Chapter 15: Antiepileptic Drugs
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice
MULTIPLE CHOICE
1. Which antiepileptic drug allows once-a-day dosing?
a. topiramate (Topamax®)
b. phenobarbital sodium
c. valproic acid (Depakene®)
d. gabapentin (Neurontin®)
ANS: B
Phenobarbital has the longest half-life of all standard antiepileptic drugs, which allows once-a-day dosing.
DIF: Cognitive Level: Comprehension
2. During the nurse’s assessment, the patient describes her seizures as initial muscular contractions
throughout her body, then
alternating between contractions and relaxation. What kind of seizure is she describing?
a. Convulsion
b. Partial seizure c. Simple seizure
d. Generalized tonic–clonic seizure
ANS: D
Generalized tonic–clonic seizures are seizures that involve initial muscular contraction throughout the
body (tonic phase) and that then progress to alternating contraction and relaxation (clonic phase).
DIF: Cognitive Level: Comprehension
3. While teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home, what
information should the nurse emphasize?
a. Driving will be allowed after 2 weeks of therapy.
b. If seizures recur, the patient should take a double dose of the medication.
, c. Antacids can be taken with the AED to reduce gastrointestinal adverse effects. d. Regular consistent
dosing is important for successful treatment.
ANS: D
Consistent medication regularly taken at the same time of day at the recommended dose and with meals
to reduce the common gastrointestinal adverse effects, is the key to successful management of seizures
with AEDs. Nonadherence is the most notable factor leading to treatment failure.
DIF: Cognitive Level: Application
4. A patient has a 9-year history of a seizure disorder that has been managed well with phenytoin
therapy. He is to receive nothing by mouth because he has surgery in the morning. What should the nurse
do about his morning dose of phenytoin?
a. Give the same dose intravenously.
b. Give the morning dose with a small sip of water.
c. Contact the physician for another dosage form of the medication. d. Notify the operating room that
the medication has been withheld.
ANS: C
The physician should be contacted for an order of the appropriate dosage form of the medication. The
route should not be changed without a physician’s order. The morning dose should not be given with a
small sip of water. Withholding the medication may lead to seizure activity during the surgical procedure.
DIF: Cognitive Level: Analysis
5. A patient has been taking carbamazepine (Tegretol®) for several months and is worried because the
physician has increased the dose twice since the beginning of therapy. Which is the nurse’s best
explanation to the patient?
a. The initial dose was not sufficient to prevent seizures.
b. Autoinduction results in lower-than-expected drug concentrations.
c. Because the seizures are difficult to manage, increased doses are needed to control them. d.
Forgetting to take the medication as prescribed led to a need for increased dosage.
ANS: B
With carbamazepine, autoinduction occurs and leads to lower-than-expected drug concentrations.
Therefore, the dose may need to be adjusted over time.
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice
MULTIPLE CHOICE
1. Which antiepileptic drug allows once-a-day dosing?
a. topiramate (Topamax®)
b. phenobarbital sodium
c. valproic acid (Depakene®)
d. gabapentin (Neurontin®)
ANS: B
Phenobarbital has the longest half-life of all standard antiepileptic drugs, which allows once-a-day dosing.
DIF: Cognitive Level: Comprehension
2. During the nurse’s assessment, the patient describes her seizures as initial muscular contractions
throughout her body, then
alternating between contractions and relaxation. What kind of seizure is she describing?
a. Convulsion
b. Partial seizure c. Simple seizure
d. Generalized tonic–clonic seizure
ANS: D
Generalized tonic–clonic seizures are seizures that involve initial muscular contraction throughout the
body (tonic phase) and that then progress to alternating contraction and relaxation (clonic phase).
DIF: Cognitive Level: Comprehension
3. While teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home, what
information should the nurse emphasize?
a. Driving will be allowed after 2 weeks of therapy.
b. If seizures recur, the patient should take a double dose of the medication.
, c. Antacids can be taken with the AED to reduce gastrointestinal adverse effects. d. Regular consistent
dosing is important for successful treatment.
ANS: D
Consistent medication regularly taken at the same time of day at the recommended dose and with meals
to reduce the common gastrointestinal adverse effects, is the key to successful management of seizures
with AEDs. Nonadherence is the most notable factor leading to treatment failure.
DIF: Cognitive Level: Application
4. A patient has a 9-year history of a seizure disorder that has been managed well with phenytoin
therapy. He is to receive nothing by mouth because he has surgery in the morning. What should the nurse
do about his morning dose of phenytoin?
a. Give the same dose intravenously.
b. Give the morning dose with a small sip of water.
c. Contact the physician for another dosage form of the medication. d. Notify the operating room that
the medication has been withheld.
ANS: C
The physician should be contacted for an order of the appropriate dosage form of the medication. The
route should not be changed without a physician’s order. The morning dose should not be given with a
small sip of water. Withholding the medication may lead to seizure activity during the surgical procedure.
DIF: Cognitive Level: Analysis
5. A patient has been taking carbamazepine (Tegretol®) for several months and is worried because the
physician has increased the dose twice since the beginning of therapy. Which is the nurse’s best
explanation to the patient?
a. The initial dose was not sufficient to prevent seizures.
b. Autoinduction results in lower-than-expected drug concentrations.
c. Because the seizures are difficult to manage, increased doses are needed to control them. d.
Forgetting to take the medication as prescribed led to a need for increased dosage.
ANS: B
With carbamazepine, autoinduction occurs and leads to lower-than-expected drug concentrations.
Therefore, the dose may need to be adjusted over time.
