Anticonvulsants Flashcards
1
Q
Convulsion
A
Sudden attack of involuntary muscular contractions and relaxations
2
Q
Seizure
A
Abnormal central nervous system electrical activity
3
Q
Epilepsy
A
A group of recurrent disorders of cerebral function characterized by both seizures and convulsions
4
Q
Causes of Epilepsy
A
- Genetic (autosomal dominant)
- congenital defects
- Severe head trauma
- Ischemic injury, tumor
- Drug abuse
- UNKNOWN
5
Q
Glutamate
A
-Excitatory (tells the neuron to fire)
6
Q
GABA
A
-Inhibitory (dampens the neuron firing rate)
7
Q
Partial (focal) seizure
A
-Excessive electrical activity in one cerebral hemisphere
-Affects only part of the body
-SIMPLE PARTIAL- Person may experience a range of strange or unusual sensations
-Motor
-Sensory
-Autonomic
KEY: PRESERVATION OF CONSCIOUSNESS
COMPLEX PARTIAL:
- LOSS OF AWARNESS AT SEIZURE ONSET- person seems dazed or confused
- typically originate in frontal or temporal lobes
8
Q
Generalized Seizures
A
- Excessive electrical activity in both cerebral hemispheres
- Originate in thalamus or brainstem
- AFFECTS THE WHOLE BODY
- LOSS O FCONSCIOUSNESS IS COMMON
9
Q
Generalized Seizures
A
- Myoclonic: brief shock like muscle jerks restricted to part of one extremity
- Atonic: sudden loss o muscles tone
- TONIC SEIZURES: sudden stiffening of the body, arms, or legs
- Clonic Seizures: rhythmic jerking movements of the arms and legs without a tonic component
- TONIC CLONIC (GRAND MAL) Tonic phase followed by clonic phase 25% of all seizures
10
Q
Status Epillepticus
A
- A seizure lasting longer than 30 minutes or 3 seizures without a normal period in between
- May be fatal
- Emergency intervention required
11
Q
Seizure facts
A
- Seizures ar not usually life threatening
- the brain almost always stops the seizure on its own
- Breathing may cease for a few seconds, and the patient may turn blue
- People don’t feel pain during a seizure, muscles may be sore afterward
- person may be different for a while after the seizure
12
Q
Treatment
A
- try to find cause (fever,; head trauma, drug abuse)
- Recurrent seizures that cannot be attributed to any cause are seen in patients with epilepsy
- Therapy is control NO CURE
- Type of seizure determines the choice of drug
- More than 80% can have seizures controlled with medications
13
Q
Therapeutics
A
- Inhibition of Na+ channels to slow neuron firing
- Enhancement o the inhibitory effects of the neurotransmitter GABA
- Inhibition of calcium channels
14
Q
Na+ Channel Drugs
A
- Phenytoin (Dilantin, phenytek)- MOST USED**
- Cabamazepine (Tegretol, carbatrol)
- Valproic Acid (Depakote, Depakane)
- Lamotrigine (Lamictal)
- Topiramate (Topamax)
- Zonisamide (Zonegran)
- Lidocaine
15
Q
Phenytoin (Dilantin)
A
- Most widely used
- NA+ Channel blocker
- First choice for partial and generalized tonic clonic seizures
- Decreased blood levels of medications
- Increases blood levels of PHENOBARBITOL AND COUMADIN (interacts with P450 enzyme)
- Adverse effects- Hirsutism , acne, GINIGIVAL HYPERPLASIA
