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seizures slick
seizure drugs
| Question | Answer |
|---|---|
| absence seizure | seizure with a loss or reduction of normal activity, including staring and transient loss of responsiveness |
| atonic seizure | very short lasting seizure during which the patient may stumble and fall for no apparent reason |
| convulsions | uncontrolled musclue contraction or spasm that occurs in the face, torso, arms or legs |
| eclampsia | pregnancy induced hypertensive disorder |
| epilepsy | disorder of CNS characterized by seizures and/or convulsions |
| febrile seizure | tonic-clonic motor activity lasting 1-2 minutes with rapid return of consciousness that occurs in conjunction with elevated body temperature |
| generalized seizure | seizures that travel throughout the entire body |
| myoclonic seizure | seizure characterized by brief, sudden contractions of a group of muscles |
| partial (focal) seizure | seizure that starts on one side of the brain and travels a short distance before stopping |
| seizure | symptom of epilepsy characterized by abnormal neuronal discharges within the brain |
| status epilepticus | condition characterized by repeated seizures or one prolonged seizure attack that continues for at least 30 minutes |
| tonic-clonic seizures | seizure characterized by intense jerking motions and loss of consciousness |
| Phenobarbital | luminal |
| diazepam | valium |
| phenytoin | dilantin |
| valproic acid | depakote |
| ethosuximide | zarontin |
| drugs that potentiate GABA action | barbiturates and benzodiazepines |
| a seizure is clinical sign of | epilepsy |
| seizure | a disturbance of electrical activity in the brain |
| convulsions | refer to involuntary, violent spasms of the large skeletal muscles of the face, neck, arms and legs |
| Antiseizure drugs can cause _____ deficiency | folate (neural tube defect) |
| seizure symptoms | sudden violent shaking; total loss of consciousness; muscle twitching or slight tremor or a limb; staring into space; altered vision; difficult speech |
| 3 classes of seizures | partial, general, special syndromes |
| this type of seizure is a medical emergency and is repeated continuously | status epilepticus |
| status epilepticus can lead to: | hypoglycemia, acidosis and hypothermia due to increased metabolic needs, lactic acidosis and heat loss |
| status epilepticus important to do | maintain airway;give valium |
| Anticonvulsant drugs goal: | prevent or control seizures while maintaining a reasonable quality of life |
| Anticonvulsant drugs therap goal | reduce incidence while minimizing drug toxicity |
| repeated seizures will occur if AED levels are not ___ _____ | kept constant |
| serum drug levels _____ in determining drug concentration | assist |
| serum drug concentrations are useful___ | guidelines |
| slowly ____ to lowest effective serum level that _______ seizure disorders. this will ____ and _____ | titrate/control; decrease adverse effects and decrease interactions |
| goal of antiseizure pharm | suppress neuronal activity just enough to prevent abnormal or repetitive firing |
| 3 Mech of actions for antiseizure drugs | when the receptor GABA is stimulated by the antiseizure drug, chloride ions move into the cell and suppress the firing of neurons; delay influx of sodium into the neuron; delay influx of calcium into the neuron |
| AED's have a ____ therapeutic index | narrow |
| barbiturate example | phenobarbital (luminal) |
| Luminal treats | variety of seizures and insomnia |
| luminal mech | enhances the action of the GABA neurotransmitter which suppresses abnormal neuronal discharges without causing sedation |
| luminal drug-drug | many; do not give with CNS depressants-respiratory depression |
| Luminal dosing | once a day |
| luminal is drug of choice for ___ | neonatal seizures |
| luminal adverse | drowsiness, hypotension, laryngospams |
| luminal assess | risk for respiratory depression, bruising, petechiae, epitaxis, GI bleeding, menorrhagia and hematuria, vit d deficiency, folate or b-9 and b-12 deficiency |
| luminal labs | CBC, H&H |
| luminal adverse really got to know | folate or b-9 and b-12 deficency |
| luminal route | parenteral is a soft tissue irritant; IV rarely used bc of extravasations and necrosis (vasoconstricts so no blood flow) |
| benzodiazepine drug | diazepam/valium |
| parenteral valium used as | first line tx to terminate status epilepticus |
| valium-treatment of epilepsy | serves as an adjunct, not given alone to treat seizures |
| valium is drug of choice due to | quick onset |
| valium route | im, oral, (IV-rectal gel-quick onset) |
| valium half life | 20-80 hrs |
| valium: short or long term treatment | short term |
| valium: herbal supplements | may react |
| IV valium monitor | hypotension, tachycardia, resp depression and musclular weakness |
| valium mech | binds to GABA recptor. supresses the neuronal foci and subsequent impulses that cause seizures |
| hydantoin drug | phenytoin/dilantin |
| dilantin treats | all types of seizures except absence seizures |
| absence (petit mal) presents | lasts |
| dilantin mech: | desensitizing sodium channels in CNS responsible for neuronal response; acts an an antidysrhythmic activity |
| dilantin route IV info | Iv: mix with saline. prime and flush with saline before and after hanging dilanting; needs its own line |
| dilantin Iv more info | use a filter; large vein; purple glove syndrome |
| dilantin adverse short term | HA, ataxia, hypoglycemia, dysrhythmias; ventricular fibrillation or bradycardia, hypotension, hyperglycemia, confusion, insomnia, slurred speech and blood dyscrasias; aplastic anemia and agranulocytosis. skin rxns; rashes (affects vitamin K) |
| dilantin adverse long term | gingival hyperplasia, acne, hirsutism, "dilantin facies' (hypertrophy of subq facial tissue), osteoporosis (may need vitamin D therapy) |
| dilantin route | IV, PO/ twice or once a day |
| dilantin interactions | anticoagulants, cardiac and herbal supplements, etc |
| dilantin drug-drug | anticoagulants, cardiac |
| dilantin herbal/food | herbal laxatives may increase potassium loss |
| dilantin labs | may increase serum levels of glucose and alkaline phosphatase, CBC, h&h |
| seizure drugs miscellaneous agents | valproic acid/depakote, depakene |
| depakote treats | generalized seizures and shown to control partial seizures; migraines and bipolar |
| depakote mech | desensitizing sodium channels in CNS responsible for neuronal response; |
| depakote drug-drug first part | aspirin, cimetidine,erythromycin, warfarin |
| depakote instructions (taking) | don't mix with carbonated beverages, triggers immediate relase. don't chew ER tablets; you can open the capsule and sprinke on soft food |
| depakote side effects | mouth sores if pt chews ER tablets |
| depakote food instructions | take with food to decrease GI upset |
| depakote adverse | sedation, drowsiness, GI upset, PROLONGED BLEEDING TIME, weight gain, muscle weakness, N/V, tremors and transient hair loss; fatal hepatoxicity or pancreatitis (amylase&lipase) |
| Succinimides drug | ethosuximide-zarontin |
| zarontin drug of choice for these seizures | absence (petit mal) |
| zarontin mech of action | delays calcium influx |
| zarontin ask if allergic to | sulfa |
| zarontin d/c | abrupt may induce grand mal |
| zarontin obtain a before giving | medical hx to confirm baseline seizure activity, renal and hepatic fxns |
| zarontin side effects | drowsiness, h/a, fatigue, dizziness, depression or euphoria, N/V, diarrhea, weight loss, sleep difficulties, hiccups, ab pain, EXTREME MOOD SWINGS, SUICIDAL INTENT |
| zarontin: OD symptoms | CNS depression, stupor, ataxia, tongue swelling and coma |
| RN diagnosis antiseizure | low self esteem, impaired social interaction, deficient knowledge, risk for injury |
Created by:
bamababe