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Physical Therapy > Pharm Seizure Meds > Flashcards

Pharm Seizure Meds Flashcards

1
Q

What are seizures

A

Recurrent, uncontrolled cerebral excitation

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2
Q

What initiates seizures

A

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

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3
Q

What causes seizures in children

A

Unknown cause, but there is some sort of cerebral insult

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4
Q

What causes seizures in adults

A

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

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5
Q

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

A

Could do either depending on the type of seizure

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6
Q

What are the types of partial seizures

A

Simple (focal) and Complex

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7
Q

What are simple (focal) seizures

A

Limited to one area of the brain

Cause motor and sensory loss

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8
Q

What are complex seizures

A

Start in one area but can progress to generalized seizure

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9
Q

What are the types of generalized seizures

A

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

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10
Q

What is the most common seizure

A

Complex partial

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11
Q

What is the most common generalized seizure

A

Grand mal

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12
Q

What is the goal of anti-seizure medication

A

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

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13
Q

Why should the anti-seizure drugs be selective

A

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

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14
Q

What are the primary anti-seizure drugs

A 
The front four 
Dilantin 
Depakote
Tegretol 
Zartonin
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15
Q

Why are the front four usually chosen first

A

They are more selective

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16
Q

What are the “other” drugs used for seizures

A

Benzodiazepines

Barbiturates

17
Q

Why are the “other” drugs used

A

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
Q

What are the second generation anti-seizure drugs

A 
Neurontin 
Lamictal 
Keppra 
Lyrica 
Gabitril 
Topamax
19
Q

What is the benefit of the second generation drugs

A

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
Q

How would the 2nd gen drugs work for chronic pain

A

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

21
Q

Which specific drug could be used to stop neuropathic pain

A

Neurontin

22
Q

What is the mechanism of the primary drugs

A

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

23
Q

Which drugs will inhibit the Na channels

A

Dilantin
Tegretol
Depakote

24
Q

Which drug will inhibit Ca channels

A

Zarontin

25
Q

Which drugs will increase the inhibitory effect of GABA

A

Benzodiazepine

Barbiturates

26
Q

What is the mechanism of the newer drugs

A

Decrease the release of excitatory amino acids

27
Q

What are the minor side effects of anti-seizure drugs

A 
Sedation 
Headache 
Dizziness 
Incoordination 
GI problmes
28
Q

Why do we call them minor side effects

A

They are not life threatening

Will usually deal with adjusting the dosage so side effects go away

29
Q

What are the major side effects of anti-seizure meds

A 
Liver toxicity 
Blood dyscrasia(bad mixture) 
Increase risk of birth defects
30
Q

What are the types of blood dycrasisa

A 
Aplastic anemia (bone marrow and blood cells damaged)
Agranlocytosis (problems or low WBC's)
31
Q

Why do the anti-seizure meds cause birth defects

A

Neural tube defects will double risk

Mother cannot decide to go off meds by herself

32
Q

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

A

60-70%

33
Q

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

A

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
Q

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

A

Any patients taking anti-seizure meds

Document seizure activity to monitor efficacy of drugs

Physical Therapy (18 decks)

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