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NURS 572 epilepsy
Epilepsy, spasm, spasticity, local anesthetics
| Question | Answer |
|---|---|
| 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
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