Final: Antiepileptics Flashcards
Phenytoin (Hydantoin)
Stabilize nerve membranes throughout CNS directly by influencing sodium ionic channels in the cell membrane
Decreases excitability and hyperexcitability to stimulation
Well absorbed from GI tract, metabolized in liver, excreted in urine
PO or IV (MUST administer IV slowly due to sodium effects on heart)
IV: Inject no more than 50mg/min or 25 mg/min for older adults
Monitor plasma levels (Dilantin)
Therapeutic level: 10-20 mcg/ml (dial at ten)
Adverse effects: Gingival hyperplasia, use alternative birth control, unusual LFT, unusual CBC, mouth care/preventative dental checkup, maculopapular rash, soft tooth brush, seizures occur if stopped abruptly, stop alcohol, sleepy (CNS effects)
Carbamazapine (Partial Complex Seizures)
Monitor INR and PT levels if on warfarin, decreases effectiveness of oral contraceptives
No Grapefruit
Contraindications: Severe hepatic and renal dysfunction, decreased fertility with males
Adverse effects: Drowsiness, ataxia, dizziness, nausea, vomiting, CV complications, hepatitis, hematological disorders, Stevens-Johnsons syndrome, anorexia, headache
