Epilepsy

Question 1

what happens when someone is having a seizure

Answer 1

simultaneous electrical activity in the neuron

Question 2

is epilepsy a disorder

Answer 2

yes

Question 3

best trt practices for seizures

Answer 3

find out what the underlying cause is

Question 4

when selecting the drug therapy for seizures, do this 1st

Answer 4

get good pt. med. hx, EEG results, lab studies

Question 5

***if someone is in status epilepticus what med do we give

Answer 5

benzodiazepines

Question 6

what is status epilepticus

Answer 6

grand mal seizures ldg to brain death

Question 7

when dosing what are best practices

Answer 7

lowest dose that is effective, titrate up very slowly

Question 8

if you have seizures does it mean you have epilepsy

Answer 8

no - can have seizures for other reasons

Question 9

how long will it take to see the benefits of drug therapy for epilepsy

Answer 9

may take a few months

Question 10

what do we teach pts. being treated for epilepsy

Answer 10

medication adherence
if taking other meds do so under care of neuro
***freq. bld work/monthly blood levels r/t s/e

Question 11

2 classes of AED’s

Answer 11

traditional - still very common - more s/e

new - developed after 1993

Question 12

MOA for all AED’s

Answer 12

help suppress neural impulses

Question 13

*when thinking of Dilantin think of this

Answer 13

dosing is difficult - narrow therapeutic index - hard to get therapeutic dose - easy to make toxic in the body

Question 14

s/s of Dilantin toxicity

Answer 14

seizures - gum disease - rash - Stevens Johnson’s Syndrome (skin sloths off) - cognitive impairment - double vision

Question 15

what should we avoid while on anti-seizure meds

Answer 15

alcohol

Question 16

how is dilantin administered

Answer 16

PO or IV

Question 17

what should we know about tegretol

Answer 17

hepato-toxic - fewer s/e than dilantin - easier to dose

Question 18

s/e of tegretol

Answer 18

some CNS depression

• aplastic anemia
• thrombocytopenia
• photo-sensitivity

Question 19

pt teaching for tegretol

Answer 19

sunscreen, hat; no citrus juices

Question 20

how is tegretol given

Answer 20

PO

Question 21

drug interactions with Tegretol

Answer 21

warfarin, oral contraceptives, grapefruit (competes)

Question 22

***no grapefruit margaritas on the beach to help remember Tegretol s/e

Answer 22

beach - photo-sensitivity
avoid alcohol
stay away from citrus fruit

Question 23

**depakote s/e

Answer 23

increased ammonia levels

pancreatitis

Question 24

pt teaching for depakote

Answer 24

avoid alcohol

Question 25

lab tests while taking depakote

Answer 25

liver fxn tests, pancreatic enzyme levels

Question 26

why is zarontin normally prescribed

Answer 26

for absent seizures

Question 27

why is zarontin normally prescribed

Answer 27

for absent seizures

Question 28

s/e of phenobarbital’s

Answer 28

significant CNS side effects

Question 29

Ativan/Valium (benzos) are given for

Answer 29

status epilepticus

Question 30

how are benzos given for status epilepticus

Answer 30

iv

Question 31

how do we recognize benzos

Answer 31

“pam”

Question 32

the most common newer AED

Answer 32

keppra

Question 33

the most common newer AED

Answer 33

keppra