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autonomic pharmacology > epilepsy > Flashcards

epilepsy Flashcards

1
Q

what is the meaning seizure?

A

a single occurrence of sudden , uncontrollable electrical disturbances in the brain

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2
Q

what is the definition of epilepsy?

A

brain disorder charaterized by two or more unprovoked seizures

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3
Q

what is epilepsy syndrome?

A

due to unique type of epilepsy
- childhood absence epilepsy
( characterised by frequent absence seizures in children with good prognosis)
- lennox gastaut syndrome
( a severe form of epilepsy that includes multiple types of seizures and often has poor prognosis)
- juvenile myoclonic epilepsy
( features myoclonic jerks , usually in the morning with strong genetic component )

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4
Q

what pathophysiology of epilepsy?

A

excessive electrical activity due to imbalance of glutamate and GABA neurotransmitter

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5
Q

state classification of seizures.

A
  • onset of seizures
  • level of awareness
  • whether movement when happen seizures
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6
Q

type of seizure depends on onset

A
  • focal onset
  • generalised onset
  • unknown onset
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7
Q

state type of motor symptoms

A
  • myoclonus ( muscle twitching )
  • clonic ( muscle jerking )
  • tonic ( muscle rigidity )
  • atonic ( muscle weak )
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8
Q

state type of non motor symptoms

A
  • absence ( blanking and staring )
  • main symptoms do not involve muscle movements
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9
Q

what is the risk factor of epilepsy?

A
  • any injury in brain
  • bleeding , swelling in brain
  • lack of oxygen to brain
  • stroke
  • brain tumors
  • infection ( meningitis)
  • genetic

in children
- small size of birth
- seizure in first month of life
- having seizures due to high fever

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10
Q

how to diagnose seizures?

A
  • at least 2 unprovoked seizures occurring more than 24 hours apart
  • assessment by neurologist include EEG , CT and MRI scan
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11
Q

what is the complication that can occur ?

A
  • difficulty learning
  • aspiration pneumonia
  • injury from falls
  • mood problems
  • permanent brain damage
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12
Q

what is non pharmacological treatments can be used ?

A
  • surgery to remove a small part of brain that cause seizure
  • procedure to put a small electric device inside body that can help control seizures ( vagus nreve stimulator )
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13
Q

what is lifestyle advice can be used ?

A
  • avoid from swimming or use dangerous things alone
  • avoid triggers ( lack of sleep )
  • keep diary of seizures
  • don’t stop taking or change dose
  • make sure don’t run out of meds
  • when to call 999?
    ( first time seizure)
    ( seizure that last more than 5 min or more than 1 seizures wthin 5 min without return to normal consciousness)
    ( injured during seizure)
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14
Q

what is the moa of anti epileptic

A
  • inhibit glutamate activity
  • increase GABA activity
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15
Q

what is the example of antiepileptic drug ?

A
  • phenytoin
  • carbamazepine
  • benzodiazepine
  • lamotrigine
  • barbiturate
  • oxcarbazepine
  • phenobarbital
  • sodium valporate
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16
Q

what is the side effect of phenytoin?

A
  • cleft palate
  • hirsutism
  • gingival hyperplasia
17
Q

what is the side effect of carbamazepine and oxcarbazepine ?

A
  • diplopia
  • bruising
  • jaundice
18
Q

what common side effect of antiepileptic drug?

A
  • nausea
  • dizziness
  • anxiety
  • mood changes
19
Q

what is the other side effect of carbamazepine, phenobarbital, phenytoin and sodium valporate ?

A
  • cause thinner and brittle bones
  • need to take extra vitamin and do some exercise
20
Q

goal of antiepileptic treatment.

A
  • aim to try and stop seizures happening
21
Q

whats factor that need to consider of taking antiepileptic drug?

A
  • type of seizures
  • concomitant seizures
  • comorbidity
  • age
  • sex
22
Q

how to take antiepileptic drug

A
  • taken at regular times each day , it may trigger seizures if missed it
23
Q

drug interactions

A
  • enzyme inducer ( phenytoin, carbamazepine, phenobarbital)
  • enzyme inhibitors ( sodium valporate)
  • oral contraceptives ( COC become less effective when combine with enzyme inducer ) need to double the dose or other method
24
Q

do antiepileptic safe for pregnancy?

A
  • valporate is teratogenic that increases risk of birth defect to newborn baby
  • if seizure is not threat during pregnancy, need to withdraw drug then continue at 3rd trimester
  • if take AED during pregnancy , mother must take supplementation with vitamin K injection to newborn to minimise risk of neonatal haemorrhage.
25
Q

what drug that safe for pregnancy in epileptic drug ?

A
  • lamotrigine
  • levetiracetam
    ok for breastfeed if monotherapy
26
Q

why antiepileptic not working ?

A
  • person not taking regularly
  • person’s epilepsy itself may have changed
  • person’s body may got used to antiepileptic , so it no longer works

autonomic pharmacology (13 decks)

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