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Antiepileptics

Chapter 13 - Nsg. 118

QuestionAnswer
Brief episodes of abnormal electrical activity in the nerve cells of the brain Seizures
Involuntary spasmodic contractions of any or all voluntary muscles throughout the body Convulsions
Chronic, recurrent pattern of seizures Epilepsy
Two types of Epilepsy: Primary = unknown cause & Secondary = distinct cause (trauma,infections)
Classification of Epilepsy: Partial (Simplex & Complex); Generalized; Unclassified; Status epilepticus (continuous seizures)
Drugs that control & prevent seizures and lessen adverse effects of seizures are Antiepileptic drugs (AEDs)
Characteristics of AEDs usualy lifelong therapy, and can be used in combination with other drugs
Method of Action for AEDs 1. Stabilize Neurons 2. decrease neuron hyperexcitability 3. decrease spread of excessive nerve impulses
Indications for AEDs Prevent & control seizure activity, Long-Term maintenance for chronic seizures, acute treatment of convulsitons & status epilepticus
Phenytoin (Dilantin) - most commonly used for tonic-clonic Adverse Effects: lethargy, abnormal movements mental confusion, cognitive changes. Therapeutic Level: 10-20mcg/mL Contraindications: Exaggerated effectsif low serum albumin; very irritating to veins so give slowly (<50mg/min and follow with NS)
Fosphenytoin (Cerebyx) give 1.5 of this inplace of 1.0 of phenytoin This drug alleviates teh buring during injections. Give at a rate of 150mg PE/min to avoid hypotension & cardiorespiratory depression . Only give with 0.9%NaCl or D5W.
Valproic Acid (Depakote) Adverse Effects: Drowsiness, NV, tremors, weight gain, hepatotoxicity & pancreatitis; Interactions: carbonated beverages or milk
Carbamazepine (Tegretol) most commonly prescribed Therapeutic level 4-12mcg/mL; undergoes autoinduction: Interactions: Grapefruit increases toxicity. Can be given with food to reduce GI distress.
Gabapentin (Neurontin) (blank)
Clonazepam (Klonipin) causes hallucinations Indications: Lennox-Gastaut
IM injections of these should not be used in any patient barbiturates or phenytoin
Levetiracetam (Keppra) Most common adverse effects are: somnolence, asthenia(thin), and dizziness
Created by: LILES
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