Exam 2: Seizure Pharmacology questions and answers completed and graded to pass!

What is the major therapy goals for anti-epileptics? -raise seizure threshold so that it takes MORE electrical activity to induce a seizure -enable a patient to live as normal as possible. Are AED"s typically long term treatments? Yes 00:40 01:08 What is the balance between with AED's? Must balance the desire for seizure control with adverse effects. How do AED's work? -suppress seizure focus -prevent spread of seizure activity to additional neurons. What are the 4 basic mechanisms by which AED's work? -suppress Na influx -suppress Ca influx -block receptors for glutamate -potentiate GABA Why does it help to suppress sodium and calcium in patients with seizure disorders? Sodium and calcium are a part of action potentials, which involves the movement of electrolytes in and out of cells via channels. Suppressing these electrolytes can help prevent seizure foci from spreading. MOA of Phenytoin (Dilantin) Na/Ca Blocker -reversibly binds to sodium which prolongs channel inactivation so that it takes a longer period of time and more stimulation to open channels again & allow Na/Ca into cell. Nutshell -inhibits hyperactive sodium channels Also: -CYP inducer and substrate Indication for Phenytoin (Dilantin) All forms of epilepsy, except absence seizures. Safety Considerations for Phenytoin (Dilantin) -narrow therapeutic range. -LOTS OF drug interactions. AE of phenytoin (Dilantin) Causes Drug-Nonadherence -hirsutism -acne -gingival hyperplasia -teratogenic -cardiovascular dysrhythmias (w/ injection) NI for phenytoin (Dilantin) Teach -have really good oral care d/t the gingival hyperplasia. If not kept up, can lead to gum disease. Administration -inject slowly and dilute to prevent cardiac dysrhythmias Avoid -alcohol and grapefruit juice (inhibitors!!) Pregnancy -teratogenic -drug interaction with oral contraceptives--so unplanned pregnancy is a risk ---MULTIPLE FORMS OF BIRTH CONTROL What are example of drugs that suppress Na/Ca influx? -phenytoin (Dilantin) -carbamazepine (Tegretol) -Valproic acid (Depacon)