Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
46 Cards in this Set
- Front
- Back
|
# of seizures needed to diagnose epilepsy
|
2 unprovoked seizures
|
|
|
Cause of epilepsy
|
neurons become depolarized and repetitively fire action potentials
|
|
|
cause of seizures
|
disruption of enzymes and neurotransmitters
|
|
|
which type of Seizure: may have muscle twitching or sensory hallucinations; no loss of conciousness
|
simple partial; considered unilateral; associated with an aura and automatism
|
|
|
which type of Seizure: may have impaired consciousness, confusion, blank stare, and postseizure amnesia
|
complex partial
|
|
|
which type of Seizure: Body becomes rigid, patient may fall
|
tonic (lasts less than one minute)
|
|
|
which type of Seizure: muscle jerks
|
clonic; may be accompanied by shallow breathing, loss of bladder control, and excess salivation; a few minutes
|
|
|
which type of Seizure: blank stare, rotation eyes, uncontrolled facial movements
|
absence seizure; usually lasts 30 seconds or less
CHILDREN |
|
|
which type of Seizure: sudden, massive, brief muscle jerks, may throw patient down
|
myoclonic; consciousness is not lost; can occur during sleep
|
|
|
which type of Seizure: sudden loss of muscle tone and consciousness
|
Atonic seizures
May last few seconds to minute |
|
|
antiepileptic drug therapy initiation
|
always start monotherapy at low dose and increase slowly over 3-4 weeks; maintain at therapeutic steady state
|
|
|
Anticonvulsant MOA
|
-enhancement of sodium channel inactivation
-reducing current through t-type calcium channels -enhancement of GABA activity -antiglutamate activity |
|
|
Decrease folate and vitamin k
|
phenobarbitol and phenytoin; no folate can cause megaloblastic anemia
|
|
|
Phenobarbitol therapeutic level
|
10-40 mcg/L
|
|
|
Phenobarbitol serious side effects
|
Hepatic failure, SJS, hemorrhagic disease
decreased ability to retain memory with chronic abuse? |
|
|
Phenytoin therapeutic level
|
10-20 mg/L
|
|
|
Metabolized in the liver to phenobarbitol
|
Primodone
|
|
|
Primodone therapeutic level
|
8-12 mcg/mL
|
|
|
Anti seizure drug that can induce its own metabolism
|
carbamazepine
|
|
|
Serious side effects carbamazepine
|
hepatotoxicity, aplastic anemia (WBC <2-3000; Neu 1,000-1500) consider discontinuing meds)
|
|
|
Carbamazepine therapeutic range
|
Mono: 4-12 mg/L
Poly 4-8 mg/L |
|
|
Valproic acid therapeutic range
|
50-100 mg/dL
|
|
|
Blocks high frequency firing of neurons and modifies amino acid metabolism
|
Valproic Acid
|
|
|
Can cause neural tube defect (spina bifida)
|
Valproic Acid
|
|
|
Can have FATAL hepatotoxicity or hemorrhagic pancreatitis
|
Valproic Acid
|
|
|
Gabapentin therapeutic range
|
1200-1800 mg
|
|
|
Gabapentin Side effects
|
somnolence, dizziness, ataxia
|
|
|
Decreases excitatory transmission by acting on VG calcium channel presynaptically
|
gabapentin
|
|
|
work on hepatic enzymes
|
all seizure medication
|
|
|
seizure drugs that cause enzymatic changes
|
carbamazepine, phenobarbitol, phenytoin, valproic acid
|
|
|
Lamotrigine side effects
|
dizziness, ha, diplopia, skin rash SJS
|
|
|
antiseizure med that can be used for migraines
|
topiramate
|
|
|
which antiseizure drugs could potentially precipitate kidney stones?
|
topiramate, zonisamide
|
|
|
side effects topiramate
|
somnolence, coginitive slowing, confusion, parastehsias, loss of appetitie, matabolic acidosis, kidney stones, significant weight loss, word finding
|
|
|
Potentiates topiramate
|
alcohol, morphine, codeine, acetazolamide
metformin concentration is increased |
|
|
decreases topiramate
|
phenobarbitol, phenytoin, valproic acid
valproic acid and oral contraceptives are decreased |
|
|
zonisamide side effects
|
kidney stones, weight loss, psychosis, oligohidrosis
|
|
|
Zonisamide concentration is decreased by:
|
carbamazepin, phenobarbitol, pheytoin, valproic acid
|
|
|
status epilepticus lasts at least:
|
30 minutes
|
|
|
doc status epilepticus
|
benzodiazepines: diazepam or lorazepam
|
|
|
benign seizure lasting less than 15 minutes; no occuring more than once in 24 hours
|
simple febrile seizure
|
|
|
focal prolonged >15 min reoccuring w/ in 24 hours
|
complex febrile seizure
|
|
|
seizure associated with hormonal changes during menstruation
|
catamenial
|
|
|
seizure that begins in first 6 months of life; occurs in clusters severa times a day
|
infantile spasms
|
|
|
occurs with head trauma
|
post traumatic epilepsy; begin phenytoin for 7 days then discontinue
|
|
|
docs complicated febrile seizure
|
phenytoin or phebobarbitol
|
