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Pharm Seizure Meds
Neurology Seizure Meds
| Question | Answer |
|---|---|
| High-dose abx, cocaine and antipsychotics may cause | Seizure |
| Over what time period should antiseizure meds be titrated? | over 3-4 weeks |
| What percentage of patients do well on 1 drug? | 40-75% |
| When should you consider polytherapy? | Consider second agent if inadequate control after trials of two different single agents |
| What type of seizures can Phenytoin and Fosphenytoin be used for? | generalized tonic-clonic, simple and complex partial seizures |
| For obese pts, how should you dose phenytoin? | Based on Ideal body weight. If small, then use their true weight |
| Advantage of Fosphenytoin IV to Phenytoin IV | less phlebitis |
| Phenytoin requires a _______ dose and a _______ dose | Oral loading and a maintenance dose |
| If you double the dose of Phenytoin | the effect is more than double |
| Phenytoin, Fosphenytoin, Carbamazapine, Oxcarbazepine, Lamotrigine and Zonisamide are all | Sodium Channel Blockers |
| about 90% of this drug is bound to albumin | Phenytoin. only 10% of active drug circulating. |
| Which measure of Phenytoin is preferred? | Free Phenytoin |
| When a patient is ambulatory, how long after their first dose of phenytoin should they be checked? | 7 days after dosage, then change every 2-4 weeks until stable |
| Gingival Hyperplasia, hirutism, folate deficiency, and fetal hydantoin syndrome are associated with | Phenytoin AE's |
| Phenytoin ________the effects of many drugs | decreases |
| ________ induces its own metabolism | Carbamazepine |
| How long should pts serum be monitored for when prescribed Carbamazepine | Monitor serum concentrations for 1-2 months after therapeutic dose/serum concentrations acheived |
| Worst AE of Carbamazepine | Bone marrow suppression (leudkopenia, thrombocytopenia, aplastic anemia, agranulocytosis). |
| Carbamazepine has ______ drug interactions | TONS of!!!! |
| Oxcarbazepine can be used in what seizure type? | Monotherapy of adjunctive therapy for partial seizures in adults. Adjunctive therapy for partial seizures in children 4-16 years old |
| AE's with Oxcarbazepine | Leukopenia and thrombocytopenia have been reported, Multiorgan hypersensitivity disorders, erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis reported postmarketing, AE profile otherwise similar to carbamazepine |
| Phenobarbital and Primidone MOA | enhance GABAA-ergic inhibition, reduce NA and T Ca current. Result of combined mechanisms reduces high frequency repetitive firing |
| Phenobarbital and Primidone Indications | Generalized myoclonic seizures, partial, febrile, sedation, hypnosis, preanesthesia |
| USe __________ after failure of benzodiazepines and DPH for status epilepticus | Phenobarbital |
| What should be monitored with Phenobarbital | BP and respiratory monitoring |
| Do children get a higher or lower dose of Phenobarbital and Primidone than adults? | Children get a higher dose b/c their liver clears the drug more quickly. |
| ___ is used for migraine prophylaxis and seizure control | Valproic Acid (Depakene) |
| Which drug is a schedule V controlled substance (euphoria)? | Pregabalin (Lyrica) |
| _______is related to antifolate drugs | Lamotrigine (Lamictal) |
| How do you dose adjust Topamax in a pt with a CrCl <70ml/min? | 1/2 the dose |
| _______ is a sulfonamide | Zonisamide (Zonegran). May not work in a sulfa-allergy patient |
| __________Seems best used as an alternative add-on agent for patients with unsatisfactory partial seizure control or intolerable adverse effects to traditional therapies for partial and tonic-clonic seizures. | Tigabine |
| Keppra indication | adjunctive therapy for tx of partial onset seizures in adults, however, it is often used in adult seizures. no serum concentration effect monitoring. No serious AEs |
| Nephrolithiasis, open angle glaucoma, hypohidrosis are serious AE's of | Topiramate |
| Hyponatremia is an AE of | Oxcarbazepine (more common in the elderly) |
| Lamictal is what pregnancy category? | Category C |
| ________ has the greatest risk of teratogenicity and should be avoided during pregnancy and in women of childbearing age | Valproic Acid |
| Stevens Johnsons is a severe AE that can be caused by | Lamictal |
| Low-albumin states is concerning in a patient taking which seizure medication? | Phenytoin |
Created by:
ltm12