ANTISEIZURE AGENTS Flashcards
Epilepsy
-most prevalent of the neurological disorders
-Collection of different syndrome
-Seizures
-a loss of control
Nature of seizures
-seems to be caused by abnormal neurons sensitive to stimulation or prone to over responsiveness
-primary seizures
-secondary seizures
-Best method for diagnosing a seizure is through an EEG
Types of seizures
-tonic clonic seizure
-Absence seizure
-status epilepticus
Yusuf anti-epileptic agents across the lifespan: children
- can affect learning and social development
-More sensitive to the sedating effects
-May need to switch medication
-Dosing
What should you not do on anti-epileptic agents?
Breast-feed
Hydantoins ( drug name)
Phenytoin
Hydantoins ( actions)
-stabilize the nerve membranes by blocking channels in the cell membrane or altering receptor sites
-decreases excitability and hyperexcitability to stimulation
Hydantoins indication?
Seizures
Hydantoins (pharmacokinetics)
-Therapeutic serum phenytoin levels: 10 to 20 mcg/mL
Hydantoins (cautions and interactions)
Cautions
-Elderly or debilitated patients
-Impaired renal or liver function
-Depression or psychosis
Interactions
-alcohol
Hydantoins (adverse effects)
-CNS depression
-Cardiac arrhythmias and hypotension
-Severe liver toxicity
-bonemarrow suppression
-urinary retention
-Loss of libido
Barbiturates and benzodiazepines (drug names and half-life)
Barbiturates (half-life is up to 100 hours)
-phenobarbital
-primidone
Benzodiazepines (half-life is 18 to 50 hours)
-AZEPAM
clonazepam
Diazepam
Barbiturates and benzodiazepines (action, indication, contraindication, cautions, drug interactions)
All the same as hydantoins
Barbiturates and benzodiazepines (adverse effects)
CNS depression: confusion, drowsiness, lethargy, fatigue
Cardiac: arrhythmias, changes in blood pressure
Other: urinary retention, loss of Levito, physical dependence, and withdrawal
Blackbox warning : benzodiazepines and opioids together can result in profound sedation, respiratory depression, coma, death
Succinimides (drug names)
-SUXIMIDE
ethosuximide
Methsuximide
Succinimides (actions)
-suppresses the abnormal electrical activity in the brain
Succinimides (indications)
-seizures, most frequently absence seizures
Succinimides (cautions and interactions)
Caution
-Renal or hepatic disease
Interactions
-primidone
Succinimides (adverse effects)
-CNS depressant effects
-bonemarrow suppression
-Stevens Johnson syndrome
GABA modulators (drug names)
Valproic acid
Divalproex
GABA modulators (action)
-reduces abnormal electrical activity in the brain
-Increases GABA levels in the brain
GABA modulators (indication)
Seizures
GABA modulators (caution and interactions)
Caution
-hepatic or renal impairment
Interactions
-other anti-seizure drugs (risk of toxicity and a risk of breakthrough seizures)
GABA modulators (adverse effects)
-CNS depression
-Liver toxicity
-pancreatitis
-drug reaction with eosinophilia and systematic systems (DRESS)
Other drugs to treat seizures
- all these drugs, have an adverse effect of CNS depression AND have interactions with CNS depressants, alcohol, hormonal birth control
Carbamazepine
-blackbox warning for serious skin reactions
-ADE
Lamotrigine
-blackbox warning for serious skin reactions
Levetiracetam
Topiramate
-ADE: series skin reactions
Anti-seizure agents implementation
-Administer with food
-Monitor CBC before and during therapy
-Protect from infection
-Prepared to discontinue the drug due to skin rash, bone marrow, suppression unusual depression, or personality changes
-discontinue the drug slowly
