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;
25 Cards in this Set
- Front
- Back
|
A type of seizure involving excessive stimulation of neurons in the brain and characterized by the spasmodic contraction of voluntary muscles.
|
Convulsion
|
|
|
General term used fro any group of neurologic disorders characterized by recurrent episodes of convulsive seizures, sensory disturbances, abnormal behavior, loss of consciousness, or any combination of these.
|
Epilepsy
|
|
|
Excessive stimulation of neurons in the brain leading to a sudden burst of abnormal neuron activity resulting in temporary changes in brain function.
|
Seizure
|
|
|
Type of epilepsy in which the cause is unknown.
|
Primary/idiopathic epilepsy
|
|
|
Type of epilepsy that can be caused by trauma, infection, cerebrovascular disorder, or other illness.
|
Secondary epilepsy
|
|
|
Type of seizure; short alteration of consciousness, repetitive unusual movements, psychologic changes, and confusion.
|
Partial seizures
|
|
|
Type of seizure; no impaired consciousness, motor symptoms, hallucinations of sight, hearing, or taste along with somatosensory changes (tingling).
|
Simple seizures
|
|
|
Type of seizure; impaired consciousness, memory impairment, behavioral effects, purposeless behavior, aura, chewing and swallowing movements, unreal feelings, bizarre behavior, tonic, clonic, or tonic-clonic.
|
Complex seizures
|
|
|
Type of seizure; 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 are common symptoms. May have rhythmic movements but not convulsions; may have several attacks per day. Involves both cerebral hemispheres; tonic, clonic, myoclonic, atonic, or tonic-clonic; possible infantile spasms, head drop, or falling down sensations.
|
Generalized seizures
|
|
|
Formerly called grand mal seizure; this type of epilepsy is characterized by a series of generalized movements of tonic and clonic muscular contraction.
|
Tonic-clonic seizure
|
|
|
Means stiffening
|
Tonic
|
|
|
Means rapid, synchronized jerking
|
Clonic
|
|
|
AEDs; most are indicated for the management of all types of epilepsy.
|
Antiepileptic drugs
|
|
|
Medications that are used to prevents seizures typically associated with epilepsy
|
Anticonvulsants
|
|
|
Pharmacologic effects of AEDs
|
1) Increase the threshold of activity in the area of the brain called the motor cortex (make it harder to excite nerve cells)
2) Act to depress or limit the spread of a seizure discharge from its origin 3) Can decrease the speed of nerve impulse conduction within a given neuron, indirectly affecting the area in the brain responsible for the problem by altering the blood supply, for example, to that area The overall effect is to stabilize neurons and keep them from becoming hyperexcited and generalizing excessive nerve impulses to adjacent neurons. |
|
|
Cannot mix this drug with insulin, lidocaine, or sugar (D5W - turns white when mixed with this); do not exceed 50 mg/min; only mix in saline; for tonic-clonic seizures. It decreases the effect of gingko.
|
Dilantin
(phenytoin) |
|
|
Life-threatening emergency characterized by generalized tonic-clonic convulsions that occur in succession; hypotension, hypoxia, cardiac dysrhythmias
Rx: Valium 5-10 mg; other drugs: Cerebyx (fosphenytoin), Ativan (lorazepam), Solfoton (phenobarbitol), and Dilantin (phenytoin) |
Status epilepticus
|
|
|
-This drug has a narrow therapeutic index
-Inject IV slowly - do not exceed 50 mg/min in adults (hypotension, ventricular fibrillation) -IV dose 15-20 mg/kg; very irritating to skin -Can only mix in saline -Replaced by Cerebyx to overcome this drug's shortcomings -Adult PO: 300-600 mg/day -For tonic-clonic, psychomotor seizures, convulsions -Side effects: lethargy, abnormal movements, mental confusion, and cognitive changes -Therapeutic levels: 10-20 mcg/mL -Toxic levels: nystagmus (eye shaking), ataxia, dysarthria (speech difficulty), and encephalopathy (abnormal function of brain tissues -Long-term: gingival hyperplasia, acne, hirsutism, osteoporosis, and hypertrophy of the subcutaneous facial tissue resulting in "Dilantic facies" -Highly bound to protein and induces hepatic microsomal enzymes P-450 system -Long half-life |
Dilantin
(phenytoin) |
|
|
-Barbiturate
-Adult doses - PO: 100-300 mg/day; IM/IV: 200-800 mg followed by 120-240 mg dose every 20 minutes until seizure is controlled or a total dose of 1-2 g is reached -Side effects: sedation is most common -Therapeutic index: 14-40 mcg/mL -Long half-life; interacts with other drugs because it is a major inducer of hepatic enzymes |
Solfoton
(phenobarbital) |
|
|
-For partial seizures with complex symptoms; tonic-clonic mixed seizures
-2nd most prescribed in the U.S. -Adult: 400-2400 mg/day -Autoinduction --> process by which the drug increases its own metabolism over time, leading to lower concentrations in the system |
Tegretol
(carbamazepine) |
|
|
-Benzodiazepine
-Reduces frequency of generalized absence, clonic-tonic, and myoclonic seizures -High toxicity -Adverse effects: drowsiness, ataxia, and personality changes -Restless leg syndrome |
Klonopin
(clonazepam) |
|
|
-Long-acting benzodiazepine
-Used to treat partial seizures -Adult: 22-90 mg/day |
Tranxene
(clorazepate dipotassium) |
|
|
-Sucinimide
-Very safe; used to treat absence seizures in children -Side effects: nausea and abdominal cramps, drowsiness, anorexia, and headache -Adult: 500 mg/day then adjust |
Zarontin
(ethosuximide) |
|
|
-Used for generalized seizures; prolongs bleeding times; also used for migraine and manic problems; often used with a mixture of drugs for a synergistic effect
-Side effects: drowsiness, nausea, vomiting, GI disturbances, tremors, weight gain, and hair loss -Serious side effects: hepatoxicity and pancreatitis -Adult PO: 15-60 mg/kg/day divided bid-tid |
Depakote, Depakene
(valporic acid) |
|
|
Nursing interventions for antiepileptic drugs
|
-Give meds at the same time each day
-Shake oral solutions, do not crush capsules -Use 23-gauge, 1.5 inch needle for deep IM, very caustic to skin -IVs: especially Dilantin - give slowly, monitor pulse, BP, and respiratory rate; may cause hypotension and ventricular fibrillation -Keep a journal of seizure activity |
