Seizures Flashcards
Seizure medications can do 2 different things. What are they?
Raise seizure threshold
Decrease excitatory neurotransmitters and increase inhibitory neurotransmitters
What are the three types of seizures
Partial
General
Special syndrome
What stimulates the action potential
Influx of sodium and calcium
What slows or stops the action potential
Influx of chloride or efflux of potassium
What is an example of an inhibitory neurotransmitter
GABA
gamma-amniobutyric acid
Why would you initially give a low dose for seizure medication
Gradually increase until goal achieved or side effects are tolerable
Why are serum drug levels routinely obtained with seizure medications
Narrow therapeutic index
How should you instruct someone to discontinue a seizure medication
Gradually, over a 6-12 month period
Newer drugs are better because they have less side effects but what is one downfall of them
Doubles risk of suicide behavior
Barbiturates mechanism of action of seizures
Stimulating GABA receptors causing influx of chloride ions
Side effects of barbiturates for seizures
Profound CNS depression
Phenobarbital (barbiturate agent)
Less CNS effects
Inexpensive
Takes a while to work
Doesn’t work for absence seizures
What is the drug of choice for neonatal seizures
Phenobarbital
Indications of benzodiazepines
Myoclonus and absence seizures
Are benzodiazepines generally used alone or in adjunct
Adjunct
Mechanism of action for benzodiazepines
Stimulate GABA
Klonopin (clonazepam)
Benzodiazepine
Ativan (lorazepam)
Benzodiazepine
Valium (diazepam)
Benzodiazepine
Drug of choice for status epilepticus
Works in seconds
Newer GABA related drugs for nerve pain
Neurontin (gabapentine)
Lyrica (pregabalin)
Topamax (topiramate)
Newer GABA related drug
Who would get a Valium suppository
Kids
Hydantoins (for seizures)
Increase seizure threshold by suppressing influx of sodium
Side effects of hydantoins
Drowsiness
Headaches
Dizziness
Dilantin (phenytoin)
Cerebyx (fosphenytoin)
Hydantoins for seizures
Also first line drug for status epilepticus
Why are Valium and Dilantin both first line drugs for status epilepticus
Give at same time
Valium works faster but Dilantin works longer
Mechanism of action for phenytoin-like drugs for seizures
Suppress influx of sodium
Side effects of phenytoin-like drugs
Dizziness Ataxia Somnolence Headache Blurred vision
Tegretol (carbamazepine)
Phenytoin-like
Bipolar disorders
Tonic-clonic seizures and partial seizure
Depakote (valproic acid)
Phenytoin-like
Absence and partial seizures
Bipolar disorders
Lamictal (lamotrigine)
Phenytoin-like
Broad spectrum anti-seizure
Long term bipolar maintenance
