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3.1 midterms > epilepsy > Flashcards

epilepsy Flashcards

1
Q

seizure vs epilepsy

A

seizure = single episode
epilepsy = >2 unprovoked seizures

not all people with seizures have epilepsy.
all people with epilepsy have seizures

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2
Q

idiopathic generalised epilepsy characteristics

A
  • appears in childhood/adolescence
  • can be: absence, generalised, myoclonic
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3
Q

idiopathic partial epilepsy characteristics

A
  • begins in childhood, outgrown by puberty
  • never diagnosed in adulthood
  • seizures occur during sleep
  • partial motor- seizure involving face
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4
Q

evidence of high risk for recurrence
[3]

A
  1. previous seizure
  2. epileptiform EEG
  3. abnormal brain scan
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5
Q

evidence of low risk for recurrence [3]`

A
  • single seizure
  • normal EEG
  • normal brain scan
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6
Q

types of generalised seizures [5]

A
  1. generalised tonic clonic (grand mal)
  2. absence (petit mal)
  3. myoclonic
  4. clonic
  5. tonic
  6. atonic
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7
Q

Generalised tonic-clonic seizure (grand mal) characteristics

A
  1. unconsciousness
  2. body stiffening (tonic)
  3. violent jerking (clonic)
  4. deep sleep (postictal)
  • shrill cry, apnoea, incontinence, dilated pupils
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7
Q

absence (petit mal) characteristics

A
  • sudden behavioural arrest
  • 1-15 sec
  • brief LOC
  • interrupts activity, may occur several times a day
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8
Q

myoclonic characteristics

A
  • bilateral sporadic jerks
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9
Q

clonic characteristics

A

bilateral rhythmic jerks

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9
Q

tonic characteristics

A

muscle stiffness, rigidity

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10
Q

atonic characteristics

A
  • loss of muscle tone in 4 limbs
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11
Q

types of partial seizures [3]

A
  1. simple
  2. complex
  3. partial with 2ndary generalisation
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12
Q

phenytoin MOA

A

block Na channels –> decrease membrane excitability

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13
Q

phenytoin considerations [3]

A
  • narrow therapeutic range
  • non-linear r/s btw dose & serum conc. > req frequent monitoring
  • teratogenetic –> contraindicated for pregnancy
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14
Q

carbamazepine MOA

A

block Na channels –> reduce membrane excitability

15
Q

carbamazepine considerations

A
  • accelerates elimination of other drugs (hepatic enzyme CYP450 inducer, half-life shortens with repeated doses)
  • aplastic anemia: rare but severe S/E
16
Q

which drugs block Na channels to reduce membrane excitability

A

phenytoin and carbamazepine

17
Q

valporate MOA [2]

A
  1. block Na & Ca channels
  2. increase GABA (inhibitory neurotransmitter)
18
Q

can valporate be used for all seizures

A

yes

19
Q

can phenytoin be used for all seizures

A

no, not for absence seizures

20
Q

can carbamazepine be used for all seizures

A

no, not for absence seizures

21
Q

general antiepileptic dose-related side effects

A
  • drowsiness, confusion, mental changes
  • nystagmus
  • ataxia
  • slurred spech
  • nausea
21
Q

valporate considerations

A

strongly binds to plasma proteins and DISPLACES OTHER ANTIEPILEPTICS

22
Q

general antiepileptic non dose related side effects
[6]

A
  • hirsutism (abnormal hair growth_
  • acne
  • gingival hyperplasia
  • folate deficiency
  • osteomalacia (bone tissue softening)
  • hypersensitivity (steven-johnson)
23
Q

benzodiazepine MOA

A

enhance GABA

24
Q

benzodiazepines onset of action

A

short: hours
intermediate: up to 24h
long: >24h

25
Q

which type of benzodiazepines are used for seizures?

A

intermediate & long acting
- used for refractory seizures (not controlled w first line) and status epilepticus

26
Q

simple seizures characteristics

A
  • no LOC
  • motor: jerking, muscle rigidity, spasm, head turning
  • sensory
27
Q

complex seizures characteristics

A
  • automatism, involuntary but coordinated movement
  • no awareness of what they are doing but no LOC
28
Q

partial seizure with secondary generalisation characteristics

A

initially associated with preservation of consciousness & evolves into LOC & convulsions

29
Q

nursing management for seizure [5]

A
  • maintain airway > turn to side, monitor SpO2
  • oral suctioning
  • establish IV access (med adm)
  • mark serizure start time, observe duration & characteristics
  • protect from hitting hard surfaces
30
Q

which drug can be used for absence seizures

A

sodium valporate

31
Q

when to test antiepileptic drug levels

A
  • assess compliance
  • possible antiepileptic drug toxicity
  • titration of dose
  • routine testing is not required
32
Q
A

3.1 midterms (7 decks)

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