Drug Management Of Seizure Disorders

10 Questions | Total Attempts: 582

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Drug Management Of Seizure Disorders

This quiz includes anti-convulsant drugs for seizure disorders.


Questions and Answers
  • 1. 
    Hydantoins are Anti-convulsants.  Phenytoin (Dilantin) and Fosphenytoin (used for status epilepticus (IV)) What is true of Dilantin?
    • A. 

      Used for status epilepticus (IV) (a persistent state of seizure)

    • B. 

      Taken orally, occasionally IV

    • C. 

      For partial or generalized seizures

    • D. 

      Is most commonly used

    • E. 

      Therapeutic blood levels 10-20, dose varies widely between individuals

  • 2. 
    Anti-convulsants: Hydantoins: Phenytoin (Dilantin): Adverse Effects:
    • A. 

      Few Sedative effects

    • B. 

      Gingival Hyertrophy (GUMS) 20-30% (brush teeth carefully and floss daily)

    • C. 

      Cardiac: depresses pacemaker activity in heart. Cardiac monitoring with IV form, Contraindicated in bradycardia, heart block, CV collapse possible with IV

    • D. 

      GI: Anorexia, nausea, vomiting, pain

    • E. 

      Skin: rash, Steven Johnson Syndrome, lupus, excess hair growth, coarsening of features

  • 3. 
    Anticonvulsants: Hydantoins: Phenytoin (Dilantin).  Dilantin Toxicity symptoms:
    • A. 

      Ataxia (lack of muscle coordination) and nystagmus (involuntary eye movement)

    • B. 

      Double vision, lethargy, slurred speech

    • C. 

      N/v

    • D. 

      Hypotension

    • E. 

      Hypersensitivity (first 3-8 weeks) includes rash, fever, lymph node enlargement (can be fatal)

  • 4. 
    Nursing interventions: Anti-convulsants: Hydantoins: Dilantin:
    • A. 

      Monitor for adverse effects

    • B. 

      Monitor blood levels: therapeutic 10-20

    • C. 

      Patient education (purpose, dose, important of compliance, adverse reactions)

    • D. 

      Many drug interactions

  • 5. 
    Anti-convulsants: Barbiturates: Phenobarbital
    • A. 

      Used for febrile seizures

    • B. 

      Used for partial seizures

    • C. 

      Used for tonic-clonic seizures (affects the whole brain)

    • D. 

      May be used in combo with dilantin or as part of multi-drug regimen

  • 6. 
    Anti-convulsants: Barbiturates: Phenobarbital: Adverse reactions
    • A. 

      CNS Depression, Sedation

    • B. 

      Resp Depression- Contraindicated in resp disorders

    • C. 

      Hypersensitivity

    • D. 

      GI upset and pain

    • E. 

      Blood dyscrasias

  • 7. 
    Carbamazepine (Tegretol) is the second most common prescribed anticonvulsant.  It is structurally related to tricyclic antidepressants.  It can also be used with combinations of Dilantin or Phenobarbital.  Uses:
    • A. 

      Partial and tonic clonic seizures

    • B. 

      Neuropathic pain management

    • C. 

      Schizophrenia

    • D. 

      Bipolar disorder

  • 8. 
    Carbamazepine (Tegretol) Adverse effects:
    • A. 

      CNS Depression: Restlessness, irritability, agitation, dizzy, confused, ataxia (lack of muscle coordination), encephalopathy (disorder or disease of the brain)

    • B. 

      Renal: Renal Failure, urinary frequency, water retention (stimulates ADH)

    • C. 

      Visual Changes

    • D. 

      Toxicity similar to Dilantin ( bone marrow depression, hepatic dysfuction, visual changes)

    • E. 

      Numerous drug interactions

  • 9. 
    Anticonvulsants: Bezodiazepines include:Diazepam (Valium) IV, IMLorazepam (Ativan) IV.
    • A. 

      Terminate Status Epilepticus (state of persistent seizure)

    • B. 

      Need close medical supervision

    • C. 

      Resuscitation equipment should be available

  • 10. 
    Anti-convulsant drug implications
    • A. 

      Drug initiations Titrating up based on effectiveness, blood levels, toxic effects Change to another drug if not effective or tolerated

    • B. 

      Patient Education- Importance of Compliance

    • C. 

      Duration of Therapy- May be withdrawn if seizure - free 2 years (12-36% recurrence)

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