Class Basics
What are some possible causes for seizures? (list at least 3)
Fever, hypoglycemia, electrolyte imbalance, drug overdoses, withdrawal from alcohol or sedative hypnotics, birth defects, eclampsia, Alzheimer’s head injury, stroke, brain tumor, can also be idiopathic
What are the goals of traditional anti-epileptic drugs (AEDS)?
To reduce seizure frequency and preserve quality of life.
Which drug has the action of increasing sodium channels inactive period in order to decrease excitability?
Phenytoin (Dilantin)
What traditional anti-epileptic drug causes gum hyperplasia?
Phenytoin (Dilantin)
What would be important to educate patients taking Benzodiazaoines (Ativan, Xanax) on?
Do NOT operate machinery and do NOT make any major decisions (confusion is increased)
When a seizure occurs, there is an imbalance of neurotransmitters. Which neurotransmitter outweighs GABA, leading to neurons firing uncontrollably?
Glutamate
What meds can be used for tonic clonic (generalized) seizures?
Lamotrigine (lamictal), Levetiracetam (Keppra), and Topiramate (topamax)
Which drug interacts with GABA receptors to reduce excitability?
Phenobarbital
Carbamazepine (Tegretol) causes what serious side effects?
Blood dycrasia, hyponatremia, SIADH, pancreatitis, hepatitis
If a patient has PCOS, what drug would the nurse educate them on that may worsen their symptoms?
Valproic acid (Depakene/Depakote)
Which type of seizure is widely conducted and throughout both hemispheres?
Generalized seizure
What meds are best for status epilepticus?
Benzodiazepines (Ativan, Xanax)
Which drug mimics the action of GABA and is used for acute treatment, not long term?
Benzodiazapines
What two drugs cause photophobia?
Carbamazepine (Tegretol) and Lamotrigine (lamictal)
When giving a patient Depakene, what are signs of toxic epidermal necrolysis?
Skin shredding and open sores
What is the difference between a simple partial and complex partial seizure?
Simple partial seizures include no loss of consciousness, and during a complex partial seizure there is a change in consciousness.
What can Phenobarbital (Luminal) also be used for in terminal geriatric patients?
Restlessness & behavioral issues
Which drug binds to the synaptic vesicle protein 2A (SV2A)?
Keppra
What drug causes paradoxical hyperactivity in children?
Phenobarbital (Luminal)
Which drug would cause the nurse to closely monitor changes in behavior and mood?
Keppra
What factors influence whether or not a patient receives medication treatment for seizures?
How frequent they occur, how long they last, and how much the seizures impact their life.
What can Valproic acid be used for off-label?
Migraines
Which drug blocks sodium channels in order to reduce ion exchange and decrease membrane depolarization?
Topamax
What serious side effects can Lamotrigine (lamictal) cause?
Aseptic meningitis, DRESS syndrome, and Toxic epidermal necrolysis (TEN)
What should you teach a patient on Phenytoin (Dilantin)?
Proper oral hygiene.