Podcast
Questions and Answers
What effect does Phenytoin have on seizure activity following head trauma?
What effect does Phenytoin have on seizure activity following head trauma?
- Increases the frequency of electrical discharges
- Increases the risk of seizures post-surgery
- Reduces voltage and frequency of electrical discharges (correct)
- Has no effect on seizure activity
What condition is treated with Dobutamine?
What condition is treated with Dobutamine?
- Long-term myocardial depression
- Short term cardiac decompensation (correct)
- Pulmonary hypertension
- Chronic heart failure
Which receptor does Dobutamine primarily stimulate?
Which receptor does Dobutamine primarily stimulate?
- Muscarinic receptors
- Beta 2 receptors
- Alpha 1 receptors
- Beta 1 receptors (correct)
What side effect is commonly associated with Dobutamine administration?
What side effect is commonly associated with Dobutamine administration?
Why must ECG monitoring be performed when administering Dobutamine?
Why must ECG monitoring be performed when administering Dobutamine?
In patients undergoing surgical repair of congenital heart disease, what primary symptom might Phenytoin help manage?
In patients undergoing surgical repair of congenital heart disease, what primary symptom might Phenytoin help manage?
What is one of the adverse effects of digitalis intoxication that could be monitored?
What is one of the adverse effects of digitalis intoxication that could be monitored?
Which vital parameters should be assessed during Dobutamine treatment?
Which vital parameters should be assessed during Dobutamine treatment?
What is a primary use of Atropin®?
What is a primary use of Atropin®?
What neurotransmitter does Atropine block?
What neurotransmitter does Atropine block?
Which of the following symptoms might Atropine cause?
Which of the following symptoms might Atropine cause?
In which condition might the dosage of medication need to be increased due to faster drug metabolism?
In which condition might the dosage of medication need to be increased due to faster drug metabolism?
What adverse reaction should be monitored in cardiac patients when using Atropine?
What adverse reaction should be monitored in cardiac patients when using Atropine?
Which muscarinic effect does Atropine specifically inhibit?
Which muscarinic effect does Atropine specifically inhibit?
What is a side effect related to gastrointestinal function when using Atropine?
What is a side effect related to gastrointestinal function when using Atropine?
What condition is treated with anticholinergics as mentioned in the content?
What condition is treated with anticholinergics as mentioned in the content?
What is the primary use of Calcium Chloride 10% IV push?
What is the primary use of Calcium Chloride 10% IV push?
Which condition should calcium chloride be used cautiously in?
Which condition should calcium chloride be used cautiously in?
What complication is associated with the administration of calcium chloride?
What complication is associated with the administration of calcium chloride?
Which of the following conditions is treated with calcium chloride?
Which of the following conditions is treated with calcium chloride?
What is the recommended calcium level to maintain during treatment?
What is the recommended calcium level to maintain during treatment?
Which electrolyte imbalance can result from excessive use of calcium chloride?
Which electrolyte imbalance can result from excessive use of calcium chloride?
What should be monitored frequently when administering calcium chloride?
What should be monitored frequently when administering calcium chloride?
Which symptom might indicate a complication from intravenous calcium chloride administration?
Which symptom might indicate a complication from intravenous calcium chloride administration?
What is one of the primary uses of Calcium Gluconate 10%?
What is one of the primary uses of Calcium Gluconate 10%?
Which condition could be treated with Sodium Bicarbonate 8.4%?
Which condition could be treated with Sodium Bicarbonate 8.4%?
What is a potential side effect of Calcium Gluconate 10%?
What is a potential side effect of Calcium Gluconate 10%?
Which of the following is a function of Vitamin D in relation to calcium?
Which of the following is a function of Vitamin D in relation to calcium?
What is a critical consideration when administering Calcium products?
What is a critical consideration when administering Calcium products?
Which drug is used for both local anesthetic and antiarrhythmic purposes?
Which drug is used for both local anesthetic and antiarrhythmic purposes?
What is a common side effect associated with Lidocaine?
What is a common side effect associated with Lidocaine?
What monitoring action is essential when using antirrhythmic drugs like Lidocaine?
What monitoring action is essential when using antirrhythmic drugs like Lidocaine?
What is the primary action of the drug Dilantin® (Phenytoin) in managing seizures?
What is the primary action of the drug Dilantin® (Phenytoin) in managing seizures?
Why should a patient not stop taking the anticonvulsant medication abruptly?
Why should a patient not stop taking the anticonvulsant medication abruptly?
Which group of patients is mentioned as being more sensitive to the effects of drugs like phenytoin?
Which group of patients is mentioned as being more sensitive to the effects of drugs like phenytoin?
What potential reaction should be monitored when treating seizures?
What potential reaction should be monitored when treating seizures?
What adverse reaction is suggested to develop from the use of anticonvulsants?
What adverse reaction is suggested to develop from the use of anticonvulsants?
Study Notes
Anticonvulsants
- Phenytoin (Dilantin®) is used to manage seizures in various forms, including tonic-clonic, partial seizures, status epilepticus, eclampsia, febrile convulsions, neonatal seizures, and febrile seizures.
- Phenytoin elevates the seizure threshold, limiting the spread of seizure activity by inhibiting the transmission of cerebral cortex by the reticular activating system.
- Phenytoin reduces the voltage, frequency, and spread of electrical discharges within the motor cortex.
- Elderly patients are more sensitive to the effects of phenytoin, and it may produce paradoxical excitement in young children.
- Do not stop phenytoin abruptly as it may worsen seizures.
- Call the prescriber immediately if any adverse reactions develop.
- Monitor for reduced seizure electrical activity if treating with phenytoin.
- Look for QT prolongation when using phenytoin.
Adrenergic (Sympathomimetics)
- Dobutamine (Dobutrex®) is a vasopressor used for short-term treatment of adults with cardiac decompensation due to depressed myocardial contractility resulting from heart disease or cardiac surgery.
- Dobutamine stimulates beta 1 receptors in the heart, increasing contractility and cardiac output.
- Monitor ECG, blood pressure, cardiac output, and urine output when using dobutamine.
- The dose may need to be increased for cigarette and marijuana smokers because smoking causes the drug to be metabolized faster.
Anticholinergics
- Atropine (Atropin®) is an anticholinergic that blocks the action of acetylcholine in the brain.
- Atropine is used to treat bradycardia and suppress secretions during surgery.
- It inhibits acetylcholine at the parasympathetic neuroeffector junction, blocking vagal effects on the SA and AV nodes, enhancing conduction through AV nodes, and increasing heart rate.
- Watch for tachycardia in cardiac patients as it may lead to ventricular fibrillation.
- Many adverse effects of Atropine (dry mouth, constipation) vary with the dose.
Alkalinizers- Fluid and Electrolyte Replacement
- Calcium Chloride (10% IV push) is used for cardiac resuscitation, treatment of acute hypokalemia, vitamin D deficiency, insect bites or stings, hypocalcemia, and hypermagnesemia.
- Calcium chloride replaces calcium and maintains calcium levels.
- Use calcium chloride cautiously in patients with cor pulmonale, respiratory acidosis, or respiratory failure.
- Monitor calcium levels frequently, maintaining the level between 9 to 10.4 mg/dl.
- Do not allow the level to exceed 12 mg/dl.
- Hypercalcemia may result after large doses in chronic renal failure.
- Report any abnormalities.
Calcium Gluconate (10% IV push)
- Calcium gluconate is used to overcome cardiac toxicity of hyperkalemia, cardiopulmonary resuscitation (repolarisation), neonatal tetany, hyperparathyroidism, and vitamin D deficiency.
- Double-check that you are giving the correct form of calcium.
- Check the cart for both calcium gluconate and calcium chloride.
Sodium bicarbonate (8.4%)
- Sodium bicarbonate is used for cardiac arrest and metabolic acidosis.
- Sodium bicarbonate restores buffering capacity and neutralizes excess acid.
- Monitor changes in urine with respect to pH.
Antidysrhythmics
- Lidocaine (Xylocaine®) is a local anesthetic with antiarrhythmic properties used in the treatment of arrhythmias (V-fibrillation)
- Lidocaine decreases cardiac excitability and reduces the risk of ventricular fibrillation.
- Monitor drug levels and the patient for toxicity.
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Description
This quiz covers key information about anticonvulsants, focusing on Phenytoin and its effects on seizure management. Learn about the uses, mechanisms, and patient considerations related to this essential medication. Additionally, it touches on the role of sympathomimetics like Dobutamine in treatment.
