CH 15: Anti Seizure Meds

Question 1

most common neurologic disorder

Answer 1

epilepsy

Question 2

consequences of epilepsy

Answer 2

blackouts
fainting spells
sensory disturbances
jerking body movements
temporary loss of memory

Question 3

disturbance of electrical activity in the brain that may affect consciousness, motor activity, and sensation

Answer 3

seizure

Question 4

cause of seizures

Answer 4

by abnormal or uncontrolled neuronal discharges
Discharges may remain in one area of the brain or focus

Question 5

specifically refer to involuntary, violent spasms of the large skeletal muscles of the face, neck, arms, and legs.

Answer 5

convulsions

Question 6

exposure to strobe or flickering lights or the occurrence of small fluid and electrolyte imbalances

Answer 6

triggers

Question 7

Over __ of seizures are idiopathic

Answer 7

50%

Question 8

most common serious neurologic problem for children

Answer 8

seizures

Question 9

possible causes of seizures

Answer 9

-Mood disorder medications can cause seizures
– toxicity or increased level of excitatory neurotransmitters
– drug abuse
– alcohol withdrawal

Question 10

Other known causes of seizures

Answer 10

-fever = febrile seizures
-infectious disease
-metabolic disorders
-neoplastic disease
-trauma
-vascular diseases

Question 11

major concern for women with epilepsy

Answer 11

pregnancy planning

Question 12

Because several AEDs decrease the effectiveness of hormonal contraceptives,

Answer 12

additional barrier methods of birth control should be used to avoid unintended pregnancy.

Question 13

a severe hypertensive disorder that continues to worsen as pregnancy progresses. It is characterized by seizures, coma, and perinatal mortality.

Answer 13

eclampsia

Question 14

differing presentation of seizures relates to

Answer 14

signs and symptoms

Question 15

symptoms of seizures may range from

Answer 15

sudden, violent shaking and total loss of consciousness to muscle twitching or slight tremor of a limb.

Question 16

seizure: sensory, motor, emotional

Answer 16

simple partial

Question 17

seizure: AURA - postictal confusion and motor symptoms

Answer 17

Complex partial psychomotor

Question 18

seizure: falling or stumbling – drop attack

Answer 18

Atonic

Question 19

seizure: AURA – intense muscle contraction followed by relaxation – loss of bowel or bladder control
– APNEA –disorientation and deep sleep/postictal

Answer 19

Tonic-clonic

Question 20

seizure: tonic clonic with rapid return to consciousness - children

Answer 20

febrile

Question 21

seizure: major muscle group - dropping things

Answer 21

myoclonic

Question 22

seizure: medical emergency - APNEA - coma - death

Answer 22

status epilepticus

Question 23

goal of antiseizure pharmacotherapy

Answer 23

to suppress neuronal activity just enough to prevent an abnormal focus from forming or spreading across the cerebrum.

Question 24

antiseizure meds are directed at controlling

Answer 24

the movement of electrolytes across neuronal membranes or affecting neurotransmitter balance

Question 24

antiseizure meds are directed at controlling

Answer 24

the movement of electrolytes across neuronal membranes or affecting neurotransmitter balance

Question 25

general mechanisms by which AEDs act:

Answer 25

*An increase in the activity of GABA in the brain (increasing influx of chloride ions)
*Inhibition of the influx of sodium into neurons

Question 26

the primary neurotransmitter in the brain

Answer 26

GABA

Question 27

how drugs mimic the effects of GABA

Answer 27

by increasing influx of chloride ions

Question 28

mimicing GABA actions

Answer 28

– suppress seizure activity and abnormal firing of neurons
– CNS suppression

Question 29

GABA potentiation drugs are used for what type of conditions

Answer 29

depression
migraines
management of neuropathic pain associated with diabetic peripheral neuropathy, postherpetic neuralgia, fibromyalgia, and spinal cord injury
management of anxiety and bipolar disorder symptoms

Question 30

two antiseizure drugs that stand out for successful management of neuropathic pain and postherpetic neuralgia

Answer 30

gabapentin
pregabalin

Question 31

antiseizure med used in treatment of trigeminal neuralgia

Answer 31

topiramate

Question 32

antiseizure drugs that potentiate GABA action

Answer 32

barbituates
benzodiazapines

Question 33

drugs that inhibit the influx of sodium into neurons
-name and MOA

Answer 33

hydantoins
If sodium channels are temporarily inactivated, neuronal activity will be suppressed

Question 34

how does phenytoin provide effective seizure suppression

Answer 34

without the abuse potential or CNS depression associated with barbiturates
dosages are highly individualized

Question 35

one of the most highly uses AED bc of effectiveness and safety

Answer 35

carbamazepine

Question 36

black box warning for phenytoin

Answer 36

IV rate no more than 50 mg/min = sever hypotension and cardiac arrythmias

Question 37

Phenytoin interactions

Answer 37

digoxin, doxycycline, furosemide, oral contraceptives, and theophylline. When combined with tricyclic antidepressants, phenytoin can trigger seizures.

Question 38

partial seizure types

Answer 38

simple and complex

Question 39

generalized seizure types

Answer 39

absence
atonic
tonic-clonic

Question 40

special seizures

Answer 40

febrile
myoclonic
status epilepticus

Question 41

black box warning for valproic acid

Answer 41

may result in fatal hepatic failure

Question 42

hepatotoxicity symptoms

Answer 42

weakness, facial edema, anorexia, and vomiting.

Question 43

who cannot take valproic acid

Answer 43

pregnant women