Seizures Flashcards
1
Q
Criteria for seizures - must have 3 or more
A
Hypersalivation, urination and/or defecation
Tonic/tonic-clonic movements or rhythmic contractions of facial/appendicular muscles
Altered mentation/decreased responsiveness
Post-ictal period - most common = absent menace
2
Q
Generalized seizure vs. focal seizure
A
Generalized = full body movement Focal = focal limbs/facial twitches, NOT full body movement
3
Q
4 types of epilepsy
A
Familial/idiopathic/primary = presumed genetic, 1-4 y/o Symptomatic/secondary = known underlying cause Reactive = toxins, etc Cryptogenic = suspect cause, though not ID’d >6 y/o
4
Q
Emergency drugs for seizures - bolus, CRI, etc
A
Bolus: diazepam IV/PR or midazolam IV/IN
CRI: midazolam or dexmedetomidine
Loading dose: PB or KBr
5
Q
Phenobarbital (PB)
- MOA
- Dose
- Half-life
- Levels
- Monitor
A
- MOA: Increased responsiveness to GABA
- Dose: 2-4 mg/kg BID
- Half-life: 40-90 hr
- Levels: 25-35 mcg/ml
- Monitor : 14d, q6m
6
Q
Potassium Bromide (KBr)
- MOA
- Dose
- Half-life
- Levels
- Monitor
A
- MOA: hyperpolarizes membrane, increases seizure threshold
- Dose: 20-40 mg/kg SID
- Half-life: 28d
- Levels: 250-300 mcg/dl (100-200 if add on)
- Monitor: 3-4 months
7
Q
Levetiracetam (Keppra)
- MOA
- Dose
- Half-life
- Levels
- Monitor
A
- MOA: inhibit v-Ca channel
- Dose: 20-60 mg/kg TID-QID
- Half-life: 3h
- Levels: 5-45 mcg
- Monitor: not routinely tested
8
Q
Zonisamide
- MOA
- Dose
- Half-life
- Levels
- Monitor
A
- MOA: block Ca and v-Na channels, bind Cl channels associated with GABA
- Dose: 5-10 mg/kg BID (higher if on PB)
- Half-life: 15h
- Levels: 1-40 mcg/ml
- Monitor: 7-10d
9
Q
What two AEDs should you avoid using together?
A
PBr and Zonisamide because both metabolized by liver
