Neuro/Epilepsy Clinical Flashcards (LPN Level)
What characterizes a Tonic-Clonic Seizure?
Loss of consciousness, tonic stiffening followed by clonic jerking. Postictal phase follows.
What is an Absence Seizure?
Brief lapse in awareness. Often seen in children. No postictal confusion.
Define Focal Aware Seizure.
No loss of consciousness. Localized twitching or sensations.
What happens during a Focal Impaired Awareness Seizure?
LOC or altered awareness. May include automatisms (lip-smacking, picking).
What describes a Myoclonic Seizure?
Brief, shock-like jerks. Often bilateral.
What occurs in an Atonic Seizure?
Sudden loss of muscle tone. Risk of falls.
What is Status Epilepticus?
Seizure >5 min or multiple without recovery. Emergency. Treat with IV benzodiazepines.
What are the side effects of Phenytoin (Dilantin)?
Gingival hyperplasia, rash, nystagmus. Narrow range (10–20 mcg/mL). Monitor levels.
List the side effects of Levetiracetam (Keppra).
- Dizziness
- Fatigue
- Behavioral changes
- Renal dosing required
What should be monitored when using Carbamazepine (Tegretol)?
Monitor for hyponatremia, rash, aplastic anemia. Autoinducer.
What are the risks associated with Valproic Acid (Depakene)?
Hepatotoxicity, pancreatitis, tremor. Monitor LFTs and platelets.
What is the risk associated with Lamotrigine (Lamictal)?
Risk of Stevens-Johnson syndrome. Titrate dose slowly.
What side effects are associated with Topiramate (Topamax)?
- Weight loss
- Cognitive slowing
- Kidney stones
- Also used for migraines
What are the side effects of Phenobarbital?
Sedation, respiratory depression. Long-acting. May impair learning.
What is Clobazam (Frisium) used for?
Used in Lennox-Gastaut. Drowsiness, tolerance may develop.
What is the route and effects of Diazepam (Valium) in emergencies?
IV/rectal route in emergencies. Sedation, hypotension.
What is the IV medication of choice for status epilepticus?
Lorazepam (Ativan). Monitor breathing.
What is Gabapentin (Neurontin) used for?
Used for neuropathic pain and seizures. Dizziness, fatigue.
What is Pregabalin (Lyrica) similar to?
Similar to gabapentin. Also for fibromyalgia. Weight gain, edema.
What are the therapeutic and toxic levels for Dilantin?
Therapeutic: 10–20 mcg/mL. Toxic: >30. Watch LFTs, albumin.
What are the therapeutic levels for Valproate?
Therapeutic: 50–100 mcg/mL. Check LFTs, CBC.
What should be monitored for Carbamazepine?
Therapeutic: 4–12 mcg/mL. Check Na+, CBC, LFTs.
What general labs are needed for anticonvulsant monitoring?
- CBC
- LFTs
- Therapeutic drug levels
- Renal function
What are the steps in Seizure First Aid?
- Lower to floor
- Protect head
- Do not restrain
- Time the seizure
- Turn on side post-event
