Antiepileptic Medications
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Questions and Answers

What percentage of patients with seizures do medications control, if properly prescribed and taken?

  • 70% to 80% (correct)
  • 50% to 60%
  • 30% to 40%
  • 90% to 100%
  • Why are medications selected for controlling seizures based on the type of seizure being treated?

  • To match the medication's mechanism of action with the type of seizure (correct)
  • To make the treatment process complex
  • To ensure longer treatment duration
  • To increase the cost of treatment
  • When might changing to another medication be necessary for seizure control?

  • If the patient prefers it
  • If the medication is popular
  • If seizure control is not achieved or if toxicity makes it impossible to increase the dosage (correct)
  • If the medication is too cheap
  • What factors may necessitate the adjustment of seizure medication?

    <p>Weight changes, increases in stress, or concurrent illness</p> Signup and view all the answers

    What are the three categories of anticonvulsant medication side effects?

    <p>Idiosyncratic/allergic disorders, acute toxicity, chronic toxicity</p> Signup and view all the answers

    What can long-term use of phenytoin lead to?

    <p>Gingival hyperplasia</p> Signup and view all the answers

    What is the half-life of phenobarbital?

    <p>53 to 118 hours</p> Signup and view all the answers

    What type of seizures is phenobarbital used for?

    <p>Generalized tonic-clonic and partial seizures</p> Signup and view all the answers

    Who may experience greater sedation from phenobarbital due to altered absorption and excretion?

    <p>Older adults</p> Signup and view all the answers

    What are the adverse effects of phenobarbital?

    <p>CNS depression, respiratory problems, Stevens-Johnson syndrome</p> Signup and view all the answers

    How does phenobarbital depress the central nervous system?

    <p>By inhibiting impulse conduction</p> Signup and view all the answers

    What is the route of absorption for phenobarbital?

    <p>Gastrointestinal tract</p> Signup and view all the answers

    How long does it take for phenobarbital to reach therapeutic serum levels?

    <p>2-3 weeks</p> Signup and view all the answers

    Who may require lower doses of phenobarbital?

    <p>Patients with renal or hepatic impairment</p> Signup and view all the answers

    What is the primary use of phenobarbital?

    <p>Sedative and antiepileptic agent</p> Signup and view all the answers

    What is the effect of phenobarbital on impulse conduction?

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

    What is a key consideration for the administration of IV diazepam?

    <p>Injecting slowly into a large vein</p> Signup and view all the answers

    For which conditions is gabapentin approved?

    <p>Partial seizures and postherpetic neuralgia pain</p> Signup and view all the answers

    What requires monitoring in patients with impaired liver function receiving gabapentin?

    <p>Elevated liver enzymes</p> Signup and view all the answers

    What is a key nursing consideration for diazepam administration?

    <p>Monitoring pulse, blood pressure, and respiration</p> Signup and view all the answers

    What is a contraindication for combining diazepam with other solutions?

    <p>Mixing in plastic bags or tubing</p> Signup and view all the answers

    What requires dosage adjustment for gabapentin?

    <p>Renal impairment based on creatinine clearance</p> Signup and view all the answers

    What is a key aspect of patient teaching for diazepam?

    <p>Advice on alcohol use and contraception</p> Signup and view all the answers

    What should be monitored during diazepam administration for seizure disorder?

    <p>Cardiovascular changes, CNS response, and alterations in elimination patterns</p> Signup and view all the answers

    What is a key consideration for combining opioids with benzodiazepines or CNS depressants?

    <p>FDA warns about serious adverse effects</p> Signup and view all the answers

    What is a key aspect of gabapentin's pharmacokinetics?

    <p>Dosage adjustments based on creatinine clearance</p> Signup and view all the answers

    What is a key difference in the goals of diazepam therapy for seizure disorder and status epilepticus?

    <p>The desired outcome and response</p> Signup and view all the answers

    What is gabapentin approved for in addition to partial seizures?

    <p>Postherpetic neuralgia pain</p> Signup and view all the answers

    What is the maximum rate of intravenous administration for phenobarbital to prevent intraarterial injection complications?

    <p>60 mg/minute</p> Signup and view all the answers

    Which therapeutic effect of phenobarbital is evidenced by decreased brain waves on EEG?

    <p>Decreased seizure activity</p> Signup and view all the answers

    What is a potential adverse effect of phenobarbital?

    <p>Paradoxical excitation</p> Signup and view all the answers

    What are the patient teaching guidelines for phenobarbital related to?

    <p>Long-term administration</p> Signup and view all the answers

    What is the primary mechanism of action of benzodiazepines like diazepam?

    <p>Potentiation of GABA effects</p> Signup and view all the answers

    For what conditions is diazepam used as an adjunctive agent?

    <p>Seizure disorders</p> Signup and view all the answers

    In which patient populations are dosage adjustments for diazepam necessary?

    <p>Older adults, patients with renal or hepatic impairment, and those with critical illness</p> Signup and view all the answers

    What is a potential adverse effect of diazepam related to the central nervous system?

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

    What are the contraindications for diazepam?

    <p>Narrow-angle glaucoma</p> Signup and view all the answers

    What may interactions with medications and herbs do to diazepam's effects?

    <p>Decrease its effects</p> Signup and view all the answers

    Which medication is used to control tonic–clonic seizures, psychomotor seizures, and nonepileptic seizures?

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

    What is a common adverse effect of long-term use of phenytoin?

    <p>Increased risk of osteoporosis</p> Signup and view all the answers

    What is a contraindication to phenytoin?

    <p>Hypersensitivity to hydantoins</p> Signup and view all the answers

    What is a caution needed in older adults regarding phenytoin?

    <p>Renal or hepatic impairment causing drug displacement</p> Signup and view all the answers

    What is a key consideration for the administration of injectable solution of phenytoin?

    <p>Highly irritating to tissues, special techniques needed for IV administration</p> Signup and view all the answers

    What is the route of administration for carbamazepine?

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

    What is the primary use of carbamazepine?

    <p>Preventing partial seizures with complex symptoms</p> Signup and view all the answers

    What is a caution needed for pregnant and breastfeeding women regarding carbamazepine?

    <p>Crosses the placenta and enters breast milk</p> Signup and view all the answers

    What is the mechanism of action of phenytoin?

    <p>Delays sodium influx</p> Signup and view all the answers

    What is an effect of carbamazepine on liver enzymes?

    <p>Induces liver enzymes to increase metabolism</p> Signup and view all the answers

    What should be monitored during phenytoin administration?

    <p>Absence of seizures and presence of hypersensitivity reactions</p> Signup and view all the answers

    What is a patient teaching guideline for phenytoin?

    <p>Using the drug as prescribed</p> Signup and view all the answers

    Which medication is used to control tonic–clonic seizures, psychomotor seizures, and nonepileptic seizures?

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

    What caution is needed in older adults when administering phenytoin?

    <p>Altered albumin levels</p> Signup and view all the answers

    What can IV administration of phenytoin lead to?

    <p>Cardiovascular collapse</p> Signup and view all the answers

    What is a common adverse effect of phenytoin?

    <p>CNS and GI tract issues</p> Signup and view all the answers

    What is a contraindication to phenytoin?

    <p>Hypersensitivity to hydantoins</p> Signup and view all the answers

    Which medication interacts with phenytoin, affecting its effectiveness and absorption of folic acid, calcium, and vitamin D?

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

    What is highly irritating to tissues and requires special techniques for IV administration?

    <p>Injectable solution of phenytoin</p> Signup and view all the answers

    What does the nurse assess for in patients taking phenytoin?

    <p>Therapeutic and adverse effects</p> Signup and view all the answers

    What are the patient teaching guidelines for phenytoin?

    <p>Taking the drug as prescribed, maintaining good oral hygiene, and using contraception</p> Signup and view all the answers

    What is the onset of action of carbamazepine?

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

    What does carbamazepine induce to increase metabolism?

    <p>Liver enzymes</p> Signup and view all the answers

    Where does carbamazepine cross and require caution in pregnant and breastfeeding women?

    <p>Placenta and breast milk</p> Signup and view all the answers

    What is dementia characterized by?

    <p>A permanent decrease in intellectual functioning</p> Signup and view all the answers

    What is the most common cause and type of dementia?

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

    What is associated with the transmission of impulses between nerve cells in the brain?

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

    What does Alzheimer's disease result in?

    <p>A continuous decline in thinking, behavioral, and social skills</p> Signup and view all the answers

    Study Notes

    Phenytoin and Carbamazepine: Pharmacological Aspects and Nursing Implications

    • Phenytoin stabilizes neuronal membrane by delaying sodium influx, used to control tonic–clonic seizures, psychomotor seizures, and nonepileptic seizures
    • Caution needed in older adults due to altered albumin levels, renal or hepatic impairment causing drug displacement
    • IV administration of phenytoin can lead to cardiovascular collapse, requiring careful monitoring
    • Common adverse effects of phenytoin include CNS and GI tract issues, long-term use may lead to increased risk of osteoporosis
    • Contraindications to phenytoin include hypersensitivity to hydantoins, caution in patients with specific conditions
    • Several medications interact with phenytoin, affecting its effectiveness and absorption of folic acid, calcium, and vitamin D
    • Injectable solution of phenytoin is highly irritating to tissues, special techniques needed for IV administration
    • Nurse assesses for therapeutic and adverse effects, including absence of seizures and presence of hypersensitivity reactions
    • Patient teaching guidelines for phenytoin include taking the drug as prescribed, maintaining good oral hygiene, and using contraception
    • Carbamazepine is administered orally, with slow onset of action, and induces liver enzymes to increase metabolism
    • Mechanism of action of carbamazepine is not fully understood, used to prevent partial seizures with complex symptoms
    • Like phenytoin, carbamazepine crosses the placenta and enters breast milk, requiring caution in pregnant and breastfeeding women

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    Description

    Test your knowledge of antiepileptic medications with this quiz covering the uses, administration, and nursing implications of phenobarbital, diazepam, phenytoin, and carbamazepine. Explore the pharmacological aspects and nursing considerations for these important drugs used to manage seizures and related conditions.

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