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16 Cards in this Set

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  • Back
What are the two categories of seizures?
1) Partial (involves one hemisphere)
2) Generalized (involves both hemispheres and loss of consciousness)
What is a tonic-clonic seizure?
It is a generalized seizure that involves series of sustained contraction of the muscles followed by relaxation
What is post-ictal state?
PEriod right after seizure
What are two types of partial seizures?
Simple - one hemisphere, no loss of consciousness
Complex - one hemisphere and consciousness impaired
What is the first drug of choice for treating seizures?
Phenytoin (Dilantin) - tonic-clonic and status epilepticus
What is the mechanism of action for Phenytoin (Dilantin)?
Na Channel Blocker (slows APs)
Metab by liver, excreted by kidneys
Selectively binds hyperactive neurons and raises threshold for seizures
What are common ADEs of Phenytoin (Dilantin)?
CNS: ataxia, lethargy
GI: N&V
Gingival hyperplasia: gum overgrowth
What are serious ADEs of Phenytoin (Dilantin)?
Dermatological Rxns: Stephen Johnson Syndrome
Hepatotoxicity
What are the black box warnings for Dilantin?
Not used for pregnant or breastfeeding women
Administer IV Slowly (large amounts can cause bradycardia)
Increases risk of suicide
What are the contraindications for Phenytoin (Dilantin)?
Bradycardia, Heart Block
CNS Depression
Allergy
What are the administration recommendations for Phenytoin (Dilantin)?
IV push give only w. normal saline
Giving with Benzodiazepines can cause Dilantin to precipitate out
Dental visits
DM many need increase in Diabetes meds
What other drugs are used for treating seizures?
Benzodiazepines (Diazepam/Valium) - not long-term
Long acting barbituates - Phenobarbitol
What are the adverse effects of long acting barbituates?
CNS depression, sedation
What is status epilepticus?
Life threatening emergecy, recurrent tonic-clonic seizures
Symptoms include loss of consciousness, drop in BP, hypoxia, cardiac arrhythmias
Can lead to brain damage and death
What do we use to treat status epilepticus?
Lorazepam (Ativan) to break the seizure
Dilantin and
What causes status epilepticus?
stop taking antiseizure meds, CNS infection, alcohol, drugs, head injury