Seizure Drugs Flashcards
What are convulsions?
Involuntary, violent spasms or large skeletal muscles of face, neck, arms, and legs.
Are all convulsions seizures?
Yes
Are all seizures convulsions?
No, sometimes with absent seizures, you don’t move.
What is a seizure?
A disturbance of the brain’s electrical activity that may affect consciousness, motor activity, and sensation.
What can cause seizures?
Infectious diseases, trauma, neoplasms, metabolic disorders, vascular disease, febrile, medications, idiopathic.
When do seizures occur?
When the seizure threshold is exceeded.
What is epilepsy?
Any disorder in which the patient experiences recurrent seizures.
Do patients with epilepsy have a higher or lower seizure threshold?
Lower
What percentage of epilepsy is idiopathic (no known cause)?
50%
What are the two categories of seizures?
- Generalized onset
2. Partial onset
What are generalized onset seizures?
Multiple foci that spread abnormal neuronal discharges across both hemispheres of the brain simultaneously.
What are the 4 types of generalized onset seizures?
- Tonic-clonic (motor)
- Absence (non-motor)
- Atonic (motor)
- Myoclonic (motor)
What is a tonic-clonic seizure?
- loss of consciousness
- aura
- intense muscle contraction
What is another name for a tonic-clonic seizure?
Grand-mal
What is an absence seizure?
- staring
- transient loss of consciousness (short time)
What is an atonic seizure?
- stumbling or falling
- no loss of consciousness
- short duration
What is a myoclonic seizure?
- no loss of consciousness
- contraction of major muscles
- jerky motion
What is a partial (focal) onset seizure?
A seizure that usually occurs in a limited portion of the brain.
What are the two types of partial seizures?
- Simple (focal aware)
2. Complex (focal impaired awareness)
What are some symptoms of simple partial onset seizures?
- motor: tonic, clonic, atonic, or repeated motions
- non-motor: autonomic, behavioural, cognitive, sensory, and emotional changes
What are some symptoms of complex partial onset seizures?
- altered level of consciousness, often w aura
- may be motor, sensory, and autonomic symptoms
What are the 4 mechanisms of action for seizure medication?
- increasing the stimulation of GABA receptors
- reducing Na+ influx into neurons
- reducing Ca influx into neurons
- block glutamate receptors
What are 3 classes of drugs that stimulate GABA receptors:
- Barbiturates
- Benzodiazepines
- Gabapentin
What are barbiturates used for?
- tonic-clonic seizures
- sedative, hypnotic and general anaesthetic purposes
Name a barbiturate:
Pentobarb
What are Benzodiazepines used for?
- absence and myoclonic seizures
- anxioolytic and sedative
Name a benzodiazepine:
Diazepam
What is Gabapentin used for?
Partial Seizures
What do GABA receptors do to vital signs?
- decreased BP
- decreased pulse
- decreased resps
- decreased LOC
- vitamin deficiency (D, B12, folate)
How do Pentobarb work?
It increases the activity of GABA receptors, reducing the excitability of post-synaptic neurons which increases the seizure threshold.
What are some of the adverse effects of Pentobarb?
- drowsiness, sedation, excitation (children), confusion, depression, headache
- vitamin deficiencies, anemia
- laryngospasm
How do drugs that reduce Na+ influx work?
They desensitize Na+ channels thereby delaying opening of channels and reducing excitability of neurons.
What class of drugs reduce Na+ influx?
Hydantoins
Name a hydantoin drug:
Dilantin
What is dilantin used for?
All seizures except absence seizures
What are some adverse effects of Dilantin?
- lethargy, drowsiness, dizziness
- headache
- bradycardia, hypotension
- agranulocytosis, leukopenia, thrombocytopenia
- gingival hyperplasia
- rashes, weight loss
- hepatotoxicity
Name another barbiturate?
Depakene
What is Depakene used for?
- absence, complex partial seizures
- migraine headaches
- bipolar disorder
What are some adverse effects of Valproic Acid?
- nausea, vomiting, diarrhea, abdominal pain, reduced appetite
- prolonged bleeding, increased clotting times
- headache, sedation, dizziness
What are some serious adverse effects of Depakene?
- bone marrow depression
- photosensitivity
- pulmonary edema
- pancreatitis
- hepatotoxicity
