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Chap - 22
PharmacologyHSC1149
| Question | Answer |
|---|---|
| medications used to reduce the number &/or severity of seizures in patients w/epilepsy | anticonvulsants |
| defined as recurrent paroxysmal disorder of brain function characterized by sudden attacks of altered consciousness, motor activity, or sensory impairment | epilepsy |
| based on type, severity, & cause of seizures | treatment of epilepsy |
| most epilepsy is __ | idiopathic |
| epilepsy can be associated with cerebrovascular disease, cerebral trauma, intracranial trauma, intracranial infection/fever, brain tumor, __ or __ | intoxication; chemical imbalance |
| anticonvulsive medication is not indicated for fever, hypoglycemia, or electrolyte imbalance, which are examples of | correctable epilepsy disorders |
| classifies seizures into 3 main categories | International Classification of Epilepsies & Epileptic Syndromes |
| bilaterally symmetrical & without local onset; includes grand mal and absence seizures | generalized seizure |
| complex symptomatology (temporal lobe/psychomotor seizures) | partial seizures |
| seizures with insufficient data to classify | unclassified |
| grand mal seizures are called | tonic-clonic |
| characterized by loss of consciousness, falling, & generalized tonic-clonic muscle contractions; usually lasts 2-5 min; urinary/fecal incontinence may occur | grand mal seizures |
| initial treatment of grand mal seizures includes __ preventing injury | only |
| if seizures are so frequent that patient does not regain consciousness between seizures, condition is known as | status epilepticus |
| medication treatment of choice for status epilepticus is __ __, or phenytoin, administered slowly | IV diazepam (Valium) |
| sometimes __ __ is given for grand mal seizures | IV phenytoin |
| absence epilepsy was previously called petit mal because of the | absence of convulsions |
| characterized by 10-30 sec. loss of consciousness w/no falling & usually occur initially in children | absence seizure |
| drug of choice for management of __ seizures is ethosuximide (Zarontin), and only effective for this type of epilepsy | absence |
| used in treatment of absence seizures when suximide is ineffective | clonazepam & valproic acid |
| sedation, dizziness/irritability, GI distress incl. anorexia, nausea, vomiting, or diarrhea, and rash & leukopenia are all __ __ of drugs for absence seizures | side effects |
| __ __ w/drugs for absence epilepsy applies to hepatic/renal disease, pregnancy/lactation, and pancreatitis (w/valproate) | extreme caution |
| stopping medications for absence seizures abruptly is | contraindicated |
| caused by lesion in temporal lobe; symptoms: confusion, impaired understanding & judgment, staggering, purposeless movements, bizarre behavior, & unintelligible sounds, but no convulsions | psychomotor seizures |
| __ seizures affect only one side of the body | unilateral |
| some patients have __ __ __ combining more than one type | mixed seizure patterns |
| it is important to observe/report __ & __ of seizures, as well as general responsiveness to medications | type; length |
| __ __ of grand mal & psychomotor seizures usually consists of phenytoin, frequently combined w/phenobarbital or valproic acid, administered orally | prophylactic treatment |
| the aim of drug therapy for epileptic patients is to prevent seizures without __ | oversedation |
| side effects of phenytoin frequently __ with continued treatment | decrease |
| sedation, ataxia, dizziness & headache; blurred vision, nystagmus & diplopia; gingivitis; GI distress incl. nausea, vomiting, anorexia, constipation or diarrhea; rash & dermatitis | side effects of phenytoin |
| life-threatening condition affecting the skin in which cell death causes the epidermis to separate from the dermis; dermatitis associated w/phenytoin use | Steven-Johnson syndrome |
| __ __ is a side effect of phenytoin use, and is treated with folic acid supplements | megoblastic anemia |
| __ is a side effects from phenytoin use, treated with vitamin D supplement | osteomalacia |
| __ is contraindicated, or to be used w/extreme caution, in patients w/kidney/liver disease, diabetes, CHF, bradycardia, heart block, hypertension, pregnant/lactating, hematological disease | phenytoin |
| abrupt DC of phenytoin is | contraindicated |
| used sometimes for partial, generalized, or mixed seizures | carbamazepine |
| cardiac, hematological, kidney, & liver __ are all side effects from carbamazepine | complications |
| carbamazepine with __ __ potentiates action & can increase risk of serious adverse effects | grapefruit juice |
| children are frequently treated with phenobarbital alone, for | febrile convulsions |
| the use of phenobarbital alone, in treatment of a child who is afebrile, is controversial because of | cognitive impairment |
| there is evidence that phenobarbital, phenytoin, & carbamazepine may have an adverse effect on __ & __ in children | behavior; cognition |
| primary advantage of newer formulations, of traditional anticonvulsants, is that there is an increased ease of __ & __ | administration; tolerability |
| anticonvulsants that usually do not require laboratory monitoring of therapuetic levels; fewer overall adverse effects & interactions | second-generation |
| second-generation anticonvulsants require a __ __ __ to avoid CNS adverse effects | slow titration period |
| determination of given component in solution by adding a liquid reagent of known strength until given endpoint reached, indicating that the component has been consumed by reaction w/reagent | titration |
| contraindicated in pregnancy/lactation; should not be abruptly discontinued | 2nd-generation anticonvulsants |
| patients taking anticonvulsants should be instructed: caution w/driving/operating machinery until __ with the medication, because of __ or dizziness | regulated; drowsiness |
| patients taking anticonvulsants should be instructed: careful __ __ until tenderness of gums subsides as treatment progresses | oral hygiene |
| patients taking anticonvulsants should be instructed to always take medication on time & never __ a dose | omit |
| __ __ from anticonvulsants can lead to status epilepticus | abrupt withdrawal |
| patients taking anticonvulsants should be instructed to always wear __ __ at all time in case of accident | Medic-Alert tag |
| 1st-generation anticonvulsant; taken for partial/mixes seizures (psychomotor); brand name for carbamazepine | Tegretol |
| 1st-generation anticonvulsant; taken for partial/mixes seizures (psychomotor); brand name for carbamazepine extended release form | Tegretol XR |
| 1st-generation anticonvulsant; taken for absence seizures; brand name for clonazepam | Klonopin |
| 1st-generation anticonvulsant; Caution: possible to confuse w/Celexa/Celebrex; brand name for fosphenytoin | Cerebyx |
| 1st-generation anticonvulsant; taken for grand mal, psychomotor, or focal seizures; frequently combined w/phenobarb; brand name for phenytoin | Dilantin |
| 1st-generation anticonvulsant; taken for absence seizures; brand name for ethosuximide | Zarontin |
| 1st-generation anticonvulsant; taken for absence, partial, & tonic-clonic seizures; brand name for Valproic acid | Depakene, Depakote, Depacon |
| 1st-generation anticonvulsant; taken for absence, partial, & tonic-clonic seizures; only one dose/day extended release form; brand name for Valproic acid | Depakote ER |
| 2nd-generation anticonvulsant; taken for partial seizures; minimal drug interactions; >dose w/renal dysfunction; brand name for gabapentin | Neurontin |
| 2nd-generation anticonvulsant; taken for partial seizures; monitor liver function; Caution do not confuse w/Lamisil; brand name for lamotrigine | Lamictal |
| 2nd-generation anticonvulsant; taken for partial seizures; may affect cognitive function at high doses; brand name for topiramate | Topamax |
| common side effects of phenytoin include GI distress, ataxia, & __ | gingivitis |
| in absence epilepsy, convulsions are __ & there is a breif loss of consciousness w/no falling | absent |
| types of generalized seizures include __ & absence | grand mal |
| 2nd-generation anticonvulsant Neurontin is indicated for treatment of __ seizures | partial |
| an alternative medication sometimes used for partial, generalized, or mixes seizures is __ (Tegretol) | carbamazepine |
| grand mal seizures usually last from two to __ minutes | five |
| grand mal seizures are characterized by loss of consciousness, falling, & __ muscle contractions | tonic-clonic |
| 2nd-generation anticonvulsants have fewer side effects & drug interactions than __ medications | 1st-generation |
| remove objects that may cause trauma, cushion head & turn it to the side, & loosen tight clothing; these are the steps to take initially in the | treatment for grand mal seizures |
Created by:
lfrancois
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