Anticonvulsants Overview: Phenytoin and More
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Questions and Answers

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?

  • Long-term myocardial depression
  • Short term cardiac decompensation (correct)
  • Pulmonary hypertension
  • Chronic heart failure
  • 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?

    <p>Headaches and fatigue</p> Signup and view all the answers

    Why must ECG monitoring be performed when administering Dobutamine?

    <p>To monitor for atrial fibrillation and rapid ventricular rate</p> Signup and view all the answers

    In patients undergoing surgical repair of congenital heart disease, what primary symptom might Phenytoin help manage?

    <p>Seizures</p> Signup and view all the answers

    What is one of the adverse effects of digitalis intoxication that could be monitored?

    <p>Prolonged QT interval</p> Signup and view all the answers

    Which vital parameters should be assessed during Dobutamine treatment?

    <p>ECG, blood pressure, and cardiac output</p> Signup and view all the answers

    What is a primary use of Atropin®?

    <p>To manage bradycardia</p> Signup and view all the answers

    What neurotransmitter does Atropine block?

    <p>Acetylcholine</p> Signup and view all the answers

    Which of the following symptoms might Atropine cause?

    <p>Dry mouth</p> Signup and view all the answers

    In which condition might the dosage of medication need to be increased due to faster drug metabolism?

    <p>Cigarette smoking</p> Signup and view all the answers

    What adverse reaction should be monitored in cardiac patients when using Atropine?

    <p>Tachycardia</p> Signup and view all the answers

    Which muscarinic effect does Atropine specifically inhibit?

    <p>Acetylcholine effects at neuroeffector junctions</p> Signup and view all the answers

    What is a side effect related to gastrointestinal function when using Atropine?

    <p>Constipation</p> Signup and view all the answers

    What condition is treated with anticholinergics as mentioned in the content?

    <p>Asthma</p> Signup and view all the answers

    What is the primary use of Calcium Chloride 10% IV push?

    <p>To maintain calcium levels</p> Signup and view all the answers

    Which condition should calcium chloride be used cautiously in?

    <p>Chronic renal failure</p> Signup and view all the answers

    What complication is associated with the administration of calcium chloride?

    <p>Hypotension</p> Signup and view all the answers

    Which of the following conditions is treated with calcium chloride?

    <p>Cardiac arrest</p> Signup and view all the answers

    What is the recommended calcium level to maintain during treatment?

    <p>9 to 10.4 mg/dl</p> Signup and view all the answers

    Which electrolyte imbalance can result from excessive use of calcium chloride?

    <p>Hypercalcemia</p> Signup and view all the answers

    What should be monitored frequently when administering calcium chloride?

    <p>Calcium levels</p> Signup and view all the answers

    Which symptom might indicate a complication from intravenous calcium chloride administration?

    <p>Pain and burning at IV sites</p> Signup and view all the answers

    What is one of the primary uses of Calcium Gluconate 10%?

    <p>To overcome cardiac toxicity of hyperkalemia</p> Signup and view all the answers

    Which condition could be treated with Sodium Bicarbonate 8.4%?

    <p>Metabolic acidosis</p> Signup and view all the answers

    What is a potential side effect of Calcium Gluconate 10%?

    <p>Tetany</p> Signup and view all the answers

    Which of the following is a function of Vitamin D in relation to calcium?

    <p>Promotes calcium absorption</p> Signup and view all the answers

    What is a critical consideration when administering Calcium products?

    <p>Double-check the form of calcium</p> Signup and view all the answers

    Which drug is used for both local anesthetic and antiarrhythmic purposes?

    <p>Lidocaine</p> Signup and view all the answers

    What is a common side effect associated with Lidocaine?

    <p>Respiratory depression</p> Signup and view all the answers

    What monitoring action is essential when using antirrhythmic drugs like Lidocaine?

    <p>Monitor drug levels for toxicity</p> Signup and view all the answers

    What is the primary action of the drug Dilantin® (Phenytoin) in managing seizures?

    <p>Elevates the seizure threshold to limit seizure activity</p> Signup and view all the answers

    Why should a patient not stop taking the anticonvulsant medication abruptly?

    <p>Abrupt cessation may increase the risk of worsening seizures</p> Signup and view all the answers

    Which group of patients is mentioned as being more sensitive to the effects of drugs like phenytoin?

    <p>Elderly patients who are less active</p> Signup and view all the answers

    What potential reaction should be monitored when treating seizures?

    <p>Electrical activity in the brain during treatment</p> Signup and view all the answers

    What adverse reaction is suggested to develop from the use of anticonvulsants?

    <p>Headaches and gastrointestinal discomfort</p> Signup and view all the answers

    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.

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