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29 Cards in this Set
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May be:
~Clonic Tonic or ~Atonic; autonomic components; or accompanying automatisms -Almost always begins in childhood and stops by age 20 -Consciousness briefly impaired -Pt unaware of attack |
Absence Sz
(petite mal) |
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May be more gradual in onset and termination than typical absence
More marked changes in tone may occur |
Atypical absences
Atypical Absent Sz |
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Single or multiple myoclonic jerks
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Myoclonic
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Tonic phase:
LOC: W/ rigidity & Resp Arrest <1 min Clonic Phase: Jerking usually for < 2-3 min Flaccid Coma: Variable duration May include incontinence or aspiration; followed by postictal confusion variable in duration. |
Tonic-Clonic
(Grand Mal) |
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Repeated seizures w/o recovery between them; a fixed and enduring epileptic condition lasting 30 min.
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Status epilepticus
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Indicated for partial seizures
general tonic-clonic seizures trigeminal neuralgia and as an alternative to lithium for bipolar Dz |
Carbamazepine
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Adverse effects include
-ataxia -CNS depression -drowsiness -GI reactions -Sometimes associated /c aplastic anemia -Can worsen absence seizures. |
Carbamazepine
A/E are: |
-ataxia
-CNS depression -drowsiness -GI reactions -Sometimes associated /c aplastic anemia -Can worsen absence seizures. |
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-Potent P450 inducer
-which increases metabolism of itself and many other drugs -shortening half life and decreasing serum levels -It can also increase lithium toxicity. |
Carbamazepine
A/E (3ct) |
Increases metabolism of itself / other Rx
Shortens half life - decreasing serum levels -Increases lithium toxicity. |
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Indicated for
-partial seizures -general tonic-clonic seizures - Interferes with folate metabolism which can lead to megaloblastic anemia Birth defects such as: -Fetal hydantoin syndrome -Ataxia -Diplopia -Nystagmus -Can worsen absence seizures. |
Phenytoin
Indicated for Birth defects such as: Can worsen _____ Sz? - Interferes with : -which can lead to |
Interferes with folate metabolism
megaloblastic anemia -Fetal hydantoin syndrome -Ataxia -Diplopia -Nystagmus -Can worsen absence seizures. |
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-Accelerates metabolism of other antiepileptics
Reduces levels of: -Digoxin -Steroid -Vit-K -Other levels -Metabolized faster if Carbamazepine is present -Slower if Cimetidine. |
Phenytoin
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-Indicated for partial Sz
-General Tonic-Clonic Sz -Alternative to lithium for bipolar Dz -Used in combo with other drugs when other drugs don't adequately control seizure. |
Valproate
Tx-s what types of Sz? 2ct Alternative Rx for what Psych Rx for what condition? |
-General Tonic-Clonic Sz
-Used in combo with other drugs when other drugs don't adequately control seizure. -Alternative to lithium for bipolar Dz |
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-Inhibits metab of other drugs
-Increases serum levels of lamotrigine -Increases or decreases -carbamazepine & -Phenytoin which in turn may decrease this Rx. -Careful serum monitoring required for all these drugs -Salicylates can increase serum ___________?. |
Valproate
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Indicated for generalized absence (choice tx in children)
not effective in adults or for anyone with other seizure types |
Ethosuximide
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May cause:
-Dizziness -Drowsiness -Gastric Distress -Nausea -Valproate inhibits ____Rx metabolism and -Increases _____Rx serum levels -When used with Haloperidol can alter seizure pattern. |
Ethosuximide
A/E? |
-Dizziness
-Drowsiness -Gastric Distress -Nausea -Valproate inhibits ____Rx metabolism and -Increases _____Rx serum levels -When used with Haloperidol can alter seizure pattern. |
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-Increases the release of GABA from central neurons
-Doesn't affect GABA receptors -GABA is an inhibitory neurotransmitter Effective alone or in combination with other drugs to treat all forms of partial seizures Minimal adverse affects |
Gabapentin
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Blocks voltage sensitive Na channels
thereby interferes with neuronal membrane conduction and release of excitatory neurotransmitters such as glutamate One of the more effective drugs in treating partial seizures. |
Lamotrigine
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Multiple types of seizures in pts /c
-mental retardation and other neuro abnormalities |
Lennox Gastaut syndrome
What is it? |
Multiple types of seizures in pts /c
-mental retardation and -other neuro abnormalities |
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Side effects include
-Cerebellar dysfunction -Drowsiness -Rash (watch for Steven's Johnson Syndrome) |
Lamotrigine
A/S-E ? |
Cerebellar dysfunction
-Drowsiness -Rash (watch for Steven's Johnson Syndrome) |
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-Blocks voltage sensitive Na channels
-Augments activation of GABA receptors blocks glutamate receptors -Effective as a single drug tx for partial seizures and in combination with other drugs for generalized seizures but not fda approved for those yet |
Topiramate
Does What? |
-Blocks voltage sensitive Na channels
-Augments Activation of GABA receptors blocks glutamate receptors |
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Can reduce serum level of oral contraceptives
Side effects include : -ataxia -dizziness -drowsiness -other CNS effects |
Topiramate
Can reduce serum level of? Side effects include ? |
-ataxia
-dizziness -drowsiness -other CNS effects |
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Mechanism of action not clear but is shown to inhibit burst firing
Opposes negative modulators of GABA and glycine gated currents in neuronal cell culture "It has shown exceptional promise as an adjunct drug in treating partial seizures in children". |
Levetiracetam
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3 commonly used IV drugs for the emergency treatment of status epilepticus.
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-Diazepam
-Lorazepam -Fosphenytoin Tx for what emergency: ? |
Emergency Tx of Status Epilepticus.
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First-line drugs (3ct) for treating
partial seizures and generalized tonic-clonic Sz |
-Carbamazepine
-Phenytoin -Valproate what are they for? |
-First-line drugs for treating
-partial Sz -generalized tonic-clonic Sz. |
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First-line Rx-s (2ct) for treating
-Generalized Sz -Absence Sz |
-Ethosuximide for Children
-Valproate for adults & Pts w other types of Sz. |
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First-line drug for treating generalized myoclonic and atonic seizures
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Valproate
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First-line drugs for treating Status epilepticus
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IV Diazepam
or Lorazepam followed by -IV Fosphenytoin or -Phenobarbital |
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Antiepileptic with the broadest spectrum of activity
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Valproate
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All antiepileptic are what pregnancy category?
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C or D
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Antiepileptics (3ct) decrease oral contraceptive efficacy?
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-Carbamazepine
-Phenytoin -Topiramate What do they do reference female Rx interaction? |
Decrease oral contraceptive efficacy?
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