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pathopharm iii > Chapter 15: Drugs for Seizures > Flashcards

Chapter 15: Drugs for Seizures Flashcards

1
Q

What are seizures?

A
  • clinically detectable sign of epilepsy
  • abnormal or uncontrolled neuronal discharges in the brain
  • symptom of an underlying disorder
  • Affect
    –> consciousness
    –> Motor activity
    –> Sensation
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2
Q

What is a convulsion?

A
  • Involuntary violent spasm of large muscles of face, neck, arms, and legs
  • not synonymous with seizures
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3
Q

What is the most common serious neurologic problem affecting children?

A

Seizures

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4
Q

What are the Etiologies of Seizures

A
  • Fever
  • Infectious disease
  • Metabolic disorders
  • Neoplastic disease
  • Trauma
  • Vascular diseases
  • Medications
  • High doses of local anesthetics
  • Eclampsia
  • Drug abuse
  • withdraw symptoms from alcohol or sedative-hypnotic drugs
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5
Q

What is Epilepsy?

A
  • seizures occurring chronically
  • International Classification of Epileptic seizures
  • will need pharmacologic management indefinitely
  • can be broken down into Partial (focal), Generalized, and Special epileptic syndromes
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6
Q

how are seizures classified in Neonates, Infants, and children?

A
  • Congenital abnormalities of CNS
  • Perinatal brain injury
  • Metabolic imbalances
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7
Q

What is the etiology of seizures in later childhood?

A
  • CNS infections
  • Neurological degenerative disorders
  • Inherited epilepsies
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8
Q

What is the etiology of seizures in adults?

A
  • Cerebral trauma
  • Cerebrovascular disorders
  • Neoplastic disease
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9
Q

What are the two types of Seizure Classifications

A

Partial and Generalized

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10
Q

How are Partial seizures further broken down?

A

Simple and Complex

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11
Q

How are Generalized seizures further broken down?

A
  • Absence (petit mal)
  • Atonic
  • Tonic-clonic (gran mal)
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12
Q

Partial simple seizure

A

CNS S/S: Hallucinations, intense emotions
MSK S/S: twitching of arms, legs, face
Aura: No
Postictal: No

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13
Q

Partial Complex seizure

A

CNS S/S: No response to verbal stimuli
MSK S/S: Fumbling with or attempting to remove clothing
Aura: Yes
Postictal: Yes

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14
Q

Absence (petit mal) seizure

A

Length: seconds
CNS s/s: stares, no response to verbal stimuli
MSK s/s: Fluttering eyelids, jerking
Aura: No
Postictal: No
Other: seen most often in children, often misdiagnosed

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15
Q

Atonic seizures

A

Length: seconds
MSK s/s: Falling or stumbling
Aura: No
Postictal: No

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16
Q

Tonic-clonic (gran mal)

A

Length: Minutes
MSK s/s: Intense contraction (tonic) –> alternating contraction/relaxation (clonic)
Aura: Yes
Posticital: Yes
Other: Loss of bladder/bowel control, shallow breathing/apnea

17
Q

What are the special syndromes seizure classifications?

A
  • Febrile seizure
  • Myoclonic seizure
  • Status epilepticus
18
Q

What is a Febrile seizure?

A
  • tonic-clonic activity lasting 1-2 minutes
  • rapid return to consciousness
  • occurs in children usually
19
Q

What is a Myoclonic seizure?

A
  • Large jerking movements of major muscle group, such as an arm
  • falling from a sitting position or dropping what is held
20
Q

What is Status epilepticus?

A
  • considered a medical emergency
  • continuous seizure activity, which can lead to coma and death
21
Q

What type of drugs potentiate GABA Action

A
  • Barbiturates
  • Benzodiazepines
  • Miscellaneous GABA Agents
21
Q

How to manage seizure medication once selected

A
  • The patient placed on a low initial dose
  • The is amount gradually increased
  • if seizure activity remains –> different medication added in small increments
  • newer antiseizure drugs have fewer adverse effects than older ddrugs
  • most cases require only a single drug
21
Q

what is the goal of antiseizure pharmacotherapy?

A
  • to suppress neuronal activity enough to prevent abnormal or repetitive firing
  • directed at controlling the movement of electrolytes across neuronal membranes
  • affecting neurotransmitter balance
22
Q

What is the target action of Barbiturates, Benzodiazepines, and Miscellaneous GABA agents

A

Acts by changing the action of gamma-aminobutyric acid (GABA), The primary inhibitory neurotransmitter in the brain

23
Q

What schedule Drug is Benzodiazepines

A

Schedule IV drug

24
Q

What are comon Adverse Reactions of Seizure medications?

A
  • drowsiness, headache, fatigue, dizziness
  • depression, or euphoria
  • N/V, weight loss
  • abdominal pain
25
Q

What are life-threatening adverse reactions of seizure medications?

A
  • severe mental depression with suicide intent
  • bone marrow suppression
  • blood dyscrasias
26
Q

When treating seizures with barbiturates, is the margin for safety high or low?

A

low

27
Q

When treating seizures with barbiturates, is the potential for depenence high or low?

A

High

28
Q

When treating seizures with barbiturates, do they cause profound CNS depression?

A

Yes

29
Q

What is the one type of seizure that barbiturates are not effective against?

A

absence seizures

30
Q

Which type of seizures are indicated for treatment with Benzodiazepines

A

absence seizures and myoclonic seizures

31
Q

Is tolerance developed quickly when using Benzodiazepines to treat seizures?

A

Yes

32
Q

Which is one of the most widely prescribed classess of seisure medicaitons

A

Benzodiazepines

33
Q

what are some other uses for Benzodiazepines outside of seizures?

A

used for anxiety, skeletal muscle spasms, and alcohol withdrawal symptoms

34
Q

How do succinimides suppress seizures

A

By delaying calcium influx into neurons

35
Q

Succinimides are generally only effective agains which type of seizure?

A

absence seizures

36
Q

What is the most commonly prescribed drug in the succinimides drug class? (prototype drug)

A

ethosuximide

pathopharm iii (9 decks)

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