Pathophysiology and Drug Therapy for Epilepsy Flashcards
What is a seizure
a brief distinct event that is irregular that results from abnormal or synchronous discharge of cortical neurons
What happens on a cellular level during seizures
small group of abnormal neurons undergo prolonged depolarizations and recruit adjacent neurons into rapid firing
What are the 3 targets of antiepileptic drugs
voltage/ligand gated ion channels, GABA channels, glutamate channels
What is epilepsy
neurological condition characterized by 2 or more seizures unprovoked by an immediately identifiable cause separated by greater than 24 hours
T/F: Greater than 2/3 of people will never know why they have seizures
True
What are the previous ,but still useful, ways to divide seizure types
Partial (focal) and generalized
What is the factor that divides partial seizures into two categories, what are those categories
alteration of consciousness/responsivness, simple and complex
T/F: In simple partial seizures a patient will become unconscious or unresponsive, while complex this does not occur
False: Complex seizures causing unconsciousness or unresponsive behavior
What is aura
event/phenomenon that occurs right before a seizure happens to a patient
What is automatism, examples
A specific unconscious behavior that is associated with a seizure/ chewing, swallowing, lipsmacking, hand movements
What are the three most common first generation antiepileptic drugs
Carbamazepine, phenytoin, valporic acid
What are the six most common 2nd/3rd generation antiepileptic drugs
Lacosamide, lamotrigine, levetiracetam, oxacarbazepine, topiramate, vigabatrin
T/F: Patients are not started on seizure medication after the first unprovoked seizure true
True
When it is determined that someone needs medication for seizure control how much of the dose should be given at first
Start low, increase slowly
T/F: When dealing with seizures patients should be given dual or triple therapy
False: Restrict therapy to monotherapy whenever possible
What are factors that may precipitate a patient’s seizures
Alcohol, lack of sleep, stress, poor diet, fever, and flickering lights
What drugs are first line for focal onset seizures and focal to bilateral seizures, 2nd line
carbamazepine, lamotrigine, levetiracetam, oxcarbazepine/ valproic acid, topiramate, lacosamide, phenytoin
What are the six Antiepileptic drugs that can be used to treat generalized onset tonic-clonic seizures
carbamezepine, lamotrigine, topiramate, levetiracetam, phenytoin, valporic acid
What are the three antiepileptic drugs that can be used to treat absence seizures
Valporic acid, lamotrigine, levetiracetam
What four AEDs drugs can treat atypical absence and atonic seizures
Lamotrigein, valporic acid, topiramate, levetiracetam
What two AEDs can treat myoclonic seizures
Valporic acid, levetiracetam
What are common AED side effects
sedation, dizziness
What AED shouldnt be used in patients who have anxiety due to a side effect
Levetiracetam
What two AEDs have chronic side effects, what are those side effects
Carbamezepine (osteoporosis, leukopenia, hyponatremia) Valporic acid (alopecia, weight gain, polycystic ovaries)
What two AEDs are also indicated for migraines, depression, and bipolar disorder
Carbamezepine and Valporic acid
What AED has no drug=drug interactions due to being metabolized mostly in the kidneys
Levetiracetam
