Drugs for Anti-Seziures

• What are the drugs for Anti-Seziure?

  - Hydantoins

  - Tegretol

  - Barbiturates

  - Benzodiazepines
• What is the prototype drug of Hydantoins?

  Phenytoin
• What is the mechanism of action of Phenytoin?

  Stabilizes the neuronal membrane by delaying the influx of sodium ions into the neurons and preventing the excitability caused by excessive stimulation
• What is the side and adverse effects of Phenytoin?

  - Ataxia, drowsiness, lethargy- Gingival hyperplasia(overgrowth of the gums)
• What is the half-life of Phenytoin?

  Half-life: 8-60 hours (dosing can be once a day)
• What is the serum drug level of Phenytoin?

  10-20 mcg/ml
• What is the nursing implication of Phenytoin?


  - Check Na level(CHEM8 and BNP), CBC, LFT's

  - Give slowly via IV with an inline filter

  - Continuous telemetry monitoring
• What is the prototype drug for Tegretol?

  Carbamazepine
• What is the mechanism of action of Carbamazepine?

  Works on Sodium Channels
• What is the side and adverse effect of Carbamazepine?

  - Neurologic effects: nystagmus (eyes shifting quickly), ataxia

  - Dermatologic effects: rash, photosensitivity
• What is the serum drug level of Carbamazepine?

  5-12 mcg/dl
• What is the nursing implication of Carbamazepine?

  Check Na levels, CBC with WBC, and LFT's
• What is the prototype drug for Barbiturates?

  "Barbies are Bad!"Phenobarbital
• What is the mechanism of action of Phenobarbital?

  Depresses the CNS by inhibiting the conduction of impulses in the ascending reticular activating system, thus depressing the cerebral cortex and cerebellar function
• What is the side and adverse effects of Phenobarbital?

  - CNS depression

  - Somnolence, agitation, confusion, vertigo, and nightmares

  - Stevens-Johnson syndrome
• Why should nurses be nervous about giving the FIRST DOSE of Phenobarbital to patients?

  The patient might have an arrest and stop breathing
• Why is Phenobarbital considered a Black Box Warning drug?

  Concern for suicidal risk with this drug
• What is the prototype drugs of Benzodiazepines?

  Lorazepam and Diazepam
• What is the mechanism of action of Lorazepam and Diazepam?

  - Used as antidepressants, antiepileptics, or skeletal muscle relaxants

  - Used for treatment of severe recurrent convulsive seizures and status epilepticus
• Why is Status Epilepticus life-threatening?

  Decreases respiratory rate
• What should nurses do if a patient is having a Status Epilepticus?

  Put the patient in a "sideline" position or recovery position
• Why do nurses use the "sideline" position?

  To stop any type of abnormal movement to the chest area, so they can continue to breathe on their own
• What is the goal of treatment for Status Epilepticus?

  - Maintain ventilation- Correct hypoglycemia- Terminate seizures
• What drugs are given to patients having Status Epilepticus?

  IV benzodiazepines [Lorazepam or Diazepam]