NSG 367 Study Guide Exam 2 Questions
And All Complete Solutions.
What differentiates a seizure, convulsion, and epilepsy? - Answer Seizure - brief episode of abnormal
electrical activity in nerve cells of the brain
Convulsion - involuntary spasmodic contractions of any or all voluntary muscles throughout the body
Epilepsy - chronic, recurrent pattern of seizures
What is a generalized onset seizure? - Answer Neuronal activity that originates simultaneously in the
gray matter of both hemispheres
Ex. tonic-clonic, absence
What is a focal onset seizure? - Answer Neuronal activity that originates in a localized or focal region of
the brain
What is a status epilepticus seizure? - Answer Multiple seizures that occur with no recovery (doesn't
end for 5+ minutes)
Why is antiepileptic therapy not recommended after a single seizure event? - Answer only a 40%
chance that a seizure will happen again
What are the general pharmacologic effects of anti epileptics? - Answer -reduce nerve's ability to be
stimulated (block sodium/calcium channels)
-suppress transmission of impulses from one nerve to the next (increase GABA, decrease Glutamate)
-Decrease the speed of nerve impulse conduction within a neuron
Cerebyx versus Celebrex - Answer Medication alert! Sound alike/look alike!
,Cerebyx is an AED
Celebrex is an NSAID
As of 2008, the FDA put a black box warning on AEDs for which adverse effect? - Answer Suicidal
thoughts and behaviors
Phenytoin (Dilantin) is an AED that has what pharmacologic effect? - Answer Stabilizes nerve cells by
blocking sodium channels
As a nurse, it is important to understand a client's diet when they are taking Phenytoin. Why? - Answer
Phenytoin is a highly protein bound drug. If a patient is malnourished, it can cause drug toxicity in the
blood
What is gingival hyperplasia and what drug causes it? - Answer Overgrowth of gums related to
phenytoin (Dilantin)
What is the therapeutic level of Phenytoin (Dilantin)? - Answer 10-20 mcg/mL
Phenytoin (Dilantin) has a narrow therapeutic range. What does this mean? - Answer Very small
window between therapeutic level and toxic level
At what rate should you push Phenytoin (Dilantin)? - Answer 50 mg/min
Push SLOWLY into a large vein
If you push too fast, could cause cardiac depression and collapse
Hydantoins, like phenytoin (Dilantin) and Cerebyx, should never be mixed with: - Answer D5W
,Can mix with propylene glycol for drug stability
What is the pharmacologic effect of Cerebyx? - Answer Converted to phenytoin in the body, which then
blocks sodium channels and stabilizes nerve cells
What is the pharmacologic effect of Carbamazepine (Tegretol)? - Answer Sodium channel blocker,
stabilizes nerve cells
What is the therapeutic level of Carbamazepine? - Answer 4-12 mcg/mL
What should you avoid when taking Carbamazepine? - Answer Grapefruit juice
Why should you always monitor the therapeutic level of Carbamazepine? - Answer Autoinduction
Can cause auto induction of hepatic enzymes, which enhance its own metabolism, leading to lower than
expected drug levels in the body
What is the pharmacological effect of Valproic Acid (Depakene, Depakote, Depacon)? - Answer Blocks
sodium channels
Increases GABA
What are the adverse effects of Valproic Acid? - Answer -Hepatotixicity
-Pancreatitis
What is the expected pharmacologic effect of Phenobarbital (anticonvulsant)? - Answer Potentiates the
effects of GABA
What is the therapeutic level of Phenobarbital? - Answer 10-40 mcg/mL
, Phenobarbital is an inducer of hepatic enzymes, meaning: - Answer it causes the rapid clearance of
some drugs
What level of controlled substances are benzodiazepines? - Answer Schedule IV
Which is the drug of choice for the treatment of status epilepticus? - Answer Benzodiazepines,
specifically lorazepam (Ativan)
Which is the drug of choice for the treatment of absence seizures? - Answer Ethosuximide (Zarontin)
Suppresses neurons in the thalamus that generate absence seizures
Which drugs cause Steven Johnson's Syndrome? - Answer AEDs
Pregabalin (Lyrica) is a schedule V controlled substance used for: - Answer Treatment of seizures as a
calcium channel blocker
Most commonly used for neuropathic brain
What is the goal of drug selection for seizures? - Answer Control seizures with minimal adverse effects,
enable patient to pursue normal daily activities
-Age
-Type of seizure
-Adverse effects
-Number of doses
IV Phenytoin should be given only with ______________ - Answer Normal saline
And All Complete Solutions.
What differentiates a seizure, convulsion, and epilepsy? - Answer Seizure - brief episode of abnormal
electrical activity in nerve cells of the brain
Convulsion - involuntary spasmodic contractions of any or all voluntary muscles throughout the body
Epilepsy - chronic, recurrent pattern of seizures
What is a generalized onset seizure? - Answer Neuronal activity that originates simultaneously in the
gray matter of both hemispheres
Ex. tonic-clonic, absence
What is a focal onset seizure? - Answer Neuronal activity that originates in a localized or focal region of
the brain
What is a status epilepticus seizure? - Answer Multiple seizures that occur with no recovery (doesn't
end for 5+ minutes)
Why is antiepileptic therapy not recommended after a single seizure event? - Answer only a 40%
chance that a seizure will happen again
What are the general pharmacologic effects of anti epileptics? - Answer -reduce nerve's ability to be
stimulated (block sodium/calcium channels)
-suppress transmission of impulses from one nerve to the next (increase GABA, decrease Glutamate)
-Decrease the speed of nerve impulse conduction within a neuron
Cerebyx versus Celebrex - Answer Medication alert! Sound alike/look alike!
,Cerebyx is an AED
Celebrex is an NSAID
As of 2008, the FDA put a black box warning on AEDs for which adverse effect? - Answer Suicidal
thoughts and behaviors
Phenytoin (Dilantin) is an AED that has what pharmacologic effect? - Answer Stabilizes nerve cells by
blocking sodium channels
As a nurse, it is important to understand a client's diet when they are taking Phenytoin. Why? - Answer
Phenytoin is a highly protein bound drug. If a patient is malnourished, it can cause drug toxicity in the
blood
What is gingival hyperplasia and what drug causes it? - Answer Overgrowth of gums related to
phenytoin (Dilantin)
What is the therapeutic level of Phenytoin (Dilantin)? - Answer 10-20 mcg/mL
Phenytoin (Dilantin) has a narrow therapeutic range. What does this mean? - Answer Very small
window between therapeutic level and toxic level
At what rate should you push Phenytoin (Dilantin)? - Answer 50 mg/min
Push SLOWLY into a large vein
If you push too fast, could cause cardiac depression and collapse
Hydantoins, like phenytoin (Dilantin) and Cerebyx, should never be mixed with: - Answer D5W
,Can mix with propylene glycol for drug stability
What is the pharmacologic effect of Cerebyx? - Answer Converted to phenytoin in the body, which then
blocks sodium channels and stabilizes nerve cells
What is the pharmacologic effect of Carbamazepine (Tegretol)? - Answer Sodium channel blocker,
stabilizes nerve cells
What is the therapeutic level of Carbamazepine? - Answer 4-12 mcg/mL
What should you avoid when taking Carbamazepine? - Answer Grapefruit juice
Why should you always monitor the therapeutic level of Carbamazepine? - Answer Autoinduction
Can cause auto induction of hepatic enzymes, which enhance its own metabolism, leading to lower than
expected drug levels in the body
What is the pharmacological effect of Valproic Acid (Depakene, Depakote, Depacon)? - Answer Blocks
sodium channels
Increases GABA
What are the adverse effects of Valproic Acid? - Answer -Hepatotixicity
-Pancreatitis
What is the expected pharmacologic effect of Phenobarbital (anticonvulsant)? - Answer Potentiates the
effects of GABA
What is the therapeutic level of Phenobarbital? - Answer 10-40 mcg/mL
, Phenobarbital is an inducer of hepatic enzymes, meaning: - Answer it causes the rapid clearance of
some drugs
What level of controlled substances are benzodiazepines? - Answer Schedule IV
Which is the drug of choice for the treatment of status epilepticus? - Answer Benzodiazepines,
specifically lorazepam (Ativan)
Which is the drug of choice for the treatment of absence seizures? - Answer Ethosuximide (Zarontin)
Suppresses neurons in the thalamus that generate absence seizures
Which drugs cause Steven Johnson's Syndrome? - Answer AEDs
Pregabalin (Lyrica) is a schedule V controlled substance used for: - Answer Treatment of seizures as a
calcium channel blocker
Most commonly used for neuropathic brain
What is the goal of drug selection for seizures? - Answer Control seizures with minimal adverse effects,
enable patient to pursue normal daily activities
-Age
-Type of seizure
-Adverse effects
-Number of doses
IV Phenytoin should be given only with ______________ - Answer Normal saline
