A client on the unit is experiencing tonic-clonic seizures. What drug does the nurse anticipate for this client because it is considered the drug of choice for this type of seizure?
1. Carbamezepine (Tegretol)
2. Valproic acid (Depakote)
3. Zonisamide (Zonegran)
4. Phenytoin (Dilantin)
Correct Answer: 1
Rationale 1: Carbamezepine (Tegretol), a phenytoin-like drug that leaves sodium channels unblocked, allowing action potential but making it less sensitive to excessive neuronal activity, is the drug of choice for tonic-clonic and partial seizures because it produces fewer adverse effects than does phenytoin or phenobarbital.
Rationale 2: Valproic acid (Depakote) is incorrect because valproic acid is the drug of choice for absence seizures.
Rationale 3: Zonisamide (Zonegran) is incorrect because zonisamide is a newer drug for partial seizures.
Rationale 4: Phenytoin (Dilantin) is incorrect because there are more side effects with phenytoin.
Global Rationale: Carbamezepine (Tegretol), a phenytoin-like drug that leaves sodium channels unblocked, allowing action potential but making it less sensitive to excessive neuronal activity, is the drug of choice for tonic-clonic and partial seizures because it produces fewer adverse effects than does phenytoin or phenobarbital. Valproic acid (Depakote) is incorrect because valproic acid is the drug of choice for absence seizures. Zonisamide (Zonegran) is incorrect because zonisamide is a newer drug for partial seizures. Phenytoin (Dilantin) is incorrect because there are more side effects with phenytoin.
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