Traditional AEDs
Help!
|
|
||||
|---|---|---|---|---|---|
| Phenytoin aka | Dilantin
🗑
|
||||
| Dilantin is used for what? | Seizures of all types except absence, often with generalized, tonic/clonic, and status ep. And cardiac problems. Narrow therapeutic range.
🗑
|
||||
| Dilantin administration | PO with meals to decrease GI distress, IM not recommended (painful, erratic absorption, crystallizes causing necrosis, NEVER Sub q. Highly alkaline
🗑
|
||||
| Dilantin IV admin. | IV not greater than 50mg/min (elderly 5-10mg/min) b/c dysrhytmias, CV collapse, dropped BP.
🗑
|
||||
| Dilantin Action | inhibits N+ channels, suppresses action potentials, inhibits spread of seizure activity in motor cortex.
🗑
|
||||
| OD/ Toxic SEs of Dilantin | double or blurred vision, N, V, ataxia, slurred speech, CV collapse, CNS depression, confusion, hallucinations, sleepy
🗑
|
||||
| SE of Dilantin | rash (D/C drug), hirutism, constipation, drowsy, ginigcal hyperplasia, folic acid deficiency, hyperglycemia, dicolors urine (pink to red-brown)
🗑
|
||||
| What if a female is on BC? (Dilantin | She needs to use another form of BC other than OC or increase the OC dosage
🗑
|
||||
| Effects of Dilantin | Decreases effect of warfarin (blood thinner), ETOH increases durg metabolism
🗑
|
||||
| Teaching with Dilantin | reduce drug gradually, metabolized by liver, excreated in urine (alkaline urine enhances excretion)
🗑
|
||||
| What is Dilantin frequently combined with? | Phenobarb
🗑
|
||||
| Barbiturates aka | Phenobarbital, prototype
🗑
|
||||
| What is a barbituate? | a long acting, widely used, oldest, cheap, AED with few SEs
🗑
|
||||
| Barbiturates action | potentiates effect of GABA. TR: 15-45
🗑
|
||||
| What are barbiturates used for? | generalized, tonic/clonic, febrile in infant, alternate for status ep, sedative/ sleep induction
🗑
|
||||
| Why would you not give barbiturates to school age children? | Intellectual decline
🗑
|
||||
| SE of barbiturates | drowsiness, lethary, dizziness, resp depression, broncospasm, dependency with L-T use, N, V, folate deficiencies, male impotence
🗑
|
||||
| Adverse SE of barbiturates | neurotoxicity, hematologic depression
🗑
|
||||
| NI with barbiturates | patent airway, resuscitatibe equipment, safety--sedative/hypnotic effects, routine CBC, use another form of BC other than OCs
🗑
|
||||
| Barbiturates with children | can cause birth defects, paradoxical response is irritability/hyperactivity
🗑
|
||||
| Valproic Acid aka | Depakene, Depakote
🗑
|
||||
| What is Valproic Acid's action? | Blocks sodium channels, suppresses calcium influx, and increaess GABA which has an inhibitory effect on synapses
🗑
|
||||
| What is Valproic Acid used for? | treat absence, myoclonic, tonic/clonic. TR: 40-100 (lower = seizure, higher = toxic)
🗑
|
||||
| SEs of valproic acid | N, V, indigestion, prolongs bleeding time, possible fatal hepatoxicity--watch for decreased appetite, malaise, abd pain, jaundice
🗑
|
||||
| What is valproic acid also used for? | bipolar disorder and prophylaxis of migraine HA
🗑
|
||||
| Contraindications of valproic acid | pregnant-->birth defects (NTD)
🗑
|
||||
| Carbamazapines aka | Tegretol
🗑
|
||||
| Tegretol's action | delays neuronal discharge around seizure foci by acting on sodium channels
🗑
|
||||
| What is tegretol used for? | generalized, tonic/clonic, simple and complex partial in both children (over 5) and adults. Not for absence. #1 drug for partial. Bipolar disorder, trigeminal, and glossopharyngeal neuralgias
🗑
|
||||
| What is tegretol similar to? | Dilantin, but with fewer SE (GI upset, dry mouth)
🗑
|
||||
| NIs with tegretol | Blood counts initially and periodically, check for hematologic toxicity (bone marrow depression, aplastic anemias)
🗑
|
||||
| what are S&S of blood abnormalities with tegretol | fever, sore throat, pallor, weakness, infection, easy bruising, petechiae
🗑
|
||||
| SE with tegretol | CHF: crackles, water retention, dependent edema, daily weight---rashes, photosensitivity, necrosis, Stevens-Johnson syndrome
🗑
|
||||
| Ethosuximide aka | Zarontin
🗑
|
||||
| What is Zarontin used for? | Drug of choice for absence seizures in children and adults (Celontin, Milontin)
🗑
|
||||
| Contraindications for Zarontin | yellow dye #5 allergy. Take with meals!
🗑
|
||||
| Action of Zarontin | depresses nerve transmission in motor cortex, raises seizure threshold
🗑
|
||||
| SE with Zarontin | N, V, drowsy, blood dyscrasis, discolors urine
🗑
|
||||
| Primidone aka | Mysoline
🗑
|
||||
| What is Primidone used for? | all major seizure disorders except absence. Nearly identical in structure to phenobarbital
🗑
|
||||
| Golden rule with primidone | Rule with another AED (phenytoin, carbamazepine) but NEVER with phenobarbital
🗑
|
||||
| Adverse effects with Primidone | sedation, ataxia, dizziness, confusion in the elderly, paradoxical hyperexcitability in children
🗑
|
||||
| Serious SE with primidone | psychosis, leuropenia, thrombocytopenia, systemic lupus erytematosus
🗑
|
||||
| What are benzodiazepines useful for? | As adjunctive and in Status Epx
🗑
|
||||
| Action of benzodiazepines | increase availability of inhibitory neurotransmitter GABA to brain neurons
🗑
|
||||
| Diazepam | Valium: restricted to acute tx of status ep and tonic/clonic. Parenteral, short acting, give repeatedly. 10mg: admin. 2mg/min
🗑
|
||||
| Clonazepam | Klonopin: only one in class used for L-T tx. Long acting, used for absence, atonic, myoclonic
🗑
|
||||
| Lorazepam | Ativan: status ep. IV-prolonged effect up to 24 hrs. Not faster than 2mg/min
🗑
|
||||
| what to check for with lorazepam? | physical dependence, check baseline VS, decreases HR, RR, BP, shorter acting. TAPPER OFF
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
Keller_KI
Popular Pharmacology sets