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Pharmacology Exam 1 > Antiseizure Agents > Flashcards

Antiseizure Agents Flashcards

Pharmacology Exam 1

1
Q

What are the 3 types of seizures?

A

Tonic-Clonic Seizure
Absence Seizure
Status Epilepticus

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2
Q

What is the suffix for the antiseizure agent class Hydantoins?

A

Phenytoin

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3
Q

What are the 2 generic medications for the antiseizure agent class Barbiturates?

A

Phenobarbital
Primidone

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4
Q

What is the suffix for the drug class Benzodiazepines?

A

“azepam”
Clonazepam
Diazepam

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5
Q

What is the suffix for the drug class Succinimides?

A

“suximide”
Ethosuximide
Methosuximide

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6
Q

What are the two generic drug names in the drug class GABA Modulators?

A

Valproic Acid & Divalproex

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7
Q

How does Hydantoins work?

A

They stabilize the nerve membranes by blocking channels in the cell membranes or by altering reception sites. This decreases excitability and hyperexcitability of the membrane.

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8
Q

How does Barbiturates & Benzodiazepines work?

A

They stabilize the nerve membranes by blocking channels in the cell membranes or by altering reception sites. This decreases excitability and hyperexcitability of the membrane.

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9
Q

How does Succinimides work?

A

They suppress the abnormal electrical activity in the brain

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10
Q

How does GABA Modulators work?

A

They suppress the abnormal electrical activity in the brain and increases GABA levels in the brain.

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11
Q

Why is Phenytoin given?

A

For Seizures

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12
Q

Why are benzodiazepines given?

A

For Seizures

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13
Q

Why are the generic drug Ethosuximide given?

A

For seizures, but most commonly with absence seizures.

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14
Q

Why are Valproic Acid and Divalproex given?

A

For Seizures

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15
Q

What drug class does Valproic Acid and Divalproex fall under?

A

GABA Modulators

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16
Q

What does GABA stand for and what does it do?

A

GABA stands for gamma-aminobutyric acid, an amino acid that functions as a neurotransmitter in the central nervous system (CNS)

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17
Q

What patients should we be cautious with giving Phenytoin to?

A

Elderly or deliberate patients
Patients with impaired renal or liver functions.
Patients with depression or psychosis

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18
Q

What patients should we be cautious with giving ‘Phenobarbital’ and ‘Diazepam’ to?

A

Elderly or deliberate patients
Patients with impaired renal or liver functions.
Patients with depression or psychosis

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19
Q

What patients should we be cautious with giving ‘Methosuximide’ to?

A

Patients who have Renal or Hepatic disease

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20
Q

What patients should we be cautious with giving ‘Divalproex’ to?

A

Patients with Hepatic or Renal impairment

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21
Q

What are the adverse effects of Hydantoins’/Phenytoin?

A

CNS Depression
Cardiac Arrythmias and Hypotension
Severe Liver Toxicity
Bone Marrow Suppression
Urinary retention
Loss of Libido

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22
Q

What are the adverse effects of Barbiturates & Benzodiazepines?

A

CNS Depression:
- Confusion, Drowsiness, lethargy, fatigue
Cardiac:
Arrythmias, Changes in BP, Urinary retention
Loss of Libido
Physical dependency and withdrawal symptoms

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23
Q

What does the Black Box Warning on Benzodiazepines and Barbiturates say?

A

Mixed with opioids this medication may cause
Profound sedation
Respiratory depression
Coma
Death

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24
Q

What are some the adverse effects of Ethosuximide?

A

CNS depressant effect
Bone Marrow Suppression
Steven Johnson Syndrome

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25
Q

What is Steven Johnson Syndrome?

A

A rare, serious, and potentially fatal skin reaction that causes blistering and peeling of the skin and mucous membranes. It’s characterized by a rash that usually starts on the upper body and spreads to other areas of the body, including the face, arms, legs, and genitals. The rash is not usually itchy, but blisters appear on the skin and burst to leave painful sore

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26
Q

What is Bone Marrow Suppression?

A

Bone marrow suppression also known as myelotoxicity or myelosuppression, is the decrease in production of cells responsible for providing immunity, carrying oxygen, and/or those responsible for normal blood clotting

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27
Q

What are the adverse effects that may happen when a patient takes Valproic Acid?

A

CNS Depression
Liver Toxicity
Pancreatitis
DRESS: Drug reaction with Eosinophilia & Systemic Symptoms

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28
Q

What is DRESS symptoms

A

Drug reaction with eosinophilia and systemic symptoms (DReSS) is a rare disorder that can affect the skin, blood and any internal organs, most commonly the liver, kidney, lungs and heart. also called drug induced hypersensitivity syndrome

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29
Q

How may antiseizure agents affect children and what considerations should be taken?

A

Can affect learning & social development.
Children are more sensitive to the sedative effect.
May need to switch medication dosing when growing.

30
Q

How may antiseizure agents affect adults and what considerations should be taken?

A

Adults should have regular routine care.
Be monitored for adverse effects.
Drugs taken during pregnancy may develop fetal abnormalities.

31
Q

How may antiseizure agents affect older adults and what considerations should be taken?

A

Older adults are more susceptible to adverse effects.
The medications affect the CNS system so safety measures should be implemented.
Renal & Hepatic impairment can occur - monitor closely
Monitor serum levels to prevent toxicity.
Should have a medic alert.

32
Q

True or False

Epilepsy is the most prevalent neurological disorder

A

True

33
Q

What history should be collected during the nursing assessment?

A

Factors for contraindications and cautions.

34
Q

What physicals examinations should be done during the nursing assessment?

A

Skin - Due to adverse effects
Vital
CNS - due to adverse effect
Muscle Strength - due to CNS effect
Abdominal - due to adverse
Urine Output - do to risk of urinary retention

35
Q

What nursing diagnosis can be made before a patient is administered Antiseizure agents?

A

Impaired Comfort - due to GI & CNS effect.

Impaired Skin Integrity - due to adverse effects

Altered Skin Integrity - Adverse effect.

Injury Risk - Due to CNS effect

Infection Risk - due to bone marrow suppression

Knowledge Deficit

36
Q

What nursing implementation can be made for a patient prescribed Antiseizure agents?

A

Administer with food - If GI adverse effect

Monitor CBC (complete blood count) due to bone marrow suppression

Prepare to discontinue the medication should any of the following occur:
Skin Rash
Bone Marrow Suppression
Unusual Depression
Personality changes

Discontinue slowly

37
Q

What is Epilepsy?

A

Most prevalent neurological disorder.
Collection of different syndromes.
Seizure
Loss of control
Frightening to patients

38
Q

What causes seizures?

A

Abnormal neurons sensitive to stimulations or over responsiveness.

39
Q

What is the best way to diagnose seizures?

A

Through EEG (Electroencephalogram) which measures electrical activity in the brain.

40
Q

What drug class does Valproic Acid belong to?

A

GABA Modulators

41
Q

What drug class does Divalproex belong to?

A

GABA Modulators

42
Q

What drug class does Primidone belong to?

A

Barbiturates

43
Q

What drug class does Ethosuximide belong to?

A

Succinimides

44
Q

What drug class does Phenytoin belong to?

A

Hydantoins

45
Q

What drug class does Diazepam belong to?

A

Benzodiazepines

46
Q

What characterizes a Tonic-Clonic seizure?

A

A seizure that has both tonic (stiffening) and clonic (jerking) muscle contractions on both side of the body in intervals. appear as spasms. Usually lasts less than 5 minutes. Loss of consciousness happens and the recovery period is characterized with exhaustion and confusion.

47
Q

What characterizes an absence seizure?

A

Seizure that is characterized by sudden but temporary loss of consciousness for about 5-15 seconds usually accompanied by blinking or staring. Usually in children 3y/o, usually outgrown by puberty.

48
Q

What is a Status Epilepticus seizure?

A

Seizure rapidly occur without cognitive recovery in between. They usually last over 5 minutes and is the most dangerous form of seizure and considered a medical emergency because they may lead to brain damage due to anoxia.

49
Q

What should be the serum levels of Hydantoins?

A

Therapeutic serum phenytoin levels: 10-20 mcg/mL

50
Q

What is the half life of Barbiturates’?

A

up to 100 hrs

51
Q

What is the half life of Benzodiazepines?

A

18-50 hrs

52
Q

What is the Drug-Drug adverse interaction to Succinimides?

A

Primidone. It lowers primidone levels when they are both taken.

53
Q

What is an adverse Drug-Drug interaction to Phenytoin?

A

Alcohol

54
Q

What is an adverse Drug-Drug interaction to Diazepam?

A

Opioids & Alcohol

55
Q

what is the adverse Drug-Drug interaction to GABA modulators?

A

Other antiseizure drugs
* Risk of toxicity
* Risk of breakthrough seizure

56
Q

Would a person be considered epileptic after one seizure episode?

A

No.
Epilepsy is chronic or recurrent seizures.

57
Q

What is a primary seizure?

A

When there is no underlying cause or reason for the seizure.

58
Q

What is a secondary seizure?

A

There is a cause for the seizure. This could be due to a head injury, drug overdose, fever or environmental factors

59
Q

Which drug is most often used to treat Status Epilepticus seizures?

A

Phenytoin, Clonazepam and Phenobarbital

60
Q

Why does children up to 6 years old possibly need a higher dosage of antiseizure agents?

A

Because they metabolize the drug faster - so dosage may need to be adjusted.

61
Q

When can an child receive adult dosing?

A

After age 10 y/o

62
Q

Can a woman breastfeed while taking antiseizure agents?

A

No bacuse the infant can experience CNS effect incl heavy sedation.

63
Q

Why would a patient be prescribed Phenytoin over Barbiturates?

A

Less sedative effect

64
Q

What substance may decrease the seizure threshold?

A

Alcohol

65
Q

How come barbiturates and Benzodiazepines have long half lives?

A

Due to their low lipid solubility so they have a long duration.

66
Q

What other antiseizure drugs has a Black Box Warning for serious skin reaction?

A

Carbamazepine, Lamotrigine, and Topiramate.

67
Q

Which drug class is Stevens-Johnson syndrome an adverse effect of?

A

Succinimides

68
Q

Which 2 drug classes are bone marrow depression an adverse effect of?

A

Hydantoins & Succinimides

69
Q

Which drug classes have CNS depression as an adverse effect?

A

All of them

70
Q

Name 3 generic drugs that have loss of libido as an adverse effect?

A

Phenytoin, Primidone and clonazepam

Pharmacology Exam 1 (9 decks)

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