Pharm Seizure Meds Flashcards Preview

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Flashcards in Pharm Seizure Meds Deck (34):
1

What are seizures

Recurrent, uncontrolled cerebral excitation

2

What initiates seizures

Specific neurons that are overactive, will spread to adjacent parts of the brain

3

What causes seizures in children

Unknown cause, but there is some sort of cerebral insult

4

What causes seizures in adults

Can be secondary to a specific event.
Trauma
CVA (stroke)
Tumor

5

How does the seizure "travel" in the CNS? Does it stay local or spread out

Could do either depending on the type of seizure

6

What are the types of partial seizures

Simple (focal) and Complex

7

What are simple (focal) seizures

Limited to one area of the brain
Cause motor and sensory loss

8

What are complex seizures

Start in one area but can progress to generalized seizure

9

What are the types of generalized seizures

Absence (petit mal)
Myoclonic
Tonic-Clonic (Grand mal)

10

What is the most common seizure

Complex partial

11

What is the most common generalized seizure

Grand mal

12

What is the goal of anti-seizure medication

Will target selective neurons that are firing too often and stop them from firing/starting the seizure

13

Why should the anti-seizure drugs be selective

Do not want to stop the firing of the surrounding neurons. This could impair other functions

14

What are the primary anti-seizure drugs

The front four
Dilantin
Depakote
Tegretol
Zartonin

15

Why are the front four usually chosen first

They are more selective

16

What are the "other" drugs used for seizures

Benzodiazepines
Barbiturates

17

Why are the "other" drugs used

They are very effective in inhibiting the CNS.
Not as selective as the front four
Barbiturates are the most commonly used anti-seizure meds in the US

18

What are the second generation anti-seizure drugs

Neurontin
Lamictal
Keppra
Lyrica
Gabitril
Topamax

19

What is the benefit of the second generation drugs

Tend to have less side effects
Able to mix with the other new meds
Could have same effect with lower dosage after mixing
Better treatment of chronic pain syndrome

20

How would the 2nd gen drugs work for chronic pain

Instead of quieting the neurons creating the seizures they would quiet the neurons causing the chronic pain

21

Which specific drug could be used to stop neuropathic pain

Neurontin

22

What is the mechanism of the primary drugs

Inhibit the Na channels of over active neurons
Inhibit the Ca++ entry into thalamic neurons
Increase the inhibitory effects of GABA

23

Which drugs will inhibit the Na channels

Dilantin
Tegretol
Depakote

24

Which drug will inhibit Ca channels

Zarontin

25

Which drugs will increase the inhibitory effect of GABA

Benzodiazepine
Barbiturates

26

What is the mechanism of the newer drugs

Decrease the release of excitatory amino acids

27

What are the minor side effects of anti-seizure drugs

Sedation
Headache
Dizziness
Incoordination
GI problmes

28

Why do we call them minor side effects

They are not life threatening
Will usually deal with adjusting the dosage so side effects go away

29

What are the major side effects of anti-seizure meds

Liver toxicity
Blood dyscrasia(bad mixture)
Increase risk of birth defects

30

What are the types of blood dycrasisa

Aplastic anemia (bone marrow and blood cells damaged)
Agranlocytosis (problems or low WBC's)

31

Why do the anti-seizure meds cause birth defects

Neural tube defects will double risk
Mother cannot decide to go off meds by herself

32

How many patients will remain seizure free after they get off meds

60-70%

33

What are the clinical signs showing you have a good chance of being seizure free after going off meds

Free of seizures for the past 2 years with meds
Have good control of seizures when they first start
Neurological exam prior to withdrawal
Initial onset of seizures was in childhood

34

What are some things we need to be aware of as physical therapists

Any patients taking anti-seizure meds
Document seizure activity to monitor efficacy of drugs