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Nursing Pharmacology > Module 14b > Flashcards

Module 14b Flashcards

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1
Q

Neurological disorder that produces brief disturbances in the normal electrical activity in the brain

A

Epilepsy

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2
Q

a sudden alteration of behaviour that is caused by CNS dysfunction

A

seizure

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3
Q

Seizure caused by primary CNS dysfunction. Due to depolarization and hypersynchronization of neurons.

A

Epileptic seizure

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4
Q

A seizure-like episode that is not the result of abnormal electrical activity in the brain

A

Non-epileptic seizure

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5
Q

A tendency for recurrent, spontaneous epileptic seizures

A

Epilepsy

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6
Q

A single, unremitting epileptic seizure of duration longer than 30 minutes OR frequent seizures without recovery of awareness in between.

A

Status epilepticus

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7
Q

Status epilepticus is an ________.

A

emergency

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8
Q

Seizures arising in one area of the brain.

A

Focal/Partial seizure

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9
Q

What are the two types of focal/partial seizures?

A

Simple partial seizure

Complex partial seizure

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10
Q

Involves no loss of consciousness.

Symptoms depend on where the seizure activity is arising from.

A

simple partial seizure

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11
Q

Loss of consciousness
Patients may appear to be awake, but are not aware of surroundings.
Symptoms depend on where the seizure is taking place.

A

Complex partial seizure

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12
Q

Seizures that have a bilateral, diffuse onset, seeming to arise from all areas of the brain at once.

A

Generalized seizure

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13
Q

What are the 5 types of generalized seizures?

A 
Absence seizures
Tonic/clonic seizures
Myoclonic seizures
Tonic seizures
Atonic seizures
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14
Q

What is another name for absence seizures?

A

Petit-mal seizures

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15
Q

Involves loss of consciousness, behavioural arrest and staring

A

Absence seizures

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16
Q

Usually brief but may occur in clusters and can recur multiples times in a day.
Rarely associated with automatisms.
More common in childhood

A

Absence seizures

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17
Q

Tonic/clonic seizures involve these.

A

Abrupt loss of consciousness
Tonic period, lasting ~1 minute
Clonic period (involuntary muscle contractions), ~2-3 minutes

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18
Q

In the post-ictal phase of this seizure type, patients may be drowsy, confused and frequently complain of headaches

A

Tonic/clonic seizures

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19
Q

Used to be called grand-mal seizures

A

tonic/clonic seizures

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20
Q

Involve sudden, brief muscle contractions that can involve any muscle group

A

Myoclonic seizures

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21
Q

Sometimes associated with later development of generalized tonic-clonic seizures

A

Myoclonic seizures

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22
Q

Often involve sudden muscle stiffening and impaired consciousness

A

Tonic seizurs

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23
Q

Involve sudden loss of muscle tone

usually brief, around 15 seconds

A

Atonic seizures

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24
Q

Also called drop seizures, as their is a potential for falling injuries.

A

Atonic seizures

25
Q

What generalized seizures have loss of consciousness?

A

Absence, tonic/clonic, tonic,

26
Q

A seizure that begins in one area of the brain and then spreads throughout the brain

A

secondary generalized seizure

27
Q

The preliminary focal phase of a secondary generalized seizure.

A

Aura

28
Q

How do we localized focal seizures?

A

By the symptoms, as they often relate to specific brain areas

29
Q

Describe where the focal seizure is likely localized:

Simple repetitive motor movements involving a localized muscle group associated with seizure activity.

A

Frontal lobe (primary motor cortex)

30
Q

Describe where the focal seizure is likely localized:

Emotions such as anger, fear, euphoria and psychic symptoms such as deja vu, jamais vu or amnesia are assocaited with seizure activity

A

temporal lobe

31
Q

Describe where the focal seizure is likely localized:

Localized paresthesias, such as numbness and “pins and needles” are associated with seizure activity

A

Parietal lobe (somatosensory cortex)

32
Q

Describe where the focal seizure is likely localized:

Visual hallucinations, such as flashing or a repeated pattern in the environment, are associated with seizure activity

A

Occipital lobe

33
Q

Describe where the focal seizure is likely localized:

Involuntary eye movement that can be seen in occipital lobe seizures

A

reflex nystagmus

34
Q

Describe where the focal seizure is likely localized:

Simple partial seizures in the occipital lobe can be mistaken for what? Why?

A

Migraine headaches, as many of the symptoms are similar to common migraine auras

35
Q

Describe where the focal seizure is likely localized:

More complex and widespread paresthesias are associated with seizure activity

A

Parietal lobe (somatosensory association cortex)

36
Q

Describe where the focal seizure is likely localized:

Complex multi-sensory hallucinations and illusions which may be hard to distinguish from temporal lobe seizure activity.

A

Parietal lobe (higher order sensory association areas)

37
Q

Describe where the focal seizure is likely localized:

Tonic posturing affecting the entire side of the body are associated with seizure activity

A

Frontal lobe ([contralateral] supplemental motor area + other higher level motor structures)

38
Q

Describe where the focal seizure is likely localized:

Auditory hallucinations of buzzing or voices talking, and olfactory and gustatory hallucinations are associated with seizure activity

A

Temporal lobe

39
Q

Describe where the focal seizure is likely localized:

More complex sensory phenomena, involving visual distortions, paresthesias (i.e. numbness) and autonomic disturbances associated with seizure activity

A

Temporal lobe

40
Q

Epilepsy arising from an identified physical cause such as brain tumor, stroke, infection, or other injury

A

Symptomatic epilepsy

41
Q

Epilepsy that does not have an identifiable cause; there is often a family history of seizures, and genetics likely play a role

A

Idiopathic epilepsy

42
Q

Epilepsy that is likely to have an underlying cause that has not been identified.

A

Cryptogenic epilepsy

43
Q

What are the three main classifications for the etiology of epilepsy?

A

Symptomatic epilepsy
Idiopathic epilepsy
Cryptogenic epilepsy

44
Q

Describe the seizure threshold.

A

The seizure threshold is the balance between excitatory and inhibitory forces in the brain.
The difficulty in reaching this threshold will dictate the difficulty in generating a seizure

45
Q

What are the four distinct mechanisms in which anti-epileptics work?

A

Blocking sodium channels
Blocking voltage-gated calcium channels
Glutamate antagonists
Potentiating the actions of GABA

46
Q

How to sodium channel blockers work as an anti-epileptic?

A

Sodium channel blockers function to prolong the inactivation state (i.e. refractory period) of the voltage-gated sodium channels, preventing neurons from firing at high frequency

47
Q

Most widely used AED (anti-epileptic drug) that blocks sodium channels.

A

Phenytoin

48
Q

Phenytoin is useful in the treatment of what seizure types?

A

All but absence seizures

49
Q

Describe the kinetics of phenytoin.

A

The liver has limited capacity to metabolize phenytoin, thus it shows non-linear kinetics –> a small increase in concentration may cause a large increase in plasma concentration

50
Q

Phenytoin has a _______ therapeutic range and thus undergoes ________ ____ ________.

A

narrow

therapeutic drug monitoring

51
Q

Adverse effects of phenytoin.

A

Sedation, gingival hyperplasia, skin rash

52
Q

Phenytoin should not be used in pregnant women because it is a ________.

A

teratogen

53
Q

How does blocking voltage-dependent calcium channels work as anti-epileptic treatment?

A

Inhibition of these calcium channels suppresses NT release, and thus action potential propagation

54
Q

Describe how glutamate antagonists help with epilepsy treatment.

A

Glutamate is an excitatory NT and is thus a target for AEDs.

55
Q

How does glutamate mediate its effects?

A

By binding to the NMDA receptor or AMPA receptor

56
Q

Glutamate antagonists used to treat epilepsy block both the ______ and _______ receptors.

A

NMDA

AMPA

57
Q

Describe the mechanism of action of drugs that potentiate the actions of GABA.

A

GABA is an inhibitor NT in the CNS
Binding of GABA to its receptors causes Cl- to rush into cells, hyperpolarizing them and making it more difficult to reach threshold

58
Q

What are the traditional AEDs?

Newer AEDs?

A

Trad - phenytoin, valproic acid

Newer - lamotrigine

59
Q

Why would newer AEDs be used instead of older ones if the effectiveness is similar?

A

Newer AEDs tend to have decreased sides and decreased propensity to induce hepatic drug metabolizing enzymes

Nursing Pharmacology (30 decks)

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