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Chp 15 Antiepileptic

Lee College Nursing Program Exam 5 Chp 15:Antiepileptic

QuestionAnswer
Define: seizure Excessive stimulation of neurons in the brain leading to a sudden burst of abnormal neuron activity that results in temporary changes in brain function, primarily affecting sensory and motor activity
Define:Convulsion Involuntary spasmodic contractions of any or all voluntary muscles throughout the body, including skeletal and facial muscles
Define: Epilepsy Chronic, recurrent pattern of seizures
Define: Primary epilepsy Epilepsy in which there is no identifiable cause. aka idiopathic (This occurs in 50% of patients with epilepsy)
Define:Secondary epilepsy Epilepsy where there is a distinct cause such as trauma, infection, cerebrovasular disorder, or other illness.
Seizures are classified into different categories based on their presenting features, name the 3 categories. 1. partial onset 2. generalized onset 3. unclassified
Generalized onset seizures were formally known as ______. Grand mal seizures
Which type of seizures have convulsions? Generalized onset seizures: the subtype tonic-clonic seizures
Generalized onset seizures have several subtypes name the 4 listed in the book: 1. tonic-clonic 2. Atonic aka drop attacks 3. Myoclonic attacks 4. Absence seizures
Of the 4 subtypes of a generalized onset seizures, which one is described as brief muscle jerks, but not extreme Myoclonic
Of the 4 subtypes of a generalized onset seizures, which one is described as a brief loss of awareness that commonly occurs with repetitive spasmodic eye blinking for up to 30 seconds. absence seizures
In regards to a tonic-clonic seizure describe the clonic half and the tonic half. tonic is the rigged/tenseness clonic is the convulsion
Name the 3 types of partial onset seizures 1. simple partial onset seizures aka petit mal seizure 2. complex partial onset seizure 3. secondary generalized tonic-clonic seizures
Of the 3 types of partial onset seizures which one is described by a brief loss of awareness (blank stare)without a loss of consciousnesses or spasmodic eye blinking as in absence seizures? simple partial onset seizure
Of the 3 types of partial onset seizures which two are associated with postictal confusion? complex and secondary generalized tonic-clonic seizures
in a complex partial onset seizure in the level of consciousness completely lost? no only reduced
What is a unclassified seizure? One that does not fit into any of the other categories
Describe status epilepticus multiple seizures occur with no recovery between them usually treated with IV diazapam
What is goal of AEDs? to control or prevent seizures while maintaining a reasonable quality of life to minimize adverse effects and drug induced toxicity
AED therapy usually last how long? life long
When starting AED therapy the prescriber will always try ____-drug therapy before _____-drug therapy single multiple
If a patient has been free from seizures for 1-2 years can they stop taking their medicine? yes, some may be able to discontinue AED therapy
what is a febrile seizure? a seizure caused by fever than occurs in from 6 months to 5 years
Do most epileptics take 1 drug or many to treat their condition? 70% will only take 1 drug
Are AEDs needed when a person has only had 1 seizure (isolated episode)? no, only after 2 or more
How do AEDs work? Mechanism of action? AED therapy must: They reduce excitability They prevent generation and spread of excessive electrical discharge from abnormally functioning nerve cells They protect surrounding normal cells
AEDs are thought to alter the movement of sodium, potassium, and calcium ions across nerve cells in the brain which causes: reduction in the nerve's ability to be stimulated suppresses transmission of impulses from one nerve to the next decreases the speed of nerve impulse conduction within a neuron
What is the overall effect of AEDs? Neurons are stabilized Neuron hyper-excitability is decreased Speed of excessive nerve impulses is decreased
Antiepileptic drugs are indicated for? the prevention or control of seizure activity long term maintenance therapy for chronic, recurring seizures acute treatment of convulsions and status epilepticus
In 2008, the FDA put a Black Box warning on AEDs for what? suicidal thoughts and behavior
What are the long-term therapy with phenytoin may cause _____,_____,_____ and _______ gingival hyperplasia, acne, hirsutism, Dilanin facies
What is an auro, when dealing with epileptic patients? a unique sign/flash/smell that a epileptic person has prior to a seizure
When assessing a epileptic patient always ask: when was your last seizure
Nursing Implications: With oral drugs remember they must be taken ______ and with _____ at the same time every day meals
If patient is NPO for a procedure, what do you do regarding AED oral dosage contact doctor
If a patient has a problem swallowing pills, is there a liquid AED? yes
What type of saline is used with IV phenytoin? normal saline ONLY
What adverse effects must a nurse monitor for regardind AEDs? Mental status changes mood changes changes in the level of consciousness eye problems sore throat fever
Patients taking AEDs are encouraged to get what every year? an eye exam
There are three classes of anti-epileptic, what are they? barbiturates, hydantoins and iminostilbenes as well as valproic acid
What type of AED is known to worsen myoclonic or absence seizures, therefore this drug never be given to people with myoclonic or absence seizures carbamazepine
Phenobarbital, phenytoin, carbamazepine and valproic acid are equally effective for what type of seizures? partial onset seizures
What is the drug of choice for convulsions and status epilepticus? diazepam
Patients who undergo brain surgery or who have experienced severe head injuries may receive ________anti-epileptic therapy. prophylactic
Adverse effects of barbiturates dizziness drowsiness lethargy paradoxical restlessness excitement nausea
Adverse effects of hydantoins nystagmus ataxia dizziness drowsiness rash gingival hyperplasia
Adverse effects of carbazepine nausea headache dizziness drowsiness unusual eye movements visual changes mental and mood changes behavioral changes
Adverse effects of valproic acid dizziness, drowsiness, GI upset, weight gain, hair thinning, ankle edema,hepatotoxicity, pancreatitis
Adverse effects of diazapam apnea (brief pauses in breathing) hypotension somnolence (sleeping for unusually long periods)
What is the first line drug used for tonic-clonic and partial seizures? Dilantin
What is the first line drug used for partial and generalized tonic-clonic seizures? **that will worsen myoclonic and absence seizures** tegretol
_______is used to treat absence,myoclonic, and tonic-clonic seizures? depakote
a type of epilepsy with an unknown cause primary
potential adverse effect of valproic acid hepatotoxicity
a brief episode of abnormal electrical activity in the nerve cells of the brain seizure
IV administration of antepileptic drugs should be delivered this way to avoid serious adverse effects slowly
A type of epilepsy with a distinct cause secondary
an involuntary spasmodic contraction of voluntary muscles throughout the body convulsion
this class of drugs is one of the 1st line drugs used to treat status epilepticus benzodiazapines
another name for primary epilepsy idiopathic
a barbiturate used primarily to control tonic-clonic and partial seizures phenobarbital
the metabolic process that occurs when the metabolism of a drug increases over time, which leads to lower than expected drug concentrations autoinduction
recurrent episodes of convulsive seizures epilepsy
a first line antiepileptic drug, the long term use of which can cause gingival hyperplasia phenytoin
A patient has been taking antiepileptic drugs for a year. The nurse is reviewing his recent history and will monitor for which condition that may develop during this time? suicidal thoughts or behavior
Created by: 1169633373