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Antiepileptics 23
MSC pharm antiepileptics 23
| Question | Answer |
|---|---|
| generalized seizures | begin in one area of the brain and rapidly spread throughout both hemispheres of the brain |
| partial seizures | begin in a one area of the brain and remain, may look alert with eyes open |
| Tonic-clonic seizures | grand mal, muscle contractions, loss of consciousness, recovery (confusion and exhaustion) |
| absence seizures | petit mal, brief 3-5 seconds loss of consciousness, may be overlooked, common in children disapear in puberty |
| Myoclonic seizures | short, sporadic periods of muscle contractions last for several minutes, rare and (often secondary seizures) |
| Febrile seizures | 104-105 high fevers, involve convulsions, self limited and do not reappear |
| Status epilepticus | most dangerous seizures, rapidly recur again and again |
| simple partial seizures | occur in a single area of the brain and may involve a single muscle movement or sensory alteration |
| complex partial seizures | involve complex sensory changes (hallucinations, mental distortion, loss of consciousness and social inhibitions). Motor changes may include involuntary urination, chewing motions, diarrhea etc. |
| Hydantoins | Stabilize nerve membanes and limit the spread of excitability from the intiation focus |
| Hydantoins Adverse reactions | nystagmus, ataxia, slurred speech and gingival hyperplasia, don't use ALCOHOL |
| Hydantoins | phenytoin (Dilantin) |
| phenytoin (Dilantin) | trts tonic-clonic and status epilepticus, prevents & treats seizures after neurosurgery, use for grand mal seiz. and migraines.1. serum (blood) 10-20mcg/ml 2. heart arrhythmias 3. use IV slowly w/ saline 4. urine pink or brown 5. promote good dental hyg. |
| Barbiturates and Barb.-like drugs | CNS depressants; inhibit impulse conduction in the ascending RAS, 1. depress cerebral cortex 2. depress motor nerve output 3. alter cerebullar function; all 3 can cause deep coma |
| Barbiturates and Barb.-like drug indications | long term treatment of generalized seizures and emergency control of certain acute convulsive episodes |
| Barbiturates and Barb.-like drug Adverse Reactions | somnolence, insomnia, vertigo, hallucinations and anxiety |
| Barbiturates and Barb.-like drugs | phenobarbial (Solfoton, Luminal) |
| phenobarbial (Solfoton, Luminal) | emergency control of status spilepticus and acute seizures; management of tonic-clonic and cortical focal seizures; treatment of simple partial seizures, use for high fever and children under 5 |
| phenobarbial (Solfoton, Luminal) action | 1. use w/ dilantin 2. therapeutic serum range 15-40mcg/ml 3. high half life 4. long duration 10-16hrs |
| Benzodiazepines action | potentiate the effects of GABA, an inhibitory neurotransmitter that stablizes nerve cell membranes |
| Benzodiazepines indications | muscle to relax and adjunct in status epilepticus and severe recurrent seizures; acute alcohol withdrawal |
| Benzodiazepines | diazepam (Valium) |
| diazepam (Valium) | useful in relieving tension, anxiety, and muscle spasm; alcohol withdrawal (IV,IM, rectal) |
| diazepam (Valium) side effect | respiratory depression |
| lorazepam (Ativan) | tranquilizer used to treat anxiety and tension and insomnia |
| Succinimides | 1. modulate the inhibitory neurotransmitter GABA 2. suppress the abnormal activity in the brain 3. treat absence seizures and petit mal seizures |
| Succinimides cautions | hepatic or renal disease |
| Succinimides adverse reaction | blurred vision |
| Succinimides | ethosuximide (Zarontin) |
| Hydantoins cautions | renal or hepatic disease |
| ethosuximide (Zarontin) | drug of choice for treating absence seizures |
| ethosuximide (Zarontin) effects | hair loss, itching, bone marrow depression |
| treating partial seizures action | 1. treat partial seizures 2. stabilize nerve membranes (altering sodium, calcium channels, and increasing activity of GABA) |
| drugs for treating partial seizures contraindications | bone marrow suppression and hepatic dysfunction (renal stones) |
| drug treating partial seizures | valproic acid (Depakene), gabapentin (Neurontin), carbamazepine (Tegretol), lamotrigine (Lamictal) |
| valproic acid (Depakene) | treat absence (petit mal) seizure and migraines, reduce abnormal electrical activity in the brain (toxic to liver) |
| gabapentin (Neurontin) | treat partial seizures, postherpetic pain, pain for shingles (don't give with antiacid) |
| carbamazepine (Tegretol) | treat partial seizures and bipolar disorders, trigeminal neuralgia |
| lamotrigine (Lamictal) | treat partial seizures, long term bipolar disorders (rash, toxic for pregnancy and breast feeding) |
| nursing implications | 1. patient understanding 2. take meds everyday 3. no ambulance 4. note seizure 5. no alcohol 6. wear ID 7. monitor blood level 8. do not drive 9. Dilantin and Depakote cause birth defects |
| Hydantoins | phenytoin (Dilantin) |
| phenytoin (Dilantin) | trts tonic-clonic & status epilepticus, prevents & treats seizures after neurosurgery, use for grand mal seiz. & migraines. 1. serum (blood) 10-20mcg/ml 2. heart arrhythmias 3. use IV slowly w/ saline 4. urine pink or brown 5. promote good dental hyg. |
| Barbiturates and Barb.-like drugs | phenobarbial (Solfoton, Luminal) |
| phenobarbial (Solfoton, Luminal) | emergency control of status epilepticus and acute seizures; management of tonic-clonic and cortical focal seizures; treatment of simple partial seizures, use for high fever and children under 5 |
| Benzodiazepines | diazepam (Valium) |
| diazepam (Valium) | useful in relieving tension, anxiety, and muscle spasm; alcohol withdrawal (IV,IM, rectal) |
| lorazepam (Ativan) | tranquilizer used to treat anxiety and tension and insomnia |
| Succinimides | ethosuximide (Zarontin) |
| ethosuximide (Zarontin) | drug of choice for treating absence seizures |
| drug treating partial seizures | valproic acid (Depakene), gabapentin (Neurontin), carbamazepine (Tegretol), lamotrigine (Lamictal) |
| valproic acid (Depakene) | treat absence (petit mal) seizure and migraines, reduce abnormal electrical activity in the brain (toxic to liver) |
| gabapentin (Neurontin) | treat partial seizures, postherpetic pain, pain for shingles (don't give with antiacid) |
| carbamazepine (Tegretol) | treat partial seizures and bipolar disorders, trigeminal neuralgia |
| lamotrigine (Lamictal) | treat partial seizures, long term bipolar disorders (rash, toxic for pregnancy and breast feeding) |
Created by:
kaila731
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