Antiepileptic Agents Overview
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Questions and Answers

What are the three ways anticonvulsant drugs work?

  • By suppressing calcium influx, preventing the electric current generated by the calcium ions to the T-type calcium channel. (correct)
  • By increasing the electrical stimulation threshold in cardiac tissue
  • By decreasing sodium influx, stabilizing cell membranes, reducing repetitive neuronal firing, and limiting seizures.
  • By suppressing sodium influx, prolonging the channel inactivation and thereby preventing neurons from firing. (correct)
  • By increasing the action of gamma-aminobutyric acid (GABA), which inhibits neurotransmitter throughout the brain. (correct)

What is the therapeutic serum range for Hydantin?

  • 30 mg/kg/d
  • 10-20 mcg/mL (correct)
  • 15-20 mg/kg/d
  • 30-50 mcg/mL
  • 4-7 mg/kg/d

Which of the following is a contraindication for Phenytoin?

  • Bradycardia
  • Heart block
  • Hypersensitivity (correct)
  • Pregnancy
  • Psychiatric disorders

Phenytoin is addictive.

<p>False (B)</p> Signup and view all the answers

What is the maximum daily dosage of Zarontin for an adult?

<p>1.5 g (C)</p> Signup and view all the answers

What is the primary use of Klonopin?

<p>Controlling petit mal, myoclonus, and status epilepticus.</p> Signup and view all the answers

What is the primary use of Tegretol?

<p>To treat refractory seizure disorders that have not responded to other anticonvulsant therapies. (B)</p> Signup and view all the answers

What is the maximum daily dosage of Tegretol for a child over 6 years old?

<p>35 mg/kg/d (C)</p> Signup and view all the answers

What is the toxic level of Depakote?

<p>50-100 mcg/mL (A)</p> Signup and view all the answers

Depakote can be used to treat bipolar disorder.

<p>True (A)</p> Signup and view all the answers

Which of the following is NOT a nursing responsibility regarding anticonvulsant medications?

<p>Administer IV anticonvulsants undiluted to ensure proper drug absorption and distribution. (B)</p> Signup and view all the answers

What is the name of the chronic neurologic disorder that affects the extrapyramidal motor tract?

<p>Parkinson's disease</p> Signup and view all the answers

What are the three primary symptoms of Parkinson's disease?

<p>Involuntary tremors of the limbs, Rigidity of muscles, Slowness of movement (bradykinesia)</p> Signup and view all the answers

Pseudoparkinsonism is often caused by adverse reactions to antipsychotic drugs.

<p>True (A)</p> Signup and view all the answers

Which of the following is NOT a category of drugs used to treat parkinsonism?

<p>MAO-A inhibitors (C)</p> Signup and view all the answers

Anticholinergic drugs have minimal effect on bradykinesia.

<p>True (A)</p> Signup and view all the answers

Which of the following is NOT a side effect of anticholinergic drugs?

<p>Increased urinary output (C)</p> Signup and view all the answers

Which of the following is a contraindication for anticholinergic drugs?

<p>Patients with glaucoma (D)</p> Signup and view all the answers

Which of the following is NOT a nursing responsibility regarding anticholinergic drugs?

<p>Check serum electrolytes. (D)</p> Signup and view all the answers

Anticholinergic drugs are prescribed for long-term treatment of Parkinson’s disease?

<p>False (B)</p> Signup and view all the answers

Levodopa itself stimulates dopamine receptors in the brain.

<p>False (B)</p> Signup and view all the answers

What is the name of the combination drug that combines carbidopa and levodopa?

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

Which of the following is NOT an advantage of combining levodopa with carbidopa?

<p>Lower risk of side effects. (A)</p> Signup and view all the answers

Which of the following is a contraindication for levodopa?

<p>Hypersensitivity (A)</p> Signup and view all the answers

Which of the following is a nursing responsibility when administering carbidopa-levodopa (Sinemet)?

<p>Administer with low-protein foods to avoid interference with drug transport to the CNS. (B)</p> Signup and view all the answers

Amantadine is an antiviral drug that can also be used to treat Parkinson’s disease.

<p>True (A)</p> Signup and view all the answers

Amantadine is typically used to treat drug-induced Parkinsonism.

<p>True (A)</p> Signup and view all the answers

What is the name of the dopamine agonist that is more effective than amantadine and anticholinergics, though not as effective as carbidopa-levodopa, for treating Parkinson’s disease?

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

Pramipexole and ropinirole are newer dopamine agonists that have fewer side effects than older agonists.

<p>True (A)</p> Signup and view all the answers

Selegiline (Eldepryl) is a COMT inhibitor.

<p>False (B)</p> Signup and view all the answers

What is the name of the first COMT inhibitor that was combined with levodopa, for advanced Parkinson’s disease?

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

Entacapone has a higher risk of liver damage than tolcapone.

<p>False (B)</p> Signup and view all the answers

Alzheimer’s disease is a reversible condition.

<p>False (B)</p> Signup and view all the answers

What are the major characteristics of Alzheimer’s disease?

<p>Chronic cognitive dysfunction. (A), Deterioration of the cholinergic neurons and deficiency in acetylcholine. (B), Acetylcholine breakdown in the brain. (C), Neuritic plaques, which form mainly outside of the neurons and in the cerebral cortex. (D), Marked cognitive decline. (E), Progressive memory loss. (F)</p> Signup and view all the answers

Which of the following is NOT a factor believed to influence the occurrence of Alzheimer’s disease?

<p>Brain tumors. (A)</p> Signup and view all the answers

Which of the following medications is NOT an acetylcholinesterase inhibitor?

<p>Memantine (Namenda) (D)</p> Signup and view all the answers

Which of the following is NOT a side effect of acetylcholinesterase inhibitors?

<p>Increased liver enzyme production (H)</p> Signup and view all the answers

Which of the following is a contraindication for acetylcholinesterase inhibitors?

<p>Liver and renal disease (A)</p> Signup and view all the answers

Muscle relaxants are used to treat only muscle spasms from traumatic injuries.

<p>False (B)</p> Signup and view all the answers

Which of the following is NOT a centrally acting muscle relaxant?

<p>Succinylcholine (Anectine) (A), Pancuronium bromide (Pavulon) (E), Vecuronium (Norcuron) (I)</p> Signup and view all the answers

Muscle relaxants can cause a wide range of side effects including anticholinergic effects, drowsiness, dizziness, headache, fever, and abdominal pain.

<p>True (A)</p> Signup and view all the answers

Which of the following is a contraindication for muscle relaxants?

<p>Cardiac arrhythmias (A), Heart failure (B), Acute myocardial infarction (C), AV blocks or bundle-branch block (D), Hyperthyroidism (E), Paralytic ileus (F), Concurrent use of monoamine oxidase inhibitors within 14 days of discontinuation of muscle relaxants. (G)</p> Signup and view all the answers

Which of the following is NOT a nursing responsibility regarding muscle relaxants?

<p>Inform the healthcare provider immediately when patient experiences respiratory compromise or acute shortness of breath. (E)</p> Signup and view all the answers

Which of the following is NOT a key component of pain management?

<p>Ensuring the patient's pain is never fully eradicated. (E)</p> Signup and view all the answers

Nociceptors are sensory pain receptors that are activated by noxious stimuli, including mechanical, thermal, and chemical stimuli, in peripheral tissues.

<p>True (A)</p> Signup and view all the answers

Which of the following is CORRECT regarding neuropathic pain?

<p>It is typically treated with nonopioid analgesics. (A), It is characterized by burning, tingling, or electrical shocks. (B)</p> Signup and view all the answers

The gate theory of pain suggests that pain is transmitted through afferent nerve fibers.

<p>True (A)</p> Signup and view all the answers

Which of the following is NOT a suitable treatment for acute pain?

<p>Scheduled potent opioids. (D), Long duration of action opioids. (E)</p> Signup and view all the answers

Which of the following is NOT a common characteristic of chronic pain?

<p>Pain that responds well to conventional treatments. (C)</p> Signup and view all the answers

Opioids are used to treat only severe pain.

<p>False (B)</p> Signup and view all the answers

Nonopioid analgesics are primarily used to treat mild to moderate pain.

<p>True (A)</p> Signup and view all the answers

Which of the following is NOT a type of nonopioid analgesic?

<p>Opioids (B)</p> Signup and view all the answers

All NSAIDs have an antipyretic effect, meaning they can help lower an elevated body temperature.

<p>True (A)</p> Signup and view all the answers

Aspirin is the oldest commercially available nonopioid analgesic.

<p>True (A)</p> Signup and view all the answers

How do NSAIDs relieve pain?

<p>By inhibiting the release of prostaglandins, which are inflammatory mediators that trigger pain. (B), By reducing inflammation in the peripheral nervous system. (D)</p> Signup and view all the answers

Selective COX-2 inhibitors are a new class of NSAIDs that were introduced to decrease inflammation and pain with reduced side effects.

<p>True (A)</p> Signup and view all the answers

Which of the following is a contraindication for aspirin?

<p>Flu symptoms in children (A), Third trimester of pregnancy (B), GI bleeding (C), Hypersensitivity to salicylates or NSAIDs (D), Concurrent use of anticoagulants (E)</p> Signup and view all the answers

Which of the following is NOT a nursing responsibility regarding aspirin?

<p>Administer IV aspirin to patients who have difficulty swallowing. (C)</p> Signup and view all the answers

Acetaminophen is a nonopioid and non-NSAID analgesic that provides pain relief, but does not have antiinflammatory effects.

<p>True (A)</p> Signup and view all the answers

Acetaminophen is a constituent of many over-the-counter medications, including cold and flu remedies.

<p>True (A)</p> Signup and view all the answers

Flashcards

Anticonvulsant Drugs Actions

Anticonvulsant drugs work in three ways: 1. Blocking sodium channels. 2. Enhancing GABA activity. 3. Decreasing glutamate release.

Hydantoins (e.g., Phenytoin)

Hydantoins are a class of anticonvulsant drugs that primarily work by blocking sodium channels.

Parkinson's Disease Symptoms

Parkinson's disease is characterized by tremor, rigidity, and bradykinesia (slow movement).

Nonpharmacologic Measures (Parkinson's)

Nonpharmacologic measures for Parkinson's include physical therapy, occupational therapy, and lifestyle modifications.

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Anticholinergic Drugs Side Effects

Anticholinergic drugs can have side effects such as dry mouth, blurred vision, constipation, and urinary retention.

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Carbidopa-Levodopa (Sinemet) Benefit

Combining carbidopa with levodopa reduces side effects and increases the effectiveness of levodopa in treating Parkinson's disease.

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Carbidopa-Levodopa (Sinemet) Side Effects

Carbidopa-Levodopa can lead to nausea, vomiting, dizziness, and orthostatic hypotension.

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Alzheimer's Disease Theories

Theories of Alzheimer's disease focus on amyloid plaques and neurofibrillary tangles.

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Acetylcholinesterase Inhibitors

These drugs increase acetylcholine levels, which can help cognitive symptoms of Alzheimer's.

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Acetylcholinesterase Inhibitors Side Effects

Acetylcholinesterase inhibitors can cause nausea, vomiting, diarrhea, and muscle cramps.

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Salicylates (Aspirin)

Salicylates are a type of NSAID that works by inhibiting cyclooxygenase enzymes.

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Side effects of Salicylates

Salicylates can cause stomach upset, tinnitus, and bleeding problems.

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Para-Chlorobenzoic Acid Derivatives

A class of nonsteroidal anti-inflammatory drugs.

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Acetaminophen Side Effects

Acetaminophen can cause liver damage if taken in high doses.

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Opioid Analgesics Side Effects

Opioid analgesics can cause drowsiness, constipation, and respiratory depression.

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Opioid Agonist-Antagonists Side Effects

Opioid agonist-antagonist drugs can cause withdrawal symptoms in people dependent on opioids.

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Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

A class of medications which reduce inflammation and relieve pain.

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Selective COX-2 Inhibitors Side Effects

Selective COX-2 inhibitors have been linked to a higher risk of heart problems.

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Migraine Preventive Treatment

Preventive treatments for migraines aim to reduce the frequency and severity of migraine attacks.

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Anti-migraine Medications Side Effects

Anti-migraine medicines can lead to side effects such as dizziness and nausea.

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Inhalation Anesthetics

Medications used for inhaling to produce anesthetic effects.

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Adrenergic Agonists

Medications that mimic the effects of the sympathetic nervous system.

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Beta-Adrenergic Blockers

Medications blocking beta-adrenergic receptors.

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Study Notes

Antiepileptic Agents

  • Used for epileptic seizures, also known as anticonvulsants
  • Stabilize nerve cell membranes and suppress abnormal electric impulses in the cerebral cortex
  • Work in one of three ways:
    • Suppress sodium influx through drug binding to the sodium channel.
    • Suppress calcium influx, preventing current generation.
    • Increase the action of GABA, an inhibitory neurotransmitter.

Hydantoins

  • Inhibit sodium influx, stabilize cell membranes, and limit seizures.
  • Act as an antidysrhythmic, increasing stimulation threshold
  • Has a small effect on sedation
  • Is nonaddictive

Dosage and Route Information

  • Includes information about adult and child dosage.
  • Includes information about the route of administration (PO or IV).
  • Data provided for therapeutic serum range and toxic levels.

Side Effects and Adverse Reactions

  • Includes potential side effects (e.g., headache, diplopia, confusion, dizziness, rashes)
  • Includes potential adverse reactions (e.g., leukopenia, hepatitis, gingival hyperplasia)
  • Life-threatening side effects include thrombocytopenia, agranulocytosis, and aplastic anemia.
  • These effects must be reported immediately.

Contraindications

  • Potential drug interactions and other reasons a patient should not take the drug.

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Description

This quiz covers antiepileptic agents, their mechanisms of action, and specific types such as hydantoins. It includes details on dosage, routes of administration, and potential side effects. Test your knowledge on how these medications stabilize nerve cell membranes and manage seizures.

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