Test 4 Antiseizure Shi Flashcards
What kinds of antiseizure drugs are there?
Tonic- clonic and Partial : Carbamazepine, Phenytoin, Phenobarbital (and broad spectrums), Lorazepam or Diazepam
Absence Seizure: Ethosuximide
Broad Spectrum: Valproic acid (Clonazepam)
Adjunct: Lamotrigine, Gabapentin
How do the Tonic Clonic antiseizure meds work?
Phenytoin: Reduces voltage frequency and spread of electrical discharges
Carbamazepine: Reduces synaptic reaction
Phenobarbital: Works like a circuit breaker in seizure ativity
Phenytoin therapeutic levels
10-20 mcg
Phenytoin Side effects
P- 450 inducer, Purple Glove syndrome
H- Hair growth (hirsutism)
E- Enlarged gums
N- Nystagmus
Y- Yucky skin rashes
T- Teratogenic
O- Osteoperosis
I- Interferes with folic acid (anemia)
N- Neuropathies
Contraindications of phenytoin
Preg/ Lact
Older adults or debilitated pt’s caution
Impaired renal or liver fx
Coma, depression, psychoses
Barbiturates and Barbituratelike Drugs
Phenobarbital
Primidone
Contraindications for Barbiturates/ barbiturate like drugs
Same as phenytoin
Adverse effects of Barbiturates and like drugs
CNS depression
Phenobarbital: Physical dependence or withdrawel syndrome ; linked to severe dermatological reactions nd development of drug tolerance
Drug Interactions of Barbiturates and like drugs
Alc
Vitamin K and D
Warfarin
Benzodiazapine drugs
Clobazam
Clonazepam
Diazepam
Benzodiazepine adverse effects
CNS depression
Physical depencence
WIthdrawels
Benzodiazepine interactions
Opioids
Alc
Succinimide drug examples
Ethosuxumide
Methsuximide
Therapeutic action of succinimides
Suppress the abnormal electrical activity in the brain that is associated with absence seizures
Indication for succinimides
Control of absence seizures
Ethosuximide should be tried first
Adverse effects for succinimides
Drowsiness
Ataxia
Dizziness
Irritability
Nervousness
Blurred Vision
Steven J’s
Pancytopenia
Drugs that modulate inhibitory neurotrasmitter GABA examples
Divalproex
Valproic
Therapeutic Action of GABA drug things
Divalproex: Increased GABA in brain
Valproic: Reduces abnormal electrical activity in brain ; may increase GABA activity at inhibitory receptors
Contraindications of GABA inhibitory drug things
Hepatic or renal impair
Preg/Lact
Adverse effects of GABA drug things
CNS
Liver tox
Hyperammonemia
Thrombocytopenia
Pacreatitis
DRESS
Carbamazepine therapeutic action
Inhibit polysynaptic responses and blocks sodium channels
Carbamazepine contrainidcations and cautions
Boxed warning for serious dermatological reactions
Monitor for aplaastic anemia
Carbamazepine adverse effects
CNS
Blood dyscrasias ; edema, HTN, fluid overload
Dermatitis
Rash
Photosens
Steven Johnson
True or False: You need to gradually decrease the dose of carbamazepine to come off the drug?
True
Lamotrigine therapeutic ax
May inhibit voltage sensitive sodium and calcium channels
Stabalize nerve cell membranes
Contraindications of Lamotrigine
Boxed warning for life threatening rashes
Preg
Adverse effects of Lamotrigine
CNS
Mild life threatening rashes
Aseptic Meningitis
Levetiracetam contraindications
Preg may decrease serum levels
Levetiracetam adverse effects
Dizziness
Weaknes
Fatigue
Agitation
Anxiety
Depression
SUicidal ideation (rare)
Topiramate contraindications
Preg
Adverse effects of topiramate
CNS depression
Metabolic acidosis
Angle closure glaucoma
Suicidal thos or behavior
