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33 Cards in this Set
- Front
- Back
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Seizures |
Finite episodes of brain dysfunction resulting from abnormal discharge of cerebral neurons |
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Seizure |
Transient alteration of behavior due to the disordered, synchronous and rhythmic firing of populations of brain neurons |
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Epilepsy |
Heterogeneous complex symptom- a chronic disorder characterized by recurrent seizures |
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Epilepsy |
Disorder of brain function characterized by the periodic and unpredictable occurence of seizures |
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Causes of Epilepsy |
Infection Neoplasms Head injury Heredity Metabolic disorder eg hypocalcaemia |
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Seizure may be triggered by: |
1.) Reduction of inhibitory synaptic activity 2.) Enhancement of excitatory synaptic activity |
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Compounds work by one of three mechanism: |
1.) Enhancement of GABAergic transmission 2.) Dimunition of excitatory transmission 3.) Modificatiin of ionic conductances |
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Classification of Seizures |
1.) Partial seizures 2.) Generalized Seizures |
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Partial Seizures include |
Simple partial Complex partial Partial seizure secondarily Generalized |
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Partial Seizure |
Seizures where a localized onset of the attack can be ascertained either clinically or by EEG |
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Simple Partial Seizures |
Normal consciousness amd awareness are preserved Sudden onset of clonic jerking of an extremity lasting 60-90 seconds Residual weakness may last 15-30mins |
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Complex Partial Seizure |
Localized onset but discharge becomes more widespread-usually bilateral Almost always involves limbic system Most arise from temporal lobe Brief AURA followed by alteration of consciousness Integrated motor behavior automatisms-lip smacking, swallowing, scratching |
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Secondarily Generalized attack |
Where a partial seizure precedes a generalized tonic clonic-grand mal-seizure |
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Generalized tonic clonic |
Tonic rigidity of all extremities, followed in 15-30secs by a tremor that is actually an interruption of the tonus by relaxation As relaxation gets longer the attack enters clonic phase with massive jerking of the body Clinic jerking slows over 60-120secs Urinary incontinence is common |
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Absent (petit mal) Seizure |
Sudden onset and abrupt cessation Consciousness is altered Less than 10secs no more than 45secs Mild clonic jerking of eyekids and extremities, automatism, autonomic phenomena |
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Atonic Seizures |
Sudden loss of postural tone Wear helmets to protect |
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Infantile Spasm |
It is an epileptic syndrome and not a seizure type |
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MOA of Phenytoin |
Blocks sustained high frequency repetitive firing of AP It decreases the synaptic release of glutamate and enhances the release of GABA |
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Phenytoin is active against: |
Partial seizures and Generalized Tonic clonic seizures |
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Phenytoin can be displaced from its binding site by |
Sulfinamides & Phenylbutazone |
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Drugs that decrease phenytoin steady state concentrations through induction of hepatic microsomal enzymes |
Phenobarbital & Carbamazepine |
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Drug that inhibits the metabolism of Phenytoin resulting in increased steady state concentrations |
Isoniazid |
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S/E of Phenytoin |
Diplopia & ataxia: most common Sedation Gingival hyperplasia & hirsutism Nystagmus: occurs early in course of treatment |
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Long term use of Phenytoin is associated with: |
Coarsening of facial features Mild peripheral neuropathy Abnormalities of Vitamin D metabolism Low folate levels and megaloblastic anaemia |
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Barbiturates |
Phenobarbital Mephobarbital Metharbital Primidone |
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Pharmacokinetics Barbiturates |
Widely metabolized except phenobarbital Metabolic pathways involve oxidation by hepatic enzymes to form alcohols, acids & ketones and appear un urine as glucuronide conjugates |
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Elimination half life if phenobarbital |
4-5 days |
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Phenibarbital is useful in the treatment of |
Partial seizures & Generalized tonic clonic seizures |
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Oxazolindinediones are used in |
Absent seizures |
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Trimethadione us used as an anticonvulsant in: |
Grand mal epilepsy To arrest status epilepticus In petit mal epilepsy |
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Trimethadione is usally given in conjunction with |
Phenytoin sodium Phenibarbital |
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Trimethadione may alsi be used in treatment of: |
Behavior problems encountered in children, status epilepticus and athetoses |
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Succinamides |
Ethosuximide: petit mal drug |
