Pharmocology

Question 1

Hydantoins
phenytoin
fosphenytoin

Answer 1

Gingival hyperplasia: Encourage good dental hygiene.
Therapeutic drug monitoring required: Phenytoin has a narrow therapeutic range
(10-20 mcg/mL).
Administer IV pushes slowly and flush only with normal saline.

Question 2

Iminostilbenes
carbamazepine
oxcarbazepine

Answer 2

Risk for toxicity: Do not take carbamazepine with grapefruit juice.

Question 3

GABA Analogs
gabapentin
pregabalin

Answer 3

Sedation: Avoid alcohol and activities requiring alertness.
Pregabalin: Risk for abuse as it can cause feelings of euphoria

Question 4

Miscellaneous
lamotrigine
valproic acid
topiramate
levetiracetam

Answer 4

Lamotrigine: Lamotrigine: Monitor for skin rash due to risk for Stevens-Johnson syndrome. If a rash is observed, hold medication and immediately notify HCP.
Valproic Acid: Monitor for hepatotoxicity and pancreatitis.
Topiramate: Can cause significant weight loss
Levetiracetam: Monitor for and report mood changes.

Question 5

Benzodiazepines and
barbiturates
Lorazepam, diazepam
Barbiturates: Phenobarbital

Answer 5

Status epilepticus: Lorazepam (IV) is drug of choice for acute management.
CNS depression: Do not mix with alcohol, opioids, or other sedatives.

Question 6

Teach client:
Take AEDs at the same time each day.
Do not stop AEDs abruptly.
Avoid activities requiring alertness.
Do not mix AEDs with other CNS depressants.
Use alternative or additional contraception.

Answer 6

General considerations
Routine blood draws are required for many AEDs to ensure drug levels are within the therapeutic range (phenytoin,
carbamazepine, valproic acid, phenobarbital).
Risk for hepatotoxicity: Monitor LFTs.
Risk for blood dyscrasias: Monitor CBC.