide

Action

A

alters electrolyte movement to stabilize the nerve membrane

25
Q

Valporic Acide

Action

A

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

26
Q

Acetazolamide/Zonisamide/Valporic Acid

Contra/cautions

A

known allergy

hepatic/renal impairment

27
Q

Acetazolamide/Zonisamide/Valporic Acid

Adverse effects

A

liver toxicity

CNS depression/suppression

28
Q

Acetazolamide/Zonisamide/Valporic Acid

Drug-Drug

A

Phenytoin: break through seizures can occur

29
Q

Drugs for partial seizures

A

“-azepine”
carbamazepine
oxcarbazepine

Gabapentin
Lamotrigine
Levetiraxetam
Topiramate

30
Q

Partial Seizure Drugs

Action

A

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

31
Q

Partial Seizure Drugs

Contra/caution

A

known allergy
severe hepatic/renal dysfunction
bone marrow suppression

32
Q

Partial Seizure Drugs

Adverse effects

A

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

33
Q

Partial Seizure Drugs

drug-drug

A

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

34
Q

Antiseizure Agents

Nursing process - assessment

A

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

35
Q

Antiseizure Agents

Nursing diagnoses

A

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

36
Q

Antiseizure Agents

Implementation

A

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

Pharm Final (15 decks)

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