A nurse is assessing a graduate nurse's knowledge of ...

[maychende]

A nurse is assessing a graduate nurse's knowledge of antiepileptic medications and asks him, How is ethosuximide (Zarontin) different from phenytoin (Dilantin) and carbamazepine (Tegretol)?
 
  Which response provided by the graduate nurse best demonstrates understanding of the differences between the medications?
  a. Ethosuximide does not block sodium channels or enhance gamma-aminobutyric acid.
  b. Ethosuximide efficacy is readily monitored by serum levels.
  c. Ethosuximide has more significant adverse events and drug interactions.
  d. Ethosuximide cannot be used in children.

Question 2

A patient with a history of seizures has been admitted to the hospital for a minor infection and will be going home tomorrow.
 
  The patient has been taking lamotrigine (Lamictal) and valproic acid (Depakote). Upon assessment, the nurse notes that the patient has widespread lesions of the skin and mucous membranes and a temperature of 102.9F, and that the patient complains of malaise. The nurse should suspect
  a. a hematological reaction.
  b. Stevens-Johnson syndrome.
  c. toxic levels of valproic acid (Depakote).
  d. toxic epidermal necrolysis.

[mcni194]

Answer to Question 1

ANS: A
Ethosuximide does not block sodium channels and does not enhance gamma-aminobutyricmediated neuronal inhibition, as do phenytoin and carbamazepine.
All the drug levels should be monitored by serum levels.
The adverse events and drug interactions are not more significant with ethosuximide, and all share serious adverse side effects.
All of the medications may be used for children.

Answer to Question 2

ANS: B
Lamotrigine can cause life-threatening rashes, including Stevens-Johnson syndrome and toxic epidermal necrolysis. Concurrent use of valproic acid increases the risk.
No evidence indicates a hematological reaction.
No evidence indicates Depakote toxicity, which may manifest as hepatotoxicity and pancreatitis.
Symptoms of toxic epidermal necrolysis are not manifested in this patient.

[maychende]

Both answers were spot on, thank you once again

[mcni194]

Great! Please up vote