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Pharmacology Exam #1 > Antiseizure Agents > Flashcards

Antiseizure Agents Flashcards

1
Q

What seems to cause seizures?

A

Abnormal neurons sensitive to stimulation or prone to over-responsiveness

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2
Q

What are primary seizures?

A

Seizures with no underlying cause

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3
Q

What are secondary seizures?

A

Seizures because of a primary cause (ie. head injury, overdose, fever)

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4
Q

What is a tonic-clonic seizure?

A

dramatic contractions/relaxations of muscles (spasms)

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5
Q

What is an absence seizure?

A

abrupt, brief loss of consciousness
Looks like daydreaming, absent stare

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6
Q

What is Status Epilepticus?

A

Most dangerous of seizures
Repeated seizures lasting longer than 5 minutes

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7
Q

Considerations for use of Antiepileptic Agents
In Children

A
  • Can affect learning and development
  • More sensitive to sedating effects
  • May need to switch doses/meds as they get older
  • They often need LARGER doses since they metabolize the drug faster
  • Parents need support and education
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8
Q

Considerations for use of Antiepileptic Agents
In Adults

A
  • Regular, routine care
  • Monitor for adv. effects
  • Medic Alert Bracelet
  • DO NOT breastfeed while taking => causes heavy sedation in infants
  • Fetal abnormalities => use barrier contraception, weigh risk vs benefit in pregnancy
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9
Q

Considerations for use of Antiepileptic Agents
In Older Adults

A
  • More susceptible to adv. effects
  • LOWER dose needed to do to impaired metabolism
  • CNS effects => need for safety precautions
  • Renal or hepatic impairment => inc. risk of toxicity
  • Monitor serum levels closely
  • Medic alert Bracelet
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10
Q

Anti-Seizure

Hydantoins
Drug Name

A

Phenytoin

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11
Q

Anti-Seizure

Hydantoins
Mechanism of Action

A

Stabilizes the nerve membranes by blocking channels in the cell membrane or altering recepter sites
* Decreases excitability and hyperexcitability to stimulation

(less sedating than barbituates)

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12
Q

Hydantoins
Indication

A

Seizures

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13
Q

Anti-Seizure

Hydantoins
Contraindications

A

Absolute:
* Allergy

Cautions:
* Elderly or debilitated patients
* Impaired renal or hepatic funtion
* Depression or pyschoses

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14
Q

Anti-Seizure

Hydantoins
Adverse Effects

A
  • CNS depression (confusion, lethargy)
  • Cardiac Arrhythmias
  • Hypotension
  • Severe liver toxicity
  • Bone Marrow suppression
  • Urinary Retention
  • Loss of libido
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15
Q

Anti-Seizure

Barbituates and Benzodiazepines
Adverse Effects

A
  • SIGNIFICANT CNS depression (confusion, lethargy, fatigue)
  • Cardiac Arrhythmias, changes in BP
  • Urinary Retention
  • Loss of libido
  • Physical dependence and withdrawal
  • Black Box Warning: Opiods & Benzodiazepines together can results in: Profound sedation, respiratory depression, coma, death
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16
Q

Anti-Seizure

Hydantoins
Drug Interactions

A

Alcohol (CNS depressant)
(also lowers seizure threshold)

17
Q

Anti-Seizure

Barbituates & Benzodiazepines
Drug Interactions

A

Alcohol (CNS depressant)
(also lowers seizure threshold)

Same as hydantoins

18
Q

Anti-Seizure

Barbituates
Drug Names

A
  • Phenobarbital
  • Primidone
19
Q

Anti-Seizure

Benzodiazepines
Drug Names

A

“-azepam”
* Clonazepam
* Diazepam

20
Q

Half Life of Barbituates and Benzodiazepines

A

Barbituates: Up to 100 hours
Benzodiazepines: 18-50 hours

Not for long term use, low lipid solubility

21
Q

Anti-Seizure

Barbituates & Benzodiazepines
Mechanism of Action

A

Same as hydantoin

Stabilizes the nerve membranes by blocking channels in the cell membrane or altering receptor sites
* Decreases excitability and hyperexcitability to stimulation

22
Q

Barbituates & Benzodiazepines
Indication

A

Seizures

23
Q

Anti-Seizure

Barbituates & Benzodiazepines
Contraindications

A

Absolute:
* Allergy

Cautions:
* Elderly or debilitated patients
* Impaired renal or hepatic funtion
* Depression or pyschoses

Same as hydantoins

24
Q

Anti-Seizure

Succinimides
Drug Names

A

“-suximide”
* Ethosuximide
* Methsuximide

25
Q

Anti-Seizure

Succinimides
MOA

A

Suppress the abnormal electrical activity in the brain

26
Q

Succinimides
Indications

A
  • Seizures
  • Most commonly used for absence seizures
27
Q

Anti-Seizure

Succinimides
Contraindications

A

Absolute:
* Allergy

Cautions:
* Renal or hepatic disease

28
Q

Anti-Seizure

Succinimides
Adverse Effects

A
  • CNS depressant effects
  • Bone Marrow suppression
  • Stevens-Johnson Syndrome
29
Q

Anti-Seizure

Succinimides
Drug Interactions

A

Primidone
Barbituate…. decreases primidone levels

30
Q

Anti-Seizure

GABA Modulators
Drug Names

A
  • Valproic Acid
  • Divalproex
31
Q

Anti-Seizure

GABA Modulators
MOA

A
  • Reduces abnormal electrical activity in brain
  • Increases GABA levels in the brain
32
Q

GABA Modulators
Indication

A

Seizures

33
Q

Anti-Seizure

GABA Modulators
Contraindication

A

Absolute:
* Allergy

Cautions:
* Hepatic or renal impairment

34
Q

Anti-Seizure

GABA Modulators
Adverse Effects

A
  • CNS Depression
  • Liver Toxicity
  • Pancreatitis
  • DRESS: Drug reaction with eosinophilia and systemic symptoms (severe hypersensitivity => in the mucus membranes => organs)
35
Q

Anti-Seizure

GABA Modulators
Drug Interactions

A

Other anti-seizure drugs
(risk of toxicity and risk of breakthrough seizures)

36
Q

What are the OTHER drugs to treat seizures?

A
  • Carbamazepine (Bloack Box warning for severe skin reactions, ADE: agranulocytosis, aplastic anemia, blood dyscrasias)
  • Lamotrigine (Black Box warning for serious skin reactions)
  • Levetiracetam
  • Topiramate (serious skin reactions)
37
Q

Antiseizure Agents Nursing Assessment

A

History:
* Contraindications and Cautions

Physical:
* Skin
* Vital Signs
* CNS
* Muscle strength
* Abdominal
* Urine output

Labs:
* ECG, renal & hepatic function tests, CBC

38
Q

Antiseizure Agents
Nursing Conclusions

A
  • Impaired comfort (GI,CNS)
  • Altered Thought Process (CNS effects)
  • Impaired skin integrity (skin reactions)
  • Injury Risk (CNS)
  • Infection Risk (bone marrow)
  • Knowledge Deficit
39
Q

Antiseizure Agents
Interventions/Patient Teaching

A
  • Administer with food
  • Monitor CBC before and during
  • Protect from infection
  • Prepare to discontinue drug (skin rash, bone marrow suppression, unusual depression, personality changes)
  • Discontinue drug slowly
  • Counseling to women of childbearing age
  • Provide safety measures
  • Patient Teaching (Medic alert bracelets, no alcohol/cns depressants)

Pharmacology Exam #1 (10 decks)

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