Pharm Seizure Meds Flashcards

(34 cards)

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

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

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