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Antiepileptic AEDs
for Test 2 - K Wolz podcast
| Question | Answer |
|---|---|
| What is significant to include in your report of seizure activity? | Note time & signs; Observe parts of the body involved; Check for deviation of eyes- Nystagmus; Assess resp. pattern; Note tonic clonic movements; |
| What is most important post-ictal (after seizure)? | Maintain patent airway (proper positioning); Provide adequate oxygenation; Maintain vascular access (Start IV); Adminiter approp. meds; Maintain seizures precautions; Evaluate patient; |
| Why is the content of your report of seizure activity so important? | Because it is the data with which the physician will make a diagnosis. |
| What is the patients' condition postictally? | Sleepy, lethargic, reports headache, arousable, |
| Is oxygen given postictally? | If there is oxygen in the room, Kathy would give it, but she wouldn't leave the room to go get oxygen. |
| What are seizure precautions? | Put the HOB in low position; use side rails; pad side rails (if nec/if P&P); Oxygen and suction should be set up; Assign the patient to a room near the nurses station. |
| Why don't they use a bite block or tongue depressor anymore? | Because of the damage that is done to the teeth. |
| Will the patient be up ad lib? | Instruct the patient to call for assistance in ambulating as a precaution. |
| In what type of seizures is Klonipin (Clonazepam) of greatest value? | Absence seizures, infantile spasms, and myoclonic seizures (petite mal). |
| When are absence and myoclonic seizures most common? | In the first year of life. |
| What are the side effects of Klonipin (Clonazepam)? | Drowsiness, ataxia, and behavioral disturbances; aggression, irritability and agitation. |
| What is the protocol for discontinuing Klonipin (Clonazepam)? | Taper off over several weeks; Do not discontinue quickly after long term use. Risk for increased restlessness, irritability, insomnia, and hand tremors. |
| What class of drug is Klonipin (Clonazepam)? | Benzodiazepine and Anticonvulsant |
| What is the use of Klonipin (Clonazepam) in Psych patients? | Anti-anxiety, so of course it SLOWS things down. |
| Why can seizures reoccur even while a patient is taking Klonipin (Clonazepam)? | Because 1/3 of patients develop a drug tolerance |
| What is the purpose of Klonipin (Clonazepam)? | To PREVENT a seizure. It cannot STOP a seizure that is occurring. |
| TEGRETOL is a BIG drug! It is a mainstay of seizure treatment and you NEED to know it!! What types of seizures does Carbamazepine (Tegretol)treat? | Partial seizures and Tonic-Clonic seizures. |
| What labs must be drawn and how often when on Carbamazepine (Tegretol)? | Blood levels must be drawn q3mos. |
| What is the therapeutic blood level for Carbamazepine (Tegretol)? | 6-12mg/L |
| What is the effect of Carbamazepine (Tegretol) toxicity? | Bone marrow depression, cardiovascular collapse, and blood dyscrasias. |
| With which drugs does Carbamazepine (Tegretol) interact? | Warfarin, Phenobarbital, and Oral Contraceptives. |
| What is the interaction between Warfarin and Carbamazepine (Tegretol)? | Tegretol will diminish the anticoagulant effect of warfarin. Monitor the PT and increase the dosage of Warfarin, if necessary. |
| What is the interaction between Phenobarbital and Carbamazepine (Tegretol)? | Tegretol enhances the metabolism of both these agents. Monitor for increased seizure activity. |
| What is the interaction between Oral Contraceptives and Carbamazepine (Tegretol)? | Tegretol enhances the metabolism of estrogens. Use of other forms of birth control is recommended. |
| What side effects should you watch for with Carbamazepine (Tegretol)? | Drowsiness, n/v, blurred vision and headaches. |
| What is important patient education about taking Carbamazepine (Tegretol)? | Do NOT take with Grapefruit juice!! |
| What does it mean that Carbamazepine (Tegretol) is teratogenic? | It crosses the placental barrier and can cause birth defects. |
| Which antiseizure medication also treats Trigeminal Neuralgia? | Trileptal |
| Which types of seizures does Trileptal treat? | Partial seizures, and Primary generalized, tonic-clonic seizures |
| Which other drug is most like Trileptal? | Carbamazepine (Tegretol) |
| Be aware of which drugs should be taken with meals and require lab tests. (Most, but WHICH) | You do NOT have to memorize Zarontin or Mysoline. |
| Barbiturates (Phenobarbital) is a BIG drug that you NEED to know! Which seizures is it used for? | Tonic-clonic, partial and febrile seizures. |
| Which type of seizure is Phenobarbital NOT used for? | Absence seizures. |
| Phenobarbital is usually used in COMBINATION with other drugs. Give an example. | Phenobarbital and Dilantin |
| Phenobarbital is a Barbiturate, so what will the side effects be in an adult? | It is going to SLOW everything down. It will make an adult sleepy. Drowsiness, dizziness, lethargy, n/v, rash. |
| What are the side effects of Phenobarbital in a child? | Irritability, hyperactivity, and depression, but it has been around a long time and is used ALLOT in Pediatrics. |
| What is the Therapeutic level for Phenobarbital? | 15-40 ug/mL |
| How long does it take to reach a plateau on Phenobarbital and why? | It will take several weeks to reach a plateau, because it has a LONG half-life. |
| For what unique property of Phenobarbital is it known for having the "LEAST"? | Least teratogenic effects. So, it may be used in a patient who is trying to get pregnant. |
| What is an important patient education issue for patients on Phenobarbital? | In a drug test, they will test positive for Barbiturates. |
| STOPPED AT 11:00 MARK | . |
Created by:
Kitty Groebli
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