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30 Cards in this Set
- Front
- Back
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what is epilepsy
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it is not a specific disease it is a broad syndrome of the CNS dysfunctions that can make sensory distrubances and every convulsions
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where are excessive electrical discharges located
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in the cerbral cortex
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what is a seizure
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brief episode of abnormal activity in the nerve cells of the brain
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what is a convulsion
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characterized by involuntary spasmodic contractions of any or all voluntary muscles throughout the body, including skeletal and facial muscles
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what is a epilepsy
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chronic, recurrent pattern of seizures
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what test help DX epilepsy
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EEG,CT, MRI
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common symptoms is epilepsy
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abnormal motor function, LOC, altered sensory awareness, adn psychic changes
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what are partial seizures
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Short alterations in consciousness, repetitive unusual movements, psychological changes, and confusion.
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what are simple seizures
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No impaired consciousness
Motor symptoms Hallucinations of sight, hearing, or taste, tingling Autonomic nervous system responses Personality changes |
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what are complex seizures
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Impaired consciousness
Memory impairment Behavioral effects Purposeless behaviors Aura, chewing and swallowing movements, unreal feelings, bizarre behavior Tonic, clonic, or tonic-clonic seizures |
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what are generalized seizures
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Most often seen in children and commonly characterized by temporary lapses in consciousness lasting a few seconds. Staring off into space, daydreaming, and inattentive look. Rhythmic movements of eyes, head, or hands but do not convulse.
Both cerebral hemispheres involved Tonic, clonic, myocolonic, atonic, or tonic-clonic seizures Brief loss of consciousness for a few seconds with no confusion Head drop of falling-down symptoms |
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what is status epilepticus
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Life-threatening emergency
Characterized by generalized tonic-clonic convulsions that occur in succession Hypotension, hypoxia, cardiac dysrhythmias Rx: Valium 5-10 mgs Other drugs – Cerebyx (fosphenytoin), Ativan(lorazepam), Phenobarbitol (Solfoton), and Phenytoin(Dilantin) |
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what is unclassified seizures
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that do not fit into any category and can start off as partial and then become generalized
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what is wntiepileptic drugs-AEDs
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manage all types of epilepsy not just convulsions
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what are anticonvulsants
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used to prevent the seizures typically associated with epilepsy
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what is the goal of AEDs
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control or prevent seizures while maintaining a reasonable quality of life
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what other illnesses to AEDs help with
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psychiatric disorders, migrane HA, and neuropathic pain syndromes
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what should you check when a pt is on AEDs
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serum levels bc they effect the control of seizures and reduce adverse effects
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what do AEDs alter the movement of
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K,Na,Ca,Mg
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what are the actions of AEDs
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Increase the threshold of activity in the area of the brain called the motor cortex (difficult to excite the nerve)
Act to depress or limit the spread of a seizure discharge form its origin Decrease the speed of nerve impulse conduction within a given neuron |
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what is generalized tonic-clonic convulsions
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pt dont regain consciousness in between convulsions
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what could happen if thearpy is not started
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hypotension, hypoxia, and cardiac dysrhythmias, brain damage, and death
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dilantin-phenytonin
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Narrow therapeutic index
Inject IV slowly – don’t exceed 50 mgs/min in adults (hypotension, ventricular fibrillation) IV dose 15-20 mg/kg Very irritating to the vein Can only mix in saline Replaced by Cerebyx to overcome the short comings of Dilantin Adult po – 300-600 mg/day For tonic-clinic, psychomotor seizures, convulsions |
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dilantin con't
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Side effects – lethargy, abnormal movements, mental confusion, and cognitive changes.
Therapeutic levels 10-20mcg/mL Toxic levels – nystagmus, ataxia, dysarthria, and encephalopathy Long term – gingival hyperplasia, acne, hirsutism, and hypertrophy of the subcutaneous facial tissue resulting in “Dilantin facies” Osteoporosis long term Highly bound to protein and induces hepatic microsomal enzymes, P-450 system Long half-life |
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solfoton-phenobarbital
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Barbiturate
Adult – PO 100-300 mg/day IM/IV – 200-800 mgs followed by 120-240 mg dose every 20 min until seizure is controlled or a total dose of 1-2 g is reached Side effects – sedation most common Therapeutic index – 14-40mcg/mL Long half life Interacts with other drugs because it is a a major induce of hepatic enzymes |
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tegretol-carbamazepine
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Barbiturate
Adult – PO 100-300 mg/day IM/IV – 200-800 mgs followed by 120-240 mg dose every 20 min until seizure is controlled or a total dose of 1-2 g is reached Side effects – sedation most common Therapeutic index – 14-40mcg/mL Long half life Interacts with other drugs because it is a a major induce of hepatic enzymes |
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klonopin-clonazepam
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Benzodiazepine
Adult – 4-20 mg/day Reduces frequency of absence, generalized clonic-tonic, an myoclonic seizures High toxicity Adverse effects – drowsiness, ataxia, and personality changes. |
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tranxene-clorazepate dipotsssium
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Benzodiazepine – long acting
Adult 22-90 mg/day Partial seizures |
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zarontin-ethosuximide
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Sucinimide
Very safe Adult – 500 mg/day then adjust Absence seizures – childhood Side Effects – Nausea and abdominal cramps, drowsiness, anorexia, and headache. |
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depakote,depakene-valporic acid
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Adult PO 15-60 mg/kg/day divided bid-tid
Generalized seizures Side effects – drowsiness, nausea, vomiting, GI disturbances, tremor, weight gain, and hair loss Serious side effects – hepatoxicity and pancreatitis |
