Share This Link

Ethosuximide (Zarontin) is considered the first-line treatment for absence seizures. It works by reducing calcium influx through T-type calcium channels in thalamic neurons, which play a key role in generating absence seizure activity. Its effectiveness and relatively favorable side effect profile make it the gold standard for treating absence seizures.

Valproic acid (Depakote) is another highly effective agent for absence seizures. In addition to blocking sodium channels, it increases brain levels of GABA, the main inhibitory neurotransmitter, which reduces seizure activity. It is often used when a client has both absence seizures and other seizure types, such as generalized tonic-clonic seizures, because of its broad-spectrum activity.

Lamotrigine (Lamictal) is also appropriate for absence seizures. It works mainly by inhibiting sodium channels and stabilizing neuronal membranes. While not always first-line, lamotrigine is considered an acceptable alternative or adjunct for absence seizures, especially when ethosuximide or valproic acid are not tolerated.Rationale for incorrect answers:

Valproic acid (Depakote) is highly effective in controlling absence seizures. It works by increasing brain levels of GABA and blocking sodium channels, thereby stabilizing neuronal firing. It is especially useful in patients who have absence seizures along with other generalized seizure types, making it a broad-spectrum option.

Clonazepam (Klonopin), a benzodiazepine, can also be prescribed for absence seizures. It enhances GABA-mediated inhibition in the central nervous system, reducing seizure activity. While effective, it is often used as an adjunct or second-line option due to the potential for tolerance and sedation.

Ethosuximide (Zarontin) is considered the first-line therapy for absence seizures. It specifically reduces abnormal thalamic activity by blocking T-type calcium channels, which are central to the pathophysiology of petit mal seizures.Rationale for incorrect answers:

Diazepam (Valium) is commonly used in emergency settings because it has a rapid onset of action when given IV or rectally. It enhances GABA activity, producing quick CNS depression that terminates seizure activity. However, its effect is relatively short-lived, so it is usually followed by a longer-acting anticonvulsant for sustained seizure control.

Midazolam (Versed) is another benzodiazepine frequently used for status epilepticus. It can be given IV, IM, or intranasally, making it useful when IV access is difficult. Like diazepam, it provides fast seizure control but also requires follow-up with maintenance therapy due to its shorter duration of action.Rationale for incorrect answers:

Phenytoin (Dilantin) is appropriate because it works by blocking sodium channels, thereby decreasing neuronal excitability. It has long been used for partial seizures as well as generalized tonic–clonic seizures.

Valproic acid (Depakene) is effective for a broad spectrum of seizures, including partial seizures, generalized seizures, and absence seizures. Its mechanism includes increasing GABA levels and stabilizing neuronal firing.

Carbamazepine (Tegretol) is a first-line drug for partial seizures. Like phenytoin, it reduces repetitive firing of neurons through sodium channel blockade, making it highly effective in focal epilepsy.Rationale for incorrect answers:

Administer in normal saline solutions is appropriate because phenytoin is incompatible with dextrose-containing solutions. When mixed with dextrose, phenytoin precipitates, making the solution unsafe for administration. Normal saline is the only suitable diluent.

Use a filter for IV infusions is correct because phenytoin can crystallize or precipitate in solution. Using an in-line filter prevents the infusion of particulate matter into the bloodstream, which could cause phlebitis or emboli.Rationale for incorrect answers:

Monitor the patient for drowsiness is essential because many AEDs cause central nervous system depression. Sedation, dizziness, and fatigue are common adverse effects, especially when therapy is first started or doses are adjusted.

Give the medication at the same time every day is critical to maintain stable blood drug levels, which help prevent seizure activity. Irregular dosing increases the risk of subtherapeutic levels and breakthrough seizures.

Notify the prescriber if the patient is unable to take the medication is vital because abrupt discontinuation of AEDs can lead to status epilepticus, a medical emergency. If a dose is missed or the patient cannot tolerate oral administration, alternative routes or adjustments should be discussed with the provider immediately.Rationale for incorrect answers: