CNS drugs 2 Flashcards
1
Q
hydantoins
A
- act primarily on the motor cortex
- inhibit spread of sz activity by decreasing/increasing the Na ions across the motor cortex during generation of nerve impulses
- also antidysrhythmic
- replace barbs:less risk of CNS depression & SI
- phenytoin (dilantin)
- fosphenytoin (cerebrex)
2
Q
dilantin indications
A
- mgmt of all sz, except absence sz
- tx/prevent sz during or after surgery
3
Q
therapeutic range dilantin
A
10-20mcg/mL
4
Q
dilantin toxicity
A
20-25mcg/mL
- 30-35: slurred speech, ataxia
- 40: extremely lethargic
5
Q
dilantin contraindications
A
- hypersensitivity
- heart block
- psych disorders
- pregnancy (cat D)
6
Q
dilantin
A
- given IV for status epilepticus (don’t give with D5W); dilute & given in large vein
- IV loading dose: 10-15mg/kg
- IVP=no more than 50mg/min=or else hypoTN or cardiac dysrhythmias
- elderly IVP=20mg/min
- oral dose=100mg q6-8hrs
- monitor for anemia; decreases folic acid
- frequent mouth care (gingival hyperplasia)
7
Q
imiostilbene
A
- tx refractory sz dx; psych dx, trigeminal neuralgia, etoh withdrawal
- inhibit influx of Na ions into motor cortex
- carbamazepime/tegretol: drug of choice
- oxycarbazepine/trileptal
8
Q
carbamazepine therapeutic range
A
4-12mcg/mL
9
Q
s/e of imiostilbene
A
- anorexia
- nausea
- dizziness
- sedation
- HA
- sore throat
10
Q
oxycarbazepine therapeutic range
A
12-30mcg/mL
11
Q
oxycarbazepine
A
- tx primarily partial sz
- monitor renal function
- monitor Na levels
12
Q
what is used to reverse CNS depression if Depakote OD occurs
A
Narcan
13
Q
what is used to lower toxic serum levels of Depakote
A
hemodialysis
14
Q
adjunct anticonvulsants
A
- gabapentin (2-10mcg/mL)
- levetiracetam
- topiramae
- lamotrigine
- zonisaminde (causes blindness)
- pregabalin (contraindication: drug abuse)
- *most don’t have therapeutic levels
15
Q
anticonvulsant s/e
A
- blood dx
- slurred speech
- muscle weakness
- discoloration of urine
- decreased urination
- confusion
- depression
- ataxia
- gingival hyperplasia
