Ch 15 (test 3)

Question 1

Antiepileptic (AED)

Answer 1

used to manage tonic-clonic seizures. (decrease number and intensity)

Question 2

Mechanism of antiepileptic agents

Answer 2

1. act on abnormal neurons to decrease excitability and response to abnormal stimuli
2. raise the seizure threshold
3. Ion theory limit movement of K, Ca, and Mg across cell membranes stabilizing neuron and making it less responsive.

Question 3

Status Epilepticus

Answer 3

Continual tonic-clonic seizures (no rest period) Treat with Valum IVP.

Question 4

Antiepileptic drug protocol when starting

Answer 4

1. start on 1 and slowly increase
2. taper while second is given.
3. don’t stop abruptly
4. watch mood change.

Question 5

phenytoin (Dilantin)

Answer 5

1. # 1 antiepileptic drug
2. SE: lethargy, confusion
3. therapeutic blood level is 10-20 mcg/mL
4. toxicity; nystagmus, ataxia, dysarthria, and encephalopathy.
5. long term use: gingival hyperlasia, acne, hirsutism, osteoporosis (vit D).
6. precipitate all IV solutions except NS.

Question 6

phenobarbital (Luminal)

Answer 6

1. antiepileptic drug
2. SEDATION (lessens with tolerance)
3. especially good for febrile seizures.
4. 15-40 mcg/mL is therapeutic

Question 7

diazepam (Valium)

Answer 7

1. antiepileptic drug
2. used for anxiety, muscle spasm, convulsions.
3. not for long term use
4. ADDICTIVE

Question 8

Newer antiepileptic drugs

Answer 8

Keppra, Topomax,Zonegran, Lyrica

Question 9

side effects of antiepileptic drugs

Answer 9

1. sedation
2. fatigue, constipation, bradycardia, liver toxicity, skin reactions.
3. risk of birth defects

Question 10

Antiepileptic drug nursing implementations

Answer 10

1. with food and full glass of water
2. Barrier contraceptives
3. medic-alert pendant
4. abrupt stop causes status epilepticus
5. ROUND THE CLOCK
6. avoid caffeine, grapefruit juice, generics.