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Chapter 25 Flashcards

1
Q

Strange sensations such as tingling, smell, or emotional changes that occur before a seizure

A

Aura

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2
Q

A disorder of the brain that causes recurrent unprovoked seizures

A

Epilepsy

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3
Q

These drugs can decrease the voltage, frequency, and spread of electrical impulses within the motor cortex of the brain which leads to decreased seizure activity

A

First line drugs for seizures

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4
Q

A seizure that is involved with the entire brain caused by electrical discharges from both sides of the brain

A

Generalized seizure

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5
Q

A seizure that starts in one part of the brain

A

Partial seizure

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6
Q

This happens after the seizure phase which is often characterized by confusion, headache, sore muscles, and fatigue

A

Postical phase

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7
Q

Alternative drug use for treatment of seizures

A

Second line drugs for seizures

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8
Q

Uncontrolled electrical activity in the brain which may cause physical conversion, minor physical signs, thought disturbances, or a combination of symptoms

A

Seizure

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9
Q

A pathologic condition resulting in a sudden episode of uncontrolled electrical activity in the brain (repeated seizures) can be called what?

A

Seizure disorder

Epilepsy

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10
Q

A prolonged seizure which usually lasts longer than 30 minutes

A

Status epilepticus

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11
Q

About how many people in it in the United States have a seizure disorder ?

A

2 million

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12
Q

What Percent of Americans will experience a seizure during some time in their life’s?

A

10%

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13
Q

Seizures may begin at what age? Most seizures begin at what age?

A

Any age

Early child hood or late adulthood

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14
Q

Abnormal electrical impulses can lead to what?

These impulses help the brain communicate with what?

A

Seizures

The spinal cord, nerves, muscles, and other parts of the brain

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15
Q

Seizures can affect what in the body?

A

Movement, senses, concentration, Communication, level of consciousness

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16
Q

What is the cause of seizures

A

Mostly unknown

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17
Q

For adults, the most common cause of seizures include what?

A

Head injury, stroke, and tumor, certain drugs

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18
Q

For children the most common cause of seizures include what?

A

Head injury, fever, central nervous system infection, hypoxia, electrolyte imbalances.

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19
Q

6 common causes of seizures?

A

Brain injury, genetic, no known cause, infections, metabolism abnormalities, tumors

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20
Q

Risk factors for seizures

A 
Brian infection 
Drugs 
Drug withdrawal 
Emotional stress
Family history 
Fevers
Head injury 
Hormone changes
Hyperventilation 
Lack of food
Metabolic disorders
Sensory stimuli 
Sleep deprivation 
Tumors
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21
Q

Common seizure causing drugs

A 
Antidepressants 
Bupropion alcohol 
Cocaine and street drugs
Anti seizure drugs
Oral contraceptives 
Phenothiazines 
Theophylline
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22
Q

Signs and symptoms of a seizure ?

A

Starting off into space
Loss of consciousness
Violent jerky movements
Aura before seizure starts

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23
Q

Seizures are divided into what two groups?

A

Generalized and partial seizures

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24
Q

These seizures affect most or all of the brain. How many types are there ?

A

Generalized seizures

6

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25
This type of generalized seizure: | Convulsions, muscle rigidity, unconsciousness (grand mal) last two to five minutes
Tonic - clinic
26
Generalized seizure: Muscle stiffness, rigidity
Tonic
27
Generalized seizure: Loss of muscle tone
Atonic
28
Generalized seizure: Brief loss of consciousness
Absence
29
Generalized seizure: Sporadic jerking movements
Myoclonic
30
Generalized seizure: Repetitive jerking movements
Clonic
31
Also called focal or local seizures
Partial seizure
32
Two major types of partial seizures
Simple and complex
33
What type of partial seizure do you remain conscious?
Simple partial seizures
34
What partial seizure do you lose consciousness? And experience amnesia after it. For how long ?
Complex for one to 3 minutes (lose consciousness)
35
Types of partial seizures : Head turning, jerking, muscle rigidity, spasms
Simple partial motor
36
Partial seizures: Unusual sensations affecting either vision, hearing, small, taste, or touch
Simple partial sensory
37
Partial seizures: Memory or emotional disturbance
Simple partial psychologic
38
Partial seizures: Automatisms (chewing, fidgeting, lip smacking , walking and repetitive movements )
Complex
39
Partial seizures: Symptoms evolve into a loss of consciousness and convulsions
Partial with secondary generalization
40
Why is it so important to treat status epilepticus seizures?
To prevent brain damage
41
How to treat status epilepticus when life threatening ?
Protect the airway Provide oxygen IV access to give Valium Determining and treating the cause
42
What to do for one having a simple partial seizure?
Watch the patient and document the time the seizure occurred and how long it lasted.
43
What to do for some one with a generalized or complex seizure?
- Remove anything that could cause injury to patient - turn on their side to prevent aspiration - let secretions drain
44
What to do if you witness a generalized or complex partial seizure?
Hope the person to the floor and cushion head Loosen clothing around neck Remove any sharp objects Turn person on one side
45
What to do if an anti seizure med does not work?
``` Up the dose Change meds More than one med Take on time to maintain blood level Start one at a time ```
46
The choice of drugs prescribed is based on what?
The type of seizures
47
Before giving any anti seizure med always do what?
Get a complete list of drugs the patient is taking including over the counter and herbals
48
Do anti seizure drugs interact with other drugs?
Yes especially phenytoin
49
Drugs for seizures can increase the effects of what drugs ?
Anticoagulant drugs
50
What to do with a patient who has had a seizure?
``` Check vitals Check level of consciousness Ask patient to describe nature of seizures Ask if they get an aura before seizure Reduce risk of injury Call light in reach Ask if pregnant ```
51
What to do after giving any anti seizure drugs
Recheck the patients level of consciousness. Check vitals because drugs can cause side effects
52
Suddenly stopping an antisezure med can do what?
May cause sezuires
53
With seizure meds if you skip a dose what should you do?
Take a missed dose asap but do not double dose
54
What to avoid when taking seizure meds ? Why?
Alcohol , driving, operating machinery . Med may cause dizziness or drowsiness
55
What should seizure patients wear/ have with them at all times?
Medical alert bracelet and ID card
56
What should be on an ID card
Diagnosis Prescribed drugs Prescribers name
57
What should you take anti sezuire meds with?
Food and plenty of water
58
What food to avoid with anti seizure meds? Why?
Grapefruit - it can increase the action of the drug and lead to side effects or adverse effects
59
What teaching should be informed with someone who is on seizure meds that is about to go into surgery?
Increased risk of bleeding
60
First line drug names for seizures?
Carbamax- carbamazepine Dilantin- phenytoin Depakote - valproic acid
61
Dosages for adults and children Carbamax- Dilantin - Depakote-
Adult-600-1600mg Children less than six 10-35mg Children over six 200-1000mg 3-4 doses Adult-400mg followed by 300mg after 2-4 hours Children- oral-5mg 2-3 doses Adults/children 10 +- oral and IV 10-15mg can increase by 5-10mg a day till controlled seizures - max dose is 60mg daily
62
What is he difference between tequila , tegretol and tegretol XR?
Tegretol is an anti seizure drug, tegretol XR is an extended release form of the drug, tequin is an antibiotic
63
What is the intended response of an anti seizure med?
To control and prevent seizures Decrease abnormal electrical impulses
64
Common side effects for first line drugs for generalized and partial seizures?
``` Dizziness Loss of coordination Drowsiness/sedation Nausea Vomiting Hypotension ```
65
Side effects where patient should call doctor immediately What do they indicate?
``` Difficulty moving Skin rashes Easy bruising Tiny Purple colored skin spots Unusual bleeding ``` Allergic reaction and adverse reactions
66
Adverse effects of carbamazepine and phenytoin
Neutropenia (decrease number of white blood cells) sore throat fever chills
67
Carbamazepine can cause what?l adverse effect?
Severe bleeding (thrombocytopenia)
68
Phenytoin can lead to what adverse effect?
Stevens Johnson's syndrome - allergic reaction-rash like burn sores
69
Serious adverse effects of valproic acid?
Damage to liver (hepatotoxicity ) and inflammation of pancreatitis
70
What to do before giving first line drugs for partial and generalized seizures? What type of saline ?
Check the IV site for patency and solution compatibility. Use normal saline because this drugs precipitates (forms solid particles)
71
Don't use dextrose solutions with what?
IV phenytoin
72
What to do after giving a first line med for seizures?
``` Remind them about oral care Check for nausea and vomiting GI symptoms? Give with food Drink plenty water Watch for side effects ```
73
What to teach the patient about first line drugs?
Tell them they may need occasional lab results done to check blood levels and liver damage Females - birth control pills may not work as effectively
74
Ppl taking carbamazepine may be more sensitive to what?
Sunlight
75
A person taking what drug should see their dentist more often. Why?
Dilantin Extra growth of gums
76
Patients should avoid taking what med or take it 2-3 hours before taking phenytoin?
Antacids
77
This med can lead to slowed healing and increased risk for infection
Depakote
78
Who is more likely to have behavior changes while taking carbamazepine?
Children
79
Adolescents often require increased dosage of anti seizure drugs . Why?
Growth and hormone changes
80
What drugs have a high likelihood of increasing risk for birth defects?
Carbamazepine Phenytoin Valproic acid
81
A seizure during pregnancy can result in what?
Oxygen loss to the fetus , physical injury to mother or fetus
82
Taking phenytoin during pregnancy increases risk of what in fetus?
Cleft palate, low birth weight , facial defects , fetal hydantoin
83
Valproic acid during pregnancy has been associated with what with the fetus? Also passes through what?
Developmental defects, low IQ , damage to liver Breast milk
84
Who is more sensitive to effects of first line drugs for generalized and partial seizure ?What effects ?
Adults Confusion, restlessness, abnormal heart beats , chest pain,
85
This drug causes CNS depression?
Ethosuximide (zarontin)
86
Intended responses for first line drugs for absence seizures
Seizures are controlled and prevented Abnormal electrical impulses decreased Resistance of CNS to abnormal stimuli is increased
87
Common Side effects of first line drugs for absent seizures Other side effects? Allergic reaction?
``` GI upset Nausea Vomiting Indigestion Loss of appetite Weight loss ``` Other: Confusion, dizzy , drowsy, headache, constipation, nervous, depression Ar- rashes fever sore throat , abnormal bleeding report to dr.
88
First line drugs for absence seizures
Ethosuximide (zarontin) - adults 250mg Children. 3-6 years old 250mg Valproic acid (depakote, depacon ) - adults and children 10 + 10-15mg a day
89
What to do before giving first line drugs for absence seizures?
Check test results | Obtain baseline weight
90
What to do after giving first line drugs for absence seizures?
Check weight daily | Give drugs with food if GI upset occurs
91
What to teach patients taking first line drugs for absence seizures?
Take as prescribed Take missed doses asap but do t double dose Don't stop taking suddenly because seizures may occur
92
Zarontin ( ethosuximide) may make eyes sensitive to what?
Light
93
Valproic acid - who not to give to and why?
Children under 2 - liver damage - could lead to death
94
Valproic acid should be used more causiously with who ? Why?
Older adults | May be more sensitive to side effects such as sleepy and dizziness
95
Common second line drugs for seizures | And side effects
Clonazepam (klonopin)- dizziness, sedation, weakness Gabapentin (neurontin) - drowsy, fatigue, dizzy, swelling in ankles, weight gain Lamotrigone (lamictal)- dizzy,upset GI, headache , unsteady, double vision, rash Phenobarbital (ancakuxur)- drowsy, dizzy Pregabalin (lyrica)- dizzy drowsy, ataxia, perepheral edema Promidone (mysoline) - anorexia - ataxia , clumsy, dizzy, unsteady, vertigo
96
The difference between neurontin and noroxin?
Neurontin is an anti seizure drug Noroxin is an anti infective drug
97
Difference between lamictal and lamisil?
Lamictal is an anti seizure drug Lamisil is an anti fungal drug
98
Lamotrigine vrs lamivudine ?
Lamo is an anti seizure drug Lamivudine is an antiretroviral drug
99
Intended reaponses of second line seizure meds?
Control and prevent seizures Abnormal electrical impulses decreased Resistance of CNS to abnormal stimuli is increased
100
Common side effects for second line drugs ?
Dizzy, drowsy, GI upset, unsteady
101
Second line drugs are often prescribed with what?
Other seizure meds
102
What happens when a patient takes morohine at the same time as gabapentin ? What to do?
Blood level of gabapentin is increased and could become toxic Lower doses
103
Promidone decreases the effects of anticoagulant drugs What to do?
Higher doses of anticoagulant
104
What to do before giving sencond line drugs for seizures?
Schedule two hours between gabapentin and antacids Ask about kidney problems Check IV site
105
What to do before giving second line drugs for seizures
Asses side effects and adverse effects Notify dr if any occur Hold the drug is rash occurs Lacictal for rash can be increased slowly over 6 to 7 weeks
106
What to teach patients taking second line drugs
Notify dr asap if allergic reactions or seizures occur
107
2nd line : | These meds may become addictive
Phenobarbital and clonazepam
108
2nd line : | Interfere with birth control
Phenobarbital and promidone
109
2nd line: | Avoid alcohol when taking this med
Phenobarbital, promidone , lamotrigine
110
2nd line : Cigarette smoke may decrease the effectiveness
Clonazepam
111
2nd line : Avoid stopping abruptly
Lyrica
112
Children and older adults are more sensitive to what second line drug?
Gabapentin and lamotrigine
113
Second line drugs have what risk to pregnant women ?
High likelihood of birth defects or feral damage

Pharm (10 decks)

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