Neurology Seizure Meds
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| High-dose abx, cocaine and antipsychotics may cause | Seizure
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| Over what time period should antiseizure meds be titrated? | over 3-4 weeks
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| What percentage of patients do well on 1 drug? | 40-75%
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| When should you consider polytherapy? | Consider second agent if inadequate control after trials of two different single agents
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| What type of seizures can Phenytoin and Fosphenytoin be used for? | generalized tonic-clonic, simple and complex partial seizures
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| For obese pts, how should you dose phenytoin? | Based on Ideal body weight. If small, then use their true weight
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| Advantage of Fosphenytoin IV to Phenytoin IV | less phlebitis
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| Phenytoin requires a _______ dose and a _______ dose | Oral loading and a maintenance dose
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| If you double the dose of Phenytoin | the effect is more than double
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| Phenytoin, Fosphenytoin, Carbamazapine, Oxcarbazepine, Lamotrigine and Zonisamide are all | Sodium Channel Blockers
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| about 90% of this drug is bound to albumin | Phenytoin. only 10% of active drug circulating.
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| Which measure of Phenytoin is preferred? | Free Phenytoin
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| 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
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| Gingival Hyperplasia, hirutism, folate deficiency, and fetal hydantoin syndrome are associated with | Phenytoin AE's
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| Phenytoin ________the effects of many drugs | decreases
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| ________ induces its own metabolism | Carbamazepine
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| How long should pts serum be monitored for when prescribed Carbamazepine | Monitor serum concentrations for 1-2 months after therapeutic dose/serum concentrations acheived
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| Worst AE of Carbamazepine | Bone marrow suppression (leudkopenia, thrombocytopenia, aplastic anemia, agranulocytosis).
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| Carbamazepine has ______ drug interactions | TONS of!!!!
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| 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
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| 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
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| Phenobarbital and Primidone MOA | enhance GABAA-ergic inhibition, reduce NA and T Ca current. Result of combined mechanisms reduces high frequency repetitive firing
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| Phenobarbital and Primidone Indications | Generalized myoclonic seizures, partial, febrile, sedation, hypnosis, preanesthesia
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| USe __________ after failure of benzodiazepines and DPH for status epilepticus | Phenobarbital
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| What should be monitored with Phenobarbital | BP and respiratory monitoring
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| 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.
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| ___ is used for migraine prophylaxis and seizure control | Valproic Acid (Depakene)
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| Which drug is a schedule V controlled substance (euphoria)? | Pregabalin (Lyrica)
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| _______is related to antifolate drugs | Lamotrigine (Lamictal)
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| How do you dose adjust Topamax in a pt with a CrCl <70ml/min? | 1/2 the dose
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| _______ is a sulfonamide | Zonisamide (Zonegran). May not work in a sulfa-allergy patient
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| __________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
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| 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
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| Nephrolithiasis, open angle glaucoma, hypohidrosis are serious AE's of | Topiramate
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| Hyponatremia is an AE of | Oxcarbazepine (more common in the elderly)
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| Lamictal is what pregnancy category? | Category C
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| ________ has the greatest risk of teratogenicity and should be avoided during pregnancy and in women of childbearing age | Valproic Acid
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| Stevens Johnsons is a severe AE that can be caused by | Lamictal
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| Low-albumin states is concerning in a patient taking which seizure medication? | Phenytoin
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Created by:
ltm12