Neuro - Antiepileptic Flashcards
1
Q
General Antiepileptic Meds
MOA
AEs
toxicity
A
-
MOA: alter movement of Na, K, Ca, & Mg ions; results in more stabilized & less excitable cell membranes OR enhance effects of GABA OR unknown
> incrs seizure threshold -
AEs
> GI upset: N/V
> CNS depression: drowsiness, lethargy, fatigue
> Dizziness
> Ataxia - Toxicity: Hepatotoxicity
2
Q
General Antiepileptic Drug-Drug
A
- CNS depressants; incrd drowsiness
- Alcohol; incrd drowsiness
- Oral contraceptives; altered metabolism = reduced efficacy
3
Q
General Antiepileptic Meds
A
- Risk severe seizure activity w/ abrupt withdrawal of med
- Monitor drug lvls for toxicity
- Pregnancy
- Black Box: suicidal ideations
4
Q
Diazepam (Valium) - class & MOA
A
- Class: Benzodiazepine
- MOA: Potentiates effects of GABA
5
Q
Diazepam (Valium) - Use & Route
A
- Use: status epilepticus
- Route: IVP; onset 1-5mins, peak 30min
6
Q
Diazepam (Valium) - AEs & Nursing
A
-
AEs
> sedation
> resp depression
> bradycardia
> hypotension - Nursing: monitor cessation of seizure & VS
7
Q
Phenytoin (Dilantin) - Class & MOA
A
- Class: Hydantoins
- MOA: stabilize nerve membranes throughout CNS resulting in less excitability
8
Q
Phenytoin (Dilantin) - AEs & D/D
A
-
AEs
> see general
> gingival hyperplasia
> bradycardia
> hypotension w/ IV admin -
Drug-Drug
> Warfarin (highly protein bound = bleeding)
9
Q
Phenytoin (Dilantin) - Nursing Considerations
A
- Monitor serum drug lvls
- good oral hygiene
10
Q
Phenytoin (Dilantin) IV Administration
A
- IVP: use large vein & large cath; do not exceed 50mg/min
- IV infusion: only dilute in NS, use filter
- Follow w/ NS flush to dcr risk of local venous irritation
- Monitor IV site for inflamm & extravasation
- Monitor cardiac rhythm (brady) & BP
11
Q
Antiepileptic Care Plan
assessment
diagnosis
outcomes
A
-
Assessment
> focus on neuro & GI
> pregnancy status, d-d (CNS depressants)
> Labs: drug lvls for toxicity -
Nursing Diagnosis
> risk for injury -
Expected Outcome
> pt will have an absence of seizure activity
> pt will understand drug therapy, AEs, safety measures
12
Q
Antiepileptic Interventions
A
- Reduce risk for falls
- Seizure precautions
- Counsel women of childbearing age
- Educate:
> seizure disorder will need med therapy for lifetime
> discontinue drug slowly; abrupt withdrawal may precipitate seizures
> caution w/ driving until effects of med are known
> lab monitoring
13
Q
Antiepileptic Evaluation
A
- Therapeutic respose
> absence of seizure activity
> serum drug lvls - AEs
- Teaching effectiveness
14
Q
Levodopa/Carbidopa (Sinemet) - Class & MOA
anti-parkinsonism
A
- Class: Dopaminergic Agent
- MOA: restores dopamine concentration in brain
15
Q
Levodopa/Carbidopa (Sinemet) - Indication & Drug/Drug
anti-parkinsonism
A
- Indication: Parkinson’s disease
- Drug-Drug: antihypertensives
