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10 Cards in this Set
- Front
- Back
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Symptoms of seizure activity
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-Change in alertness; the person cannot remember a period of time\
• Mood changes, such as unexplainable fear, panic, joy, or laughter • Change in sensation of the skin, usually spreading over the arm, leg, or trunk • Vision changes, including seeing flashing lights • Falling, loss of muscle control that occurs very suddenly • Muscle twitching that my spread up or down an arm or leg • Muscle tension or tightness that causes twisting of the body, head, arms, or lets • Shaking of the entire body • Tasting a bitter or metallic flavor |
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Seizure First Aid
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1. When the seizure occurs, the main goal is to protect the person from injury. Try to prevent a fall. Lay the person on the ground in a safe area. Clear the area of furniture, equipment, or other sharp objects.
2. Cushion the person’s head. 3. Loosen tight clothing, especially around the person’s neck. 4. Turn the person on his/her side. If vomiting occurs, this prevents vomit from being inhaled into the lungs. 5. Look for a medical ID bracelet with seizure instructions. 6. Stay with the person until he/she recovers, or until you have professional medical help. Meanwhile monitor the person’s vital signs (pulse & rate of breathing). • DO NOT restrain the person. • DO NOT place anything between the person’s teeth during a seizure (including your fingers). • DO NOT move the person unless he/she is in danger or near something hazardous. • DO NOT try to make the person stop convulsing. He/she has not control over the seizure and is not aware of what is happening at the time. • DO NOT |
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When to call 911 for seizures
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• A seizure lasts more than 2 to 5 minutes.
• The person does not awaken or have normal behavior after a seizure. • Another seizure starts soon after a seizure ends. • This is the first time the person has had a seizure. • The person had a seizure in water. • The person is pregnant, injured or has diabetes. • The person does not have a medical ID bracelet (instructions explaining what to do). There is anything different about this seizure as compared to the person’s usual seizures |
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Major excitatory neurotransmitter
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Glutamat in the cerebral cortex
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Major inhibitory neurotransmitter
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GABA
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Therapeutic goals of epilepsy
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Therapeutic Goals for Management of Epilepsy
• Decrease seizure frequency to an acceptable level of function for the patient • Balance the benefits of the medications with their potential toxicities and adverse effects • Non-compliance is an issue & may account for up to 50% of therapy failures • Quality of life goes beyond balancing seizures & ADRs. One must consider other patient concerns about driving, their future, forming relationships, safety, social isolation, stigma, etc |
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ADRs common w/ anti-epileptic drugs
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• Common ADRs: drowsiness, sedation, lethargy, confusion, nystagmus (eye tremor), diplopia (double vision), ataxia (movement awkwardness), vertigo, and dizziness
• Cognitive: 50% of patients with epilepsy complain of cognitive difficulty & believe their seizures interfere with learning; medications may also cause cognitive impairment • Osteoporosis Risk: risk of developing osteoporosis from AEDs is similar to the risk seen with chronic corticosteroid use. Patients should take supplemental calcium + vitamin D if taking carbamazepine, phenytoin, phenobarbital, oxcarbazepine, or valproate • AED-induced Rash: refer patients for evaluation of all rashes. Doctor must differentiate between mild rash, Steven-Johnson Syndrome (SJS), or toxic epidermal necrolysis (TEN). SJS & TEN can progress rapidly. SJS: blisters, fever, sore throat, chills, & fatigue. TEN: blisters & skin sloughing. SJS & TEN are medical emergencies because the AED should be stopped immediately which can increase the |
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Gabapentin M.O.A and adverse effects
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Mechanism of Action
• Enhances GABA activity and bocks opening of calcium channels Adverse Effects • Weight gain, peripheral edema (caution in Class III or IV heart failure) • Paradoxical responses in children & elderly |
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Pregablin (Lyrica) M.O.A. and ADRS
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Mechanism of Action, Other Adverse Effects, and Drug Interactions
• Similar to gabapentin • Reports of mild euphoria (Schedule C-V) |
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List the other therapeutic uses for the AEDs including management of pain, neuromuscular disorders, and psychiatric indications. You do not have to memorize which AEDs are more commonly used to treat these indications except you should know
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a. diabetic neuropathy pain, shingles pain, HIV-neuropathy, & fibromyalgia: pregabalin
b. essential tremor: primidone, propranolol |
