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Pharm > Chapter 25 > Flashcards

Chapter 25 Flashcards

1
Q

Strange sensations such as tingling, smell, or emotional changes that occur before a seizure

A

Aura

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2
Q

A disorder of the brain that causes recurrent unprovoked seizures

A

Epilepsy

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3
Q

These drugs can decrease the voltage, frequency, and spread of electrical impulses within the motor cortex of the brain which leads to decreased seizure activity

A

First line drugs for seizures

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4
Q

A seizure that is involved with the entire brain caused by electrical discharges from both sides of the brain

A

Generalized seizure

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5
Q

A seizure that starts in one part of the brain

A

Partial seizure

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6
Q

This happens after the seizure phase which is often characterized by confusion, headache, sore muscles, and fatigue

A

Postical phase

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7
Q

Alternative drug use for treatment of seizures

A

Second line drugs for seizures

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8
Q

Uncontrolled electrical activity in the brain which may cause physical conversion, minor physical signs, thought disturbances, or a combination of symptoms

A

Seizure

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9
Q

A pathologic condition resulting in a sudden episode of uncontrolled electrical activity in the brain (repeated seizures) can be called what?

A

Seizure disorder

Epilepsy

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10
Q

A prolonged seizure which usually lasts longer than 30 minutes

A

Status epilepticus

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11
Q

About how many people in it in the United States have a seizure disorder ?

A

2 million

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12
Q

What Percent of Americans will experience a seizure during some time in their life’s?

A

10%

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13
Q

Seizures may begin at what age? Most seizures begin at what age?

A

Any age

Early child hood or late adulthood

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14
Q

Abnormal electrical impulses can lead to what?

These impulses help the brain communicate with what?

A

Seizures

The spinal cord, nerves, muscles, and other parts of the brain

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15
Q

Seizures can affect what in the body?

A

Movement, senses, concentration, Communication, level of consciousness

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16
Q

What is the cause of seizures

A

Mostly unknown

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17
Q

For adults, the most common cause of seizures include what?

A

Head injury, stroke, and tumor, certain drugs

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18
Q

For children the most common cause of seizures include what?

A

Head injury, fever, central nervous system infection, hypoxia, electrolyte imbalances.

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19
Q

6 common causes of seizures?

A

Brain injury, genetic, no known cause, infections, metabolism abnormalities, tumors

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20
Q

Risk factors for seizures

A 
Brian infection 
Drugs 
Drug withdrawal 
Emotional stress
Family history 
Fevers
Head injury 
Hormone changes
Hyperventilation 
Lack of food
Metabolic disorders
Sensory stimuli 
Sleep deprivation 
Tumors
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21
Q

Common seizure causing drugs

A 
Antidepressants 
Bupropion alcohol 
Cocaine and street drugs
Anti seizure drugs
Oral contraceptives 
Phenothiazines 
Theophylline
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22
Q

Signs and symptoms of a seizure ?

A

Starting off into space
Loss of consciousness
Violent jerky movements
Aura before seizure starts

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23
Q

Seizures are divided into what two groups?

A

Generalized and partial seizures

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24
Q

These seizures affect most or all of the brain. How many types are there ?

A

Generalized seizures

6

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25
Q

This type of generalized seizure:

Convulsions, muscle rigidity, unconsciousness (grand mal) last two to five minutes

A

Tonic - clinic

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26
Q

Generalized seizure:

Muscle stiffness, rigidity

A

Tonic

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27
Q

Generalized seizure:

Loss of muscle tone

A

Atonic

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28
Q

Generalized seizure:

Brief loss of consciousness

A

Absence

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29
Q

Generalized seizure:

Sporadic jerking movements

A

Myoclonic

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30
Q

Generalized seizure:

Repetitive jerking movements

A

Clonic

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31
Q

Also called focal or local seizures

A

Partial seizure

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32
Q

Two major types of partial seizures

A

Simple and complex

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33
Q

What type of partial seizure do you remain conscious?

A

Simple partial seizures

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34
Q

What partial seizure do you lose consciousness? And experience amnesia after it. For how long ?

A

Complex for one to 3 minutes (lose consciousness)

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35
Q

Types of partial seizures :

Head turning, jerking, muscle rigidity, spasms

A

Simple partial motor

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36
Q

Partial seizures:

Unusual sensations affecting either vision, hearing, small, taste, or touch

A

Simple partial sensory

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37
Q

Partial seizures:

Memory or emotional disturbance

A

Simple partial psychologic

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38
Q

Partial seizures:

Automatisms (chewing, fidgeting, lip smacking , walking and repetitive movements )

A

Complex

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39
Q

Partial seizures:

Symptoms evolve into a loss of consciousness and convulsions

A

Partial with secondary generalization

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40
Q

Why is it so important to treat status epilepticus seizures?

A

To prevent brain damage

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41
Q

How to treat status epilepticus when life threatening ?

A

Protect the airway
Provide oxygen
IV access to give Valium
Determining and treating the cause

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42
Q

What to do for one having a simple partial seizure?

A

Watch the patient and document the time the seizure occurred and how long it lasted.

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43
Q

What to do for some one with a generalized or complex seizure?

A
  • Remove anything that could cause injury to patient
  • turn on their side to prevent aspiration
  • let secretions drain
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44
Q

What to do if you witness a generalized or complex partial seizure?

A

Hope the person to the floor and cushion head

Loosen clothing around neck

Remove any sharp objects

Turn person on one side

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45
Q

What to do if an anti seizure med does not work?

A 
Up the dose
Change meds
More than one med
Take on time to maintain blood level 
Start one at a time
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46
Q

The choice of drugs prescribed is based on what?

A

The type of seizures

47
Q

Before giving any anti seizure med always do what?

A

Get a complete list of drugs the patient is taking including over the counter and herbals

48
Q

Do anti seizure drugs interact with other drugs?

A

Yes especially phenytoin

49
Q

Drugs for seizures can increase the effects of what drugs ?

A

Anticoagulant drugs

50
Q

What to do with a patient who has had a seizure?

A 
Check vitals
Check level of consciousness 
Ask patient to describe nature of seizures
Ask if they get an aura before seizure 
Reduce risk of injury 
Call light in reach 
Ask if pregnant
51
Q

What to do after giving any anti seizure drugs

A

Recheck the patients level of consciousness. Check vitals because drugs can cause side effects

52
Q

Suddenly stopping an antisezure med can do what?

A

May cause sezuires

53
Q

With seizure meds if you skip a dose what should you do?

A

Take a missed dose asap but do not double dose

54
Q

What to avoid when taking seizure meds ? Why?

A

Alcohol , driving, operating machinery .

Med may cause dizziness or drowsiness

55
Q

What should seizure patients wear/ have with them at all times?

A

Medical alert bracelet and ID card

56
Q

What should be on an ID card

A

Diagnosis
Prescribed drugs
Prescribers name

57
Q

What should you take anti sezuire meds with?

A

Food and plenty of water

58
Q

What food to avoid with anti seizure meds? Why?

A

Grapefruit - it can increase the action of the drug and lead to side effects or adverse effects

59
Q

What teaching should be informed with someone who is on seizure meds that is about to go into surgery?

A

Increased risk of bleeding

60
Q

First line drug names for seizures?

A

Carbamax- carbamazepine
Dilantin- phenytoin
Depakote - valproic acid

61
Q

Dosages for adults and children

Carbamax-

Dilantin -

Depakote-

A

Adult-600-1600mg
Children less than six 10-35mg
Children over six 200-1000mg 3-4 doses

Adult-400mg followed by 300mg after 2-4 hours
Children- oral-5mg
2-3 doses

Adults/children 10 +- oral and IV 10-15mg can increase by 5-10mg a day till controlled seizures - max dose is 60mg daily

62
Q

What is he difference between tequila , tegretol and tegretol XR?

A

Tegretol is an anti seizure drug, tegretol XR is an extended release form of the drug, tequin is an antibiotic

63
Q

What is the intended response of an anti seizure med?

A

To control and prevent seizures

Decrease abnormal electrical impulses

64
Q

Common side effects for first line drugs for generalized and partial seizures?

A 
Dizziness 
Loss of coordination 
Drowsiness/sedation 
Nausea
Vomiting
Hypotension
65
Q

Side effects where patient should call doctor immediately

What do they indicate?

A 
Difficulty moving 
Skin rashes
Easy bruising 
Tiny
Purple colored skin spots 
Unusual bleeding

Allergic reaction and adverse reactions

66
Q

Adverse effects of carbamazepine and phenytoin

A

Neutropenia (decrease number of white blood cells) sore throat fever chills

67
Q

Carbamazepine can cause what?l adverse effect?

A

Severe bleeding (thrombocytopenia)

68
Q

Phenytoin can lead to what adverse effect?

A

Stevens Johnson’s syndrome - allergic reaction-rash like burn sores

69
Q

Serious adverse effects of valproic acid?

A

Damage to liver (hepatotoxicity ) and inflammation of pancreatitis

70
Q

What to do before giving first line drugs for partial and generalized seizures?

What type of saline ?

A

Check the IV site for patency and solution compatibility.

Use normal saline because this drugs precipitates (forms solid particles)

71
Q

Don’t use dextrose solutions with what?

A

IV phenytoin

72
Q

What to do after giving a first line med for seizures?

A 
Remind them about oral care
Check for nausea and vomiting
GI symptoms? Give with food
Drink plenty water
Watch for side effects
73
Q

What to teach the patient about first line drugs?

A

Tell them they may need occasional lab results done to check blood levels and liver damage

Females - birth control pills may not work as effectively

74
Q

Ppl taking carbamazepine may be more sensitive to what?

A

Sunlight

75
Q

A person taking what drug should see their dentist more often. Why?

A

Dilantin

Extra growth of gums

76
Q

Patients should avoid taking what med or take it 2-3 hours before taking phenytoin?

A

Antacids

77
Q

This med can lead to slowed healing and increased risk for infection

A

Depakote

78
Q

Who is more likely to have behavior changes while taking carbamazepine?

A

Children

79
Q

Adolescents often require increased dosage of anti seizure drugs . Why?

A

Growth and hormone changes

80
Q

What drugs have a high likelihood of increasing risk for birth defects?

A

Carbamazepine
Phenytoin
Valproic acid

81
Q

A seizure during pregnancy can result in what?

A

Oxygen loss to the fetus , physical injury to mother or fetus

82
Q

Taking phenytoin during pregnancy increases risk of what in fetus?

A

Cleft palate, low birth weight , facial defects , fetal hydantoin

83
Q

Valproic acid during pregnancy has been associated with what with the fetus? Also passes through what?

A

Developmental defects, low IQ , damage to liver

Breast milk

84
Q

Who is more sensitive to effects of first line drugs for generalized and partial seizure ?What effects ?

A

Adults

Confusion, restlessness, abnormal heart beats , chest pain,

85
Q

This drug causes CNS depression?

A

Ethosuximide (zarontin)

86
Q

Intended responses for first line drugs for absence seizures

A

Seizures are controlled and prevented

Abnormal electrical impulses decreased

Resistance of CNS to abnormal stimuli is increased

87
Q

Common Side effects of first line drugs for absent seizures

Other side effects?

Allergic reaction?

A 
GI upset
Nausea 
Vomiting 
Indigestion 
Loss of appetite 
Weight loss

Other:
Confusion, dizzy , drowsy, headache, constipation, nervous, depression

Ar- rashes fever sore throat , abnormal bleeding report to dr.

88
Q

First line drugs for absence seizures

A

Ethosuximide (zarontin) - adults 250mg
Children. 3-6 years old 250mg

Valproic acid (depakote, depacon ) - adults and children 10 + 10-15mg a day

89
Q

What to do before giving first line drugs for absence seizures?

A

Check test results

Obtain baseline weight

90
Q

What to do after giving first line drugs for absence seizures?

A

Check weight daily

Give drugs with food if GI upset occurs

91
Q

What to teach patients taking first line drugs for absence seizures?

A

Take as prescribed
Take missed doses asap but do t double dose
Don’t stop taking suddenly because seizures may occur

92
Q

Zarontin ( ethosuximide) may make eyes sensitive to what?

A

Light

93
Q

Valproic acid - who not to give to and why?

A

Children under 2 - liver damage - could lead to death

94
Q

Valproic acid should be used more causiously with who ? Why?

A

Older adults

May be more sensitive to side effects such as sleepy and dizziness

95
Q

Common second line drugs for seizures

And side effects

A

Clonazepam (klonopin)- dizziness, sedation, weakness
Gabapentin (neurontin) - drowsy, fatigue, dizzy, swelling in ankles, weight gain
Lamotrigone (lamictal)- dizzy,upset GI, headache , unsteady, double vision, rash
Phenobarbital (ancakuxur)- drowsy, dizzy
Pregabalin (lyrica)- dizzy drowsy, ataxia, perepheral edema
Promidone (mysoline) - anorexia - ataxia , clumsy, dizzy, unsteady, vertigo

96
Q

The difference between neurontin and noroxin?

A

Neurontin is an anti seizure drug

Noroxin is an anti infective drug

97
Q

Difference between lamictal and lamisil?

A

Lamictal is an anti seizure drug

Lamisil is an anti fungal drug

98
Q

Lamotrigine vrs lamivudine ?

A

Lamo is an anti seizure drug

Lamivudine is an antiretroviral drug

99
Q

Intended reaponses of second line seizure meds?

A

Control and prevent seizures
Abnormal electrical impulses decreased
Resistance of CNS to abnormal stimuli is increased

100
Q

Common side effects for second line drugs ?

A

Dizzy, drowsy, GI upset, unsteady

101
Q

Second line drugs are often prescribed with what?

A

Other seizure meds

102
Q

What happens when a patient takes morohine at the same time as gabapentin ?

What to do?

A

Blood level of gabapentin is increased and could become toxic

Lower doses

103
Q

Promidone decreases the effects of anticoagulant drugs

What to do?

A

Higher doses of anticoagulant

104
Q

What to do before giving sencond line drugs for seizures?

A

Schedule two hours between gabapentin and antacids

Ask about kidney problems

Check IV site

105
Q

What to do before giving second line drugs for seizures

A

Asses side effects and adverse effects

Notify dr if any occur

Hold the drug is rash occurs

Lacictal for rash can be increased slowly over 6 to 7 weeks

106
Q

What to teach patients taking second line drugs

A

Notify dr asap if allergic reactions or seizures occur

107
Q

2nd line :

These meds may become addictive

A

Phenobarbital and clonazepam

108
Q

2nd line :

Interfere with birth control

A

Phenobarbital and promidone

109
Q

2nd line:

Avoid alcohol when taking this med

A

Phenobarbital, promidone , lamotrigine

110
Q

2nd line :

Cigarette smoke may decrease the effectiveness

A

Clonazepam

111
Q

2nd line :

Avoid stopping abruptly

A

Lyrica

112
Q

Children and older adults are more sensitive to what second line drug?

A

Gabapentin and lamotrigine

113
Q

Second line drugs have what risk to pregnant women ?

A

High likelihood of birth defects or feral damage

Pharm (10 decks)

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