Management of Seizures (week 11) Flashcards
Why should you withdraw AED’s slowly?
Because you can develop status epilepticus if you go to fast
What are some issues patients have while on AED’s?
No driving
Have to keep a seizure frequency chart
Wear some type of Medic Alert
Risk to fetus
What are some interventions for patients taking AED’s?
Forewarn them about CNS Depression
Suicidal behaviors
If pregnant, MUST take folic acid
What are the 4 basic mechanisms for AED’s?
Blockade of sodium channels
Blockade of Calcium channels
Blockade of receptors for glutamate
Potentiation of GABA Receptor
Name the three drugs for Blocking Sodium Channels
Phenytoin
Carbamazepine
Lamotrigine
Name the drug that blocks calcium channels
Valproic Acid
Name the drug that blocks the receptors of glutamate
Toprimate
Name the three drugs that cause potentiation of GABA Receptors
Gabapentine
Benzodiazepines
Barbiturates
What is the MOA of Phenytoin (Dilantin)?
Delays the influx of sodium, thus slowing the propagation and spread of abnormal discharges
What is phenytoin (Dilantin) used for?
Treat all major forms of epilepsy except absence seizures
What drug is difficult to find the sweet spot for and extremely hard on the liver?
Phenytoin (Dilantin)
What are the side effects of Phenytoin (Dilantin)?
CNS Issues
Morbilliform rash
Purple Glove Syndrome
Gingival hyperplasia
What are some nursing implications for Phenytoin (Dilantin)?
Oral contraceptive deficiency Take with food - oral Large needle - IV Must take folic acid Have good hygiene
Name two more traditional AED’s
Carbamazepine (Tegretol) Valproic Acid (Depakote)
What are some serious side effects for Carbamazepine (Tegretol)?
Bone marrow suppression
Hyponatremia
What is considered the ‘package deal’ drug?
Valproic Acid (Depakote)
What are serious side effects of Valproic Acid?
Hepatotoxicity
Pancreatitis
Avoid with Liver Issues
What is the MOA of Barbiturates?
Binds to GABA receptor-chloride channel complex
What are barbiturates used for?
Short to immediate acting of seizures
What are the side effects of Barbiturates?
Respiratory depression
Suicide Vehicle
Abuse
What are some nursing implications you want to know with Barbiturates?
PMH of pregnancy
Slow infusion
Name a newer AED
Oxcarbazapine
What is the MOA of Oxcarbazepine?
Sodium channel blocker
What are the side effects of Oxcarbazepine?
Hyponatremia
Hypothyroid
CNA effects
What drug can you not take if you are allergic to Carbamazepine?
Oxcarbazepine (Triliptal)
What AED is used as a pain management adjunct and have side effects of somnolence, fatigue, nystagmus, and dizziness?
Gabapentin
