Question 1

Phenytoin (Dilantin)has a narrow therapeutic index.Which statement defines this characteristic?

Accepted Answer

A narrow therapeutic index means that a narrow difference exists between safe and toxic drug levels.These drugs require monitoring of therapeutic plasma levels.

Question 2

Which teaching tips is appropriate for the nurse to give a patient taking topiramate (Topamax)?

Accepted Answer

Topiramate and valproic acid tablets and delayed- or extended-release dosage forms are not to be altered in any way and must be taken as prescribed.Topiramate should be taken whole,not crushed or broken.Taking this medication with meals may help reduce the nausea that may occur.The medication should be taken at the same time each day,and doses should not be skipped.If adverse effects become a problem,the patient should contact the prescriber.

Question 3

When administering phenytoin (Dilantin)intravenously,what must the nurse remember?

Accepted Answer

IV phenytoin should be given with normal saline solution only.The IV dose must be given slowly.The patient must be monitored for bradycardia and decreased blood pressure.To prevent precipitation formation due to incompatibilities,phenytoin cannot be combined with other solutions.

Question 4

What is the drug of choice for the immediate treatment of status epilepticus?

Accepted Answer

Diazepam rectally administered is an initial emergent drug for status epilepticus.

Question 5

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?

Accepted Answer

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).

Question 6

A patient has been taking gabapentin (Neurontin)for several years as part of the treatment for partial seizures.His wife has called because he ran out of medication this morning,and she wonders whether he can go without it for a week until she can go to the drugstore.Which statement is true in this situation?

Accepted Answer

Abrupt discontinuation of the gabapentin can lead to withdrawal seizures.

Question 7

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?

Accepted Answer

With carbamazepine,autoinduction occurs and leads to lower-than-expected drug concentrations.Therefore,the dose may need to be adjusted over time.

Question 8

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?

Accepted Answer

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.

Question 9

Which antiepileptic drug allows once-a-day dosing?

Accepted Answer

Phenobarbital has the longest half-life of all standard antiepileptic drugs,which allows once-a-day dosing.

Question 10

While teaching a patient about taking a newly prescribed antiepileptic drug (AED)at home,what information should the nurse emphasize?

Accepted Answer

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.

Question 11

Which statements about antiepileptic drug (AED)therapy are true? (Select all that apply.)

Accepted Answer

Patients need to know that AED therapy is usually lifelong,and compliance (with consistent dosing)is important for effective seizure control.Antiepileptic drugs must never be abruptly discontinued as it may precipitate rebound seizure activity.

Quiz 15: Antiepileptic Drugs

Phenytoin (Dilantin) has a narrow therapeutic index.Which statement defines this characteristic?

Which teaching tips is appropriate for the nurse to give a patient taking topiramate (Topamax) ?

When administering phenytoin (Dilantin) intravenously,what must the nurse remember?

What is the drug of choice for the immediate treatment of status epilepticus?

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 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 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?

Which antiepileptic drug allows once-a-day dosing?

While teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home,what information should the nurse emphasize?

Which statements about antiepileptic drug (AED) therapy are true? (Select all that apply.)