Chapter 27 Pharm

constant bouts of seizures
group of disorders characterized by excessive excitability of neurons in the CNS

congenital defects
hypoxia at birth
head trauma
brain infection
stroke
cancer
genetic disorders

reduce seizures so the pt can live as normal of life as possible
balance the desire for complete seizure control with acceptable side effects

monitoring plasma drug levels
promoting patient adherence
withdrawing antiepileptic -> can restart seizure activity if you stop
suicide risk -> thought tendencies

first generation drug
MOA: selective inhibition of sodium channels
Half-life: 8 to 60 hours
Therapeutic levels: 10 to 20 mcg/mL

Use: focal-onset and tonic-clonic seizures
Class: Anticonvulsant?
Adverse: nystagmus, ataxia, gingival hyperplasia: swelling, tenderness, and bleeding of the gums
Nursing Implications: take with food, unsafe for pregnancy - teratogen, pt adherence, decreases the effects of oral contraceptives

Class: Anticonvulsant
Use: epilepsy therapy
Adverse: nystagmus, ataxia, birth defects (category d), genetic testing for Asians
Nursing implications: avoid grapefruit juice
PO tablets, oral suspensions

Class: Anticonvulsants
Use: seizure disorders
Adverse: pancreatitis, teratogenic effects, thrombocytopenia
Nursing Implications: don't give 2 yrs and under

Class: Anticonvulsants
Use: focal seizures in adults
Adverse: hypothydroidism in children
Nursing Implications: asians genetic testing HLA B1502, decrease effectiveness oral contraceptives

tonic-clonic seizures that lasts 20 to 30 minutes
Medical Emergency
treatment = maintain ventilation
Ativan or Valium first-line then Dilantin long-tern

patient adherence
plasma drug levels
can't stop taking the drugs