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ANTIEPILEPTICS - AEDs

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الكلية كلية التمريض     القسم قسم العلوم الطبية الاساسية     المرحلة 3
أستاذ المادة عمار عباس شعلان الحميري       04/01/2016 12:58:50
ANTIEPILEPTICS (AEDs)

Epilepsy
A general term for any of a group of neurologic disorders characterized by recurrent episodes of convulsive seizures, sensory disturbances, abnormal behavior, loss of consciousness, or any combination of these.
Select Prototype Medications
Barbiturates:
Phenobarbital (Luminal)
Primidone (Mysoline)
Hydantoins: phenytoin (Dilantin)
Benzodiazepines:
Diazepam (Valium)
Lorazepam (Ativan)
Carbamazepine (Tegretol)
Ethosuximide (Zarontin)
Valproic acid (Depakote)
Gabapentin (Neurontin)

Other Medications:
Lamotrigine (Lamictal)
Oxcarbazepine (Trileptal)
Expected Pharmacological Action
AEDs control seizure disorders by various mechanisms, which include:
Slowing the entrance of sodium and calcium back into the neuron and, thus extending the time it takes for the nerve to return to its active state.
Suppressing neuronal firing, which decreases seizure activity and prevents propagation of seizure activity into other areas of the brain.
Decreasing seizure activity by enhancing the inhibitory effects of gamma butyric acid (GABA)
Therapeutic Uses
Side/Adverse effect
Side/Adverse effect
Side/Adverse effect
Side/Adverse effect
Side/Adverse effect
Side/Adverse effect
Side/Adverse effect
Contraindications/Precautions
The following medications are in Pregnancy Risk Category D.
Barbiturates are contraindicated in clients with intermittent porphyria.
Phenytoin are contraindicated in clients with sinus bradycardia, sinoatrial blocks, second- and third-degree AV block, or Stokes-Adams syndrome.
Carbamazepine is contraindicated in clients with bone marrow suppression or with bleeding disorders.
Valproic acid is contraindicated in clients with liver disorders.
Interactions
Interactions
Nursing Administration
Monitor therapeutic plasma levels. Be aware of therapeutic levels for medications prescribed. Notify the provider of results.
Advise clients taking antiepileptic medications that treatment provides for control of seizures, not cure of disorder.
Encourage clients to keep a seizure frequency diary to monitor effectiveness of therapy.
Advise clients to take medications as prescribed and not to stop medications without consulting the provider. Sudden cessation of medication may trigger seizures.
Advise clients to avoid hazardous activities (driving, operating heavy machinery) until seizures are fully controlled.

Advise clients who are traveling to carry extra medication to avoid interruption of treatment in locations where their medication is not available.
Advise clients of childbearing age to avoid pregnancy, because medications may cause birth defects and congenital abnormalities.
Advise the client that phenytoin doses must be individualized. Dosing usually starts twice a day and can be switched to once a day dosing with an extended-release form when maintenance dose has been established.
Advise clients that phenytoin has a narrow therapeutic range, and strict adherence to the medication regimen is imperative to prevent toxicity or therapeutic failure.
Nursing Evaluation of Medication Effectiveness
Depending on therapeutic intent, effectiveness may be evidenced by:
Absence or decreased occurrence of seizures
Ability to perform ADLs
Absence of injury


المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .
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