The patient is receiving phenobarbital (Luminal) for seizure control. The patient asks the nurse how this little pill can stop his seizures. What is the best response by the nurse?
1. "Phenobarbital (Luminal) stops your seizures by decreasing the calcium in your brain which is responsible for the seizures."
2. "Phenobarbital (Luminal) stops your seizures by increasing a chemical called glutamate that calms down the excitability in your brain."
3. "Phenobarbital (Luminal) stops your seizures by decreasing the sodium in your brain which is responsible for the seizures."
4. "Phenobarbital (Luminal) stops your seizures by increasing a chemical called GABA that calms down the excitability in your brain."
Correct Answer: 4
Rationale: Phenobarbital (Luminal) acts biochemically in the brain by enhancing the action of the neurotransmitter GABA, which is responsible for suppressing abnormal neuronal discharges that can cause epilepsy. Glutamate is the primary excitatory neurotransmitter in the brain; enhancing this neurotransmitter will increase the likelihood of seizures. Hydantoins and phenytoin-like drugs, not phenobarbital (Luminal), suppress sodium influx. Succinimides, not phenobarbital (Luminal), suppress calcium influx.
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