Anti-epileptics (year 2)

Question 1

what is epilepsy?

Answer 1

not a diagnosis itself, is when an animal has recurrent epileptic seizures

Question 2

what is an epileptic seizure?

Answer 2

transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain

Question 3

what are the phases of an epileptic seizure?

Answer 3

prodromal
aura
ictus
post-ictal

Question 4

what happens during the prodromal phase of an epileptic seizure and how long before the seizure does it occur?

Answer 4

behaviour changes hours to days before the seizure

Question 5

what it the aura phase of an epileptic seizure and how long before the seizure does it occur?

Answer 5

first part of the seizure which includes odd behavioural with autonomic signs that occurs hours to minutes before ictus

Question 6

what is the ictus phase of an epileptic seizure?

Answer 6

this is the seizure and is involuntary muscle movements, twitches and changes in tone

Question 7

what occurs during the post-ictal phase?

Answer 7

various post seizure signs such as disorientation, toileting issues and neurological deficits

Question 8

what are the three ways seizures may present?

Answer 8

isolated seizures
cluster seizures
status epilepticus

Question 9

what is an isolated seizure?

Answer 9

1 seizure in 24 hours

Question 10

what is a cluster seizure?

Answer 10

2 or more seizures in 24 hours

Question 11

what is stats epilepticus?

Answer 11

seizures lasting more than 5 minutes or not returning to normal between seizures

Question 12

what is always the location of a seizure in the brain?

Answer 12

forebrain - telencephalon or diencephalon

Question 13

what does it mean if the location of the epileptic seizure is generalised?

Answer 13

involves the whole of both hemispheres

Question 14

what is the general reason epileptic seizures occur?

Answer 14

imbalances of excitation and inhibition of neurotransmission in the brain due to ion channel abnormalities

Question 15

what does it mean if there are increased numbers of cells in an epileptic focus of pacemaker cells?

Answer 15

increased seizure frequency

Question 16

what is the main excitatory neurotransmitter of the brain?

Answer 16

glutamate

Question 17

what is the main inhibitory neurotransmitter of the brain?

Answer 17

GABA

Question 18

what is kindling?

Answer 18

increased epileptic activity leads to increased numbers of pacemaker cells

Question 19

what can status epilepticus lead to?

Answer 19

hyperthermia, hypertension, acidosis, organ failure, hypoglycaemia

Question 20

what does treatment of epilepsy aim to do?

Answer 20

reduce seizure frequency and reduce severity of seizures

Question 21

when would you consider the animal to have responded to treatment?

Answer 21

when they have had a 50% reduction in seizure activity

Question 22

what are the 3 main modes of action of anti-epileptic drugs?

Answer 22

enhance GABA action
reduce glutamate action
modulate ion movement

Question 23

what are the three main drugs used as anti-epileptics?

Answer 23

potassium bromide, phenobarbital, imeptoin

Question 24

what is the main mode of action of potassium bromide, phenobarbital and imeptoin?

Answer 24

enhance action of GABA

Question 25

phenobarbital has other modes of action as well as enhancing GABA action, what are these?

Answer 25

reduce glutamate action and reduce calcium channel activity

Question 26

how is phenobarbital administered?

Answer 26

oral or IV solutions

Question 27

where is phenobarbital metabolised?

Answer 27

liver - care taken as it can cause liver damage

Question 28

where is phenobarbital excreted?

Answer 28

some excreted unchanged in the urine

Question 29

is phenobarbital protein bound?

Answer 29

yes highly protein bound

Question 30

how is potassium bromide administered?

Answer 30

orally but can cause gastric irritation so give with food

Question 31

what species should you not give potassium bromide?

Answer 31

cats - causes irreversible allergic pneumonitis

Question 32

how is potassium bromide excreted?

Answer 32

renal excretion

Question 33

how is imepitoin administered?

Answer 33

orally

Question 34

how is imepitoin metabolised?

Answer 34

hepatically

Question 35

how is imepitoin excreted?

Answer 35

as metabolites and some unchanged in faeces

Question 36

what presentation of epileptic seizures is imepitoin not recommended for?

Answer 36

cluster

Question 37

name a drug that can be used for emergency seizure treatment

Answer 37

diazepam