Antiepileptics: Nursing Pharmacology

Summary

This script discusses anti-epileptic drugs, detailing their mechanisms and classifications. It covers sodium channel blockers, calcium channel blockers, GABA inhibitors, and GABA analogs, highlighting their uses and side effects. The video emphasizes the importance of client education, monitoring for adverse effects, and evaluating treatment efficacy in managing seizures and ensuring patient safety.

Takeaways

• 💊 Anti-epileptics, also known as anti-convulsants, are primarily used to treat epilepsy and seizures but can also be used for mood disorders.
• 🏥 These medications can be categorized into four main groups: sodium channel blockers, calcium channel blockers, GABA inhibitors, and GABA analogs.
• 🚫 Sodium channel blockers include hydantoins, Amino sine derivatives, valproate derivatives, and latene, each with specific administration routes and side effects.
• 🤒 Common side effects of sodium channel blockers range from headaches, dizziness, and visual disturbances to more severe reactions like hepatotoxicity and blood disorders.
• ⚠️ Sodium channel blockers have several contraindications, including pregnancy, certain cardiac conditions, and hypersensitivity reactions.
• 🔄 Calcium channel blockers work by inhibiting excitatory neurons from firing action potentials, reducing seizure activity.
• 🚫 Calcium channel blockers like ethosuximide and levetiracetam have side effects such as gastrointestinal issues, headaches, and fatigue.
• 🚫 GABA inhibitors, such as vigabatrin, increase the concentration of the inhibitory neurotransmitter GABA to control seizures, with side effects including dizziness and weight gain.
• 🚫 GABA analogs, like gabapentin, have an unclear mechanism but are thought to exert an inhibitory effect, with side effects like depression and somnolence.
• 📋 Nursing considerations for anti-epileptic therapy include assessing the client's medical history, educating about side effects, monitoring during treatment, and evaluating treatment effectiveness.

Q & A

What are anti-epileptics also known as?

Anti-epileptics are also known as anti-convulsants.

What are the four main groups of anti-epileptics based on their mechanism of action?

The four main groups of anti-epileptics based on their mechanism of action are sodium channel blockers, calcium channel blockers, GABA inhibitors, and GABA analogs.

How do sodium channel blockers work in treating epilepsy?

Sodium channel blockers work by blocking voltage-gated sodium channels, which inhibits excitatory neurons from firing action potentials, thereby reducing and alleviating seizures.

What are some common side effects of hydantoins, a type of sodium channel blocker?

Common side effects of hydantoins include headaches, dizziness, visual disturbances, gingival hyperplasia, hypersensitivity reactions, hepatotoxicity, impaired metabolism of vitamin D, and hematologic side effects.

What is a contraindication for the use of phenytoin, a sodium channel blocker?

Phenytoin should be avoided during pregnancy and in clients with sinus bradycardia, heart block, and Adam's Stokes syndrome.

How do calcium channel blockers reduce seizure activity?

Calcium channel blockers reduce seizure activity by blocking voltage-gated calcium channels, which inhibits excitatory neurons from firing action potentials.

What is the primary mechanism of action of GABA inhibitors like vigabatrin?

Vigabatrin, a GABA inhibitor, acts by inhibiting the reuptake of GABA, increasing its concentration in the synaptic cleft, which helps control seizures.

What are some potential life-threatening side effects associated with vigabatrin?

Potential life-threatening side effects of vigabatrin include suicidal thoughts, malignant hypothermia, respiratory depression, and pulmonary embolism.

Why is it important to monitor clients for side effects when they are on anti-epileptic medications?

It is important to monitor clients for side effects because anti-epileptic medications can cause serious side effects such as CNS depression, hepatotoxicity, blood disorders, and suicidal thoughts.

What precautions should be taken when administering anti-epileptics to clients of childbearing age?

For clients of childbearing age, it is crucial to confirm a negative pregnancy test, stress the importance of using reliable contraception while taking anti-epileptic medications, and advise them to wear medical identification.