Flashcards in T3-Antiseizure Medications-MJ Deck (68)
If you have a seizure does that mean its epilepsy?
No, just because you have one doesn't mean its epilepsy
What is epilepsy?
Chronic, recurrent seizures
Do all seizures involve convulsions?
What is epilepsy caused by?
Hyperexcitable neurons (focus)
A ____ is a cluster of neurons that cause the seizure. Several clusters are called ____.
T or F: If the seizure is occurring (hyperexcitable neurons) in a certain lobe, the functions of that lobe is what is shown in the seizure.
True; If it's in the temporal lobe, we can expect to see the client having visual problems and seeing wild colors
What does it mean if it is a generalized seizure?
BOTH hemispheres are invoved
What are the 6 different types of generalized seizures?
What generalized seizure is this?
-Period of muscle rigidity
-Synchronous muscle jerks
Tonic-clonic (grand mal)
Tonic-clonic: What characteristic of this seizure is the tonic phase? What is the clonic phase?
Tonic- muscle rigidity
Clonic-Synchronous muscle jerks
Tonic-clonic: These seizures often cause _____, but not ____.
Cause urination, but not defection
Tonic-clonic: How are convulsions preceded?
Loud cry, cause by forceful expiration of air across the vocal cords
Tonic-clonic: What are these seizures accompanied by?
Marked impairment of consciousness and are followed by period of CNS depression (postictal state)
Tonic-clonic: How long does this seizure last?
90 seconds or less
What is the other name for absence seizures? What are they characterized by?
Petit Mal; characterized by loss of consciousness for a brief time (10-30 sec)
What do absence seizures usually involve?
Mild, symmetric motor activity (eye blinking)
Can absence seizures occur with no motor activity at all?
The patient may experience ____ of absence attacks a day.
What patients do absence seizures occur primarily in?
Children and usually cease during the early teen years
What are atonic seizures characterized by?
Sudden loss of muscle tone
Atonic seizures: If seizure activty is limited to the muscles of the neck, "____" occurs. However, if the muscles of the limbs and trunk are involved, a "____" can occur.
Atonic seizures: Which causes the patient to suddenly collapse--head drop or drop attack?
What age group are atonic seizures most often in?
What seizure consists of sudden muscle contraction that lasts for just 1 SECOND?
Myoclonic: What is it when seizure activity is limited to one limb?
Myoclonic: What is it called when seizure activity involves the entire body?
What seizure is defined as a seizure that persists for 15-30 minutes or longer or a serious of recurrent seizures during which the patient does not regain consciousness?
Status epilepticus (SE)
There are several SE, which can be life-threatening?
Generalized convulsive SE
What age group are febrile seizures associated with?
Children ages 6 months to 5 years
How do febrile seizures generally manifest as?
Generalized tonic-clonic convulsions of short duration
T or F: Children who have febrile seizures are at high risk of developing epilepsy later in life.
FALSE; they are NOT at high risk for developing epilepsy later in life
What are some treatment methods for treating seizures?
Block sodium channels
Promote GABA activity
Why do we want to promote GABA when treating seizures?
GABA are the brakes! They slow things down in the brain. They will tell the hyper excitable neurons to SLOW DOWN
What are the challenges with most drugs in preventing seizures?
1. Narrow therapeutic index
2. Lots of interactions
3. Neurosensory side effects
Challenges in preventing seizures: Talk about the neurosensory side effects.
These involves the senses and the mind (pretty unpleasant--sedation, incoordination, double or blurred vision, N/V)
*Effects all similar to what? Alcohol
Challenges in preventing seizures. Talk about compliance.
When seizure drugs aren't working its because the client isn't taking the meds like they should or maybe not even taking them at all. It is important to reinforce the importance of the drug regiment with seizure drugs!
Do seizure meds work immediately. Explain.
No, just because they started the drug doesn't mean its the "right fit" for them. Getting seizure control takes some time. Patient education!!!
What are the 4 main anti-seizure drugs?
What are the challenges with phenytoin?
Is it hard to keep phenytoin levels effective?
What is the range for phenytoin levels?
What are the side effects of phenytoin?
1. GINGIVAL HYPERPLASIA (the big one we will continually be tested on)
3. Hepatoxicity (what is J.A.U.N.D.I.C.E?)
4. Vitamin D and folic acid deficiency
What is important patient education when teaching the patient about the possible side-effects of gingival hyperplasia?
Good oral hygiene
What is purple glove syndrome the result of?
Giving phenytoin through an IV and it infiltrates (IV comes out of vein into interstitial tissue)
*A lot of hospitals now only will let you give this drug through a CENTRAL line, not peripheral)
*This purple glove syndrome can lead to amputations!
What is mild phenytoin toxicity?
What is moderate phenytoin toxicity?
Slurred speech, ataxia
What is severe phenytoin toxicity?
Confusion, lethargy, coma, seizure
Is it important to teach the patient the different levels of phenytoin toxicity?
Yes; they need to know so they can be apart of the early symptom watch!
We want them to come to the doctor with a nystagmus instead of it get too late and they go into coma!
What are some of the side-effects of Valproic acid?
Hepatotoxicity (know J.A.U.N.D.I.C.E)
Is valproic acid teratogenic?
What can valproic acid and pregnancy cause?
Neural tube defects--spina bifida
Valproic acid and IQ of the child: what happens?
The IQ of the child may decrease
If a woman at child bearing years had tired other seizure methods and valproic acid was the only one that worked, what should our patient education be?
Tell her to take extra folic acid and be sure to use effective contraceptive methods
What are the side-effects of lamotrigine?
Why do we need to start Low and go sLow with Lamotrigine?
Give a low dose, give it slowly to reduce possible steven johnson
Why do we LOVE LEVEtiracetam?
1. Few neurosensory side effects
2. WIDE therapeutic range
3. Few interactions
What are the side effects of levetiracetam?
Which anti-seizure drug has a side effect of gingival hyperplasia?
Which anti-seizure drug has a side effect of Steven Johnson?
Which anti-seizure drug has a WIDE therapeutic range?
Which anit-seizure drug is highly teratogenic?
Which anti-seizure drug has a really narrow therapeutic range and levels have to be monitored?
Which anti-seizure may cause spina bifida when taking during pregnancy?
Which anti-seizure drug has few neurosensory side effects and few interactions but has rare side effects for agitation, aggression, &/or depression?
Which anti-seizure drug has neurosensory side effects?
Which anti-seizure drugs have hepatotoxicity as side-effects?
Phenytoin and Valproic acid
Which anit-seizure drug has side-effects for hirutism and vitamin D and folic acid deficiency?