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30 Cards in this Set

  • Front
  • Back
what is epilepsy
it is not a specific disease it is a broad syndrome of the CNS dysfunctions that can make sensory distrubances and every convulsions
where are excessive electrical discharges located
in the cerbral cortex
what is a seizure
brief episode of abnormal activity in the nerve cells of the brain
what is a convulsion
characterized by involuntary spasmodic contractions of any or all voluntary muscles throughout the body, including skeletal and facial muscles
what is a epilepsy
chronic, recurrent pattern of seizures
what test help DX epilepsy
EEG,CT, MRI
common symptoms is epilepsy
abnormal motor function, LOC, altered sensory awareness, adn psychic changes
what are partial seizures
Short alterations in consciousness, repetitive unusual movements, psychological changes, and confusion.
what are simple seizures
No impaired consciousness

Motor symptoms
Hallucinations of sight, hearing, or taste, tingling
Autonomic nervous system responses

Personality changes
what are complex seizures
Impaired consciousness
Memory impairment
Behavioral effects
Purposeless behaviors
Aura, chewing and swallowing movements, unreal feelings, bizarre behavior
Tonic, clonic, or tonic-clonic seizures
what are generalized seizures
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
what is status epilepticus
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)
what is unclassified seizures
that do not fit into any category and can start off as partial and then become generalized
what is wntiepileptic drugs-AEDs
manage all types of epilepsy not just convulsions
what are anticonvulsants
used to prevent the seizures typically associated with epilepsy
what is the goal of AEDs
control or prevent seizures while maintaining a reasonable quality of life
what other illnesses to AEDs help with
psychiatric disorders, migrane HA, and neuropathic pain syndromes
what should you check when a pt is on AEDs
serum levels bc they effect the control of seizures and reduce adverse effects
what do AEDs alter the movement of
K,Na,Ca,Mg
what are the actions of AEDs
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
what is generalized tonic-clonic convulsions
pt dont regain consciousness in between convulsions
what could happen if thearpy is not started
hypotension, hypoxia, and cardiac dysrhythmias, brain damage, and death
dilantin-phenytonin
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
dilantin con't
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
solfoton-phenobarbital
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
tegretol-carbamazepine
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
klonopin-clonazepam
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.
tranxene-clorazepate dipotsssium
Benzodiazepine – long acting
Adult 22-90 mg/day
Partial seizures
zarontin-ethosuximide
Sucinimide
Very safe
Adult – 500 mg/day then adjust
Absence seizures – childhood
Side Effects – Nausea and abdominal cramps, drowsiness, anorexia, and headache.
depakote,depakene-valporic acid
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