Seizures

Question 0

Seizure medications can do 2 different things. What are they?

Answer 0

Raise seizure threshold

Decrease excitatory neurotransmitters and increase inhibitory neurotransmitters

Question 1

What are the three types of seizures

Answer 1

Partial
General
Special syndrome

Question 2

What stimulates the action potential

Answer 2

Influx of sodium and calcium

Question 3

What slows or stops the action potential

Answer 3

Influx of chloride or efflux of potassium

Question 4

What is an example of an inhibitory neurotransmitter

Answer 4

GABA

gamma-amniobutyric acid

Question 5

Why would you initially give a low dose for seizure medication

Answer 5

Gradually increase until goal achieved or side effects are tolerable

Question 6

Why are serum drug levels routinely obtained with seizure medications

Answer 6

Narrow therapeutic index

Question 7

How should you instruct someone to discontinue a seizure medication

Answer 7

Gradually, over a 6-12 month period

Question 8

Newer drugs are better because they have less side effects but what is one downfall of them

Answer 8

Doubles risk of suicide behavior

Question 9

Barbiturates mechanism of action of seizures

Answer 9

Stimulating GABA receptors causing influx of chloride ions

Question 10

Side effects of barbiturates for seizures

Answer 10

Profound CNS depression

Question 11

Phenobarbital (barbiturate agent)

Answer 11

Less CNS effects
Inexpensive
Takes a while to work
Doesn’t work for absence seizures

Question 12

What is the drug of choice for neonatal seizures

Answer 12

Phenobarbital

Question 13

Indications of benzodiazepines

Answer 13

Myoclonus and absence seizures

Question 14

Are benzodiazepines generally used alone or in adjunct

Answer 14

Adjunct

Question 15

Mechanism of action for benzodiazepines

Answer 15

Stimulate GABA

Question 16

Klonopin (clonazepam)

Answer 16

Benzodiazepine

Question 17

Ativan (lorazepam)

Answer 17

Benzodiazepine

Question 18

Valium (diazepam)

Answer 18

Benzodiazepine

Drug of choice for status epilepticus
Works in seconds

Question 19

Newer GABA related drugs for nerve pain

Answer 19

Neurontin (gabapentine)

Lyrica (pregabalin)

Question 20

Topamax (topiramate)

Answer 20

Newer GABA related drug

Question 21

Who would get a Valium suppository

Answer 21

Kids

Question 22

Hydantoins (for seizures)

Answer 22

Increase seizure threshold by suppressing influx of sodium

Question 23

Side effects of hydantoins

Answer 23

Drowsiness
Headaches
Dizziness

Question 24

Dilantin (phenytoin) | Cerebyx (fosphenytoin)

Answer 24

Hydantoins for seizures | Also first line drug for status epilepticus

Question 25

Why are Valium and Dilantin both first line drugs for status epilepticus

Answer 25

Give at same time | Valium works faster but Dilantin works longer

Question 26

Mechanism of action for phenytoin-like drugs for seizures

Answer 26

Suppress influx of sodium

Question 27

Side effects of phenytoin-like drugs

Answer 27

``` Dizziness Ataxia Somnolence Headache Blurred vision ```

Question 28

Tegretol (carbamazepine)

Answer 28

Phenytoin-like Bipolar disorders Tonic-clonic seizures and partial seizure

Question 29

Depakote (valproic acid)

Answer 29

Phenytoin-like Absence and partial seizures Bipolar disorders

Question 30

Lamictal (lamotrigine)

Answer 30

Phenytoin-like Broad spectrum anti-seizure Long term bipolar maintenance