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Pharm Test 2 > Chapter 14 Antiepileptic Drugs > Flashcards

Chapter 14 Antiepileptic Drugs Flashcards

1
Q

Seizure

A

Brief episode of abnormal electrical activity in nerve cells of the brain

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2
Q

Convulsion

A

Involuntary spasmodic contractions of any or all voluntary muscles throughout the body, including skeletal, facial, and ocular muscles

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3
Q

Epilepsy

A

Chronic, recurrent pattern of seizures

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4
Q

Primary (idiopathic) Epilepsy

A

Cause cannot be determined

Roughly 50% of epilepsy cases

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5
Q

Secondary (symptomatic) Epilepsy

A

-Distinct cause is identified

Trauma, infection, cerebrovascular disorder

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6
Q

Generalized onset seizures

A
  • Formerly known as grand mal seizures
  • Tonic-clonic seizures
  • Absence seizures
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7
Q

Partial onset seizures

A
  • Simple (formerly known as petit mal seizures)
  • Complex
  • Secondary generalized tonic-clonic
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8
Q

Status Epilepticus

A
  • Multiple seizures occur with no recovery between them
  • Result: hypotension, hypoxia, brain damage, and death
  • True medical emergency
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9
Q

Goals of therapy for Antiepileptic Drugs (AEDs)

A
  • To control or prevent seizures while maintaining a reasonable quality of life
  • To minimize adverse effects and drug-induced toxicity
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10
Q

Antiepileptic drugs traditionally used to manage seizure disorders include:

A
  • Barbiturates
  • Hydantoins
  • Iminostilbenes plus valproic acid
  • Second- and third-generation antiepileptics
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11
Q

Pharmacologic effects of Antiepileptic drugs

A
  • Reduce nerve’s ability to be stimulated
  • Suppress transmission of impulses from one nerve to the next
  • Decrease speed of nerve impulse conduction within a neuron
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12
Q

Antiepileptic Drugs: Indications

A
  • Prevention or control of seizure activity
  • Long-term maintenance therapy for chronic, recurring seizures
  • Acute treatment of convulsions and status epilepticus
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13
Q

Antiepileptic Drugs: Adverse Effects

A

-Numerous adverse effects; vary per drug
-Adverse effects often necessitate a change in medication
-Black box warning as of 2008
Suicidal thoughts and behavior
-Long-term therapy with phenytoin (Dilantin) may cause gingival hyperplasia, acne, hirsutism, and Dilantin facies.

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14
Q

Primidone is metabolized in the liver to:

A

phenobarbital

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15
Q

Most common adverse effect of Phenobarbital and Primidone (Mysoline)

A

sedation

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16
Q

Barbiturates: Phenobarbital and Primidone (Mysoline): Contraindications

A

known drug allergy, porphyria, liver or kidney impairment, and respiratory illness

17
Q

Barbiturates: Phenobarbital and Primidone (Mysoline):

Adverse effects

A

cardiovascular, CNS, gastrointestinal (GI), and dermatologic reactions

18
Q

Hydantoins: Phenytoin

Adverse Effects

A

gingival hyperplasia, acne, hirsutism, Dilantin facies, and osteoporosis

19
Q

Carbamazepine (Tegretol)

A
  • Second most commonly prescribed antiepileptic drug in the United States after phenytoin
  • Autoinduction of hepatic enzymes
20
Q

Oxcarbazepine (Trileptal)

A
  • Chemical analogue of carbamazepine

- Precise mechanism of action has not been identified

21
Q

Ethosuximide (Zarontin)

A
  • Used in the treatment of uncomplicated absence seizures
  • Not effective for secondary generalized tonic-clonic seizures
  • Contraindication: known allergy
  • Adverse effects: GI and CNS effects
  • Drug interactions: hepatic enzyme–inducing drugs
22
Q

Gabapentin (Neurontin)

A
  • Chemical analogue of GABA, a neurotransmitter that inhibits brain activity
  • Believed to work by increasing the synthesis and synaptic accumulation of GABA between neurons
  • Contraindication: known drug allergy
  • Adverse effects: CNS and GI symptoms
23
Q

Lamotrigine (Lamictal)

A
  • Also used for the treatment of bipolar disorder
  • Contraindications: drug allergy
  • Common adverse effects: relatively minor CNS and GI symptoms and possible Stevens-Johnson syndrome
24
Q

Levetiracetam (Keppra)

A
  • Adjunct therapy for partial seizures with and without secondary generalization
  • Contraindication: known drug allergy
  • Mechanism of action: unknown
  • Adverse effects: generally well tolerated, CNS
  • No drug interactions
25
Q

Pregabalin (Lyrica)

A
  • Schedule V controlled substance
  • Indication: adjunct therapy for partial seizures
  • Most common uses: neuropathic pain, postherpetic neuralgia, and fibromyalgia
  • Contraindication: known drug allergy
  • Adverse drug reactions: primarily CNS related
26
Q

Monitor for adverse effects of Antipileptic Drugs:

A
  • Mental status changes, mood changes, changes in level of consciousness or sensorium
  • Eye problems, visual disorders
  • Sore throat, fever (blood dyscrasias may occur with hydantoins)

Pharm Test 2 (8 decks)

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