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NURS 572 epilepsy

Epilepsy, spasm, spasticity, local anesthetics

MOA of antiepileptics - broadest spectrum decrease Na influx, decrease Ca influx, increase GABA
broadest spectrum antiepileptic valproic acid = VPA
valproic acid ADRs hepatatoxic, teratogenic, pancreatitis, NO CNS EFFECT
broad spectrum, most preferred antiepileptic carbamazepine
MOA valproic acid decrease Na/Ca influx, increase GABA
MOA carbamazepine selectively inhibit Na channels
carbamazepine unique metabolism increases the rate of its own metabolism
drug for partial seizures/tonic-clonic seizures phenytoin
phenytoin dosing problem small dose change can result in HUGE increase in serum levels
absence/petit-mal antiepileptic ethoxsuximide
additional antiepileptics lamotrigine
additional antiepileptic that can cause oral-cleft abnormalities if fetus exposed topiramate
MOA of local anesthetics block Na channels, non-selective action in PNS
name an ester local anesthetic that can be used with epinephrine procaine
name an alkaloid ester that CANNOT be used with epinephrine and CANNOT be used in cardiac pts cocaine
name an amide local anesthetic that is widely used lidocaine
muscle spasm - 2 centrally acting drugs diazepam, tizanidine
what drug is effective for BOTH spasm and spasticity diazepam
what centrally acting spasm drug is hepatatoxic tinzanidine
what is the MOA of muscle spasticity it is of CNS origin - like MS, CP, CVA, spinal cord trauma
3 centrally acting drugs for spasticity baclofen, diazepam, dantrolene
baclofen spasticity agent, no antidote
diazepam spasm AND spasticity - mimics GABA
dantrolene spasticity drug, hepatatoxic, suppresses release of Ca from SR
other local anesthetics - name regconition tetracaine, chlorprocaine, bezocaine, dibucaine, bupivacaine, mepivacaine, pilocaine, articaine, levobupivacaine, ropivacaine
which class of local anesthetic has a lower incidence of allergic reactions? amide class, as in lidocaine
general SEs of local anesthetics CNS: excitation followed by sedation CV: brady, hypoTN L&D: uterine contractions, depress fetus as above allergic reactions
why do we admin epinephrine with ester anesthetic procaine? prolongs duration (vasocon) with some SEs from eop
what local anesthetic has allergic reaction ADR ester-based procaine has this ADR
what locale anesthetic indicated for dysrhythmias lidocaine
Indication for cocaine EENT procedures
MOA for centrally acting muscle relaxants unclear - inhibition at presynaptic motor neurons in CNS, global CNS sedation, suppression of spinal motor reflext
MOA diazepam enhanced GABA
MOA tizanidine Alpha-2 agonist in skeletal muscle
MOA Baclofen acts in spinal cord to suppress hyeractive reflexts. No direct effect on skeletal muscle
which antiepileptics have SE of CNS effect, starting with nystagmus carbamazepine, phenytoin (and maybe ethoxsuximide which also has CNS SEs)
which antiepileptic interacts with grapefruit juice carbamazepine
MOA of ethoxsuximide inhibit Ca channels in hypothalamus
name recognition anti-epileptics oxcabazepine, gabapentin, pregabalin, tiagabine, levetiracetam, vigabatrin, zonisamide, felbamate
Created by: lorrelaws