Unit 7: CNS Drugs.Seizures Flashcards
define epilepsy
electrical storm in the brain
define seizure
paroxysmal abnormal neuronal discharges
define convulsion
forceful, involuntary spasm/contraction
the motor manifestation of a seizure
define status epilepticus
a medical emergency as the patient could stop breathing
30+ minutes of a seizure w/o regaining consciousness
what are the 2 types of partial seizures?
simple and complex
define tonic-clonic seizures
classic seizure
formerly “grand mal”
tonic phase < 1 minute: abrupt LOC, muscle rigidity, respiratory arrest
clonic phase 2-3 min: muscle jerking, lip/tongue biting, fecal/urinary incontinence
define myoclonic seizures
single or multiple myoclonic jerks
myoclonus = quick, involuntary muscle jerk
e.g. hiccups
e.g. muscle twitch when falling asleep
define absence seizures
impaired consciousness
formerly “petit mal”
sometimes with automatisms
easy to miss
What anti-seizure drugs need serum bloodwork to assess for therapeutic range?
phenytoin carbamazepine valproic acid ethosuximide lamotrigine felbamate
What anti seizure drug can also treat nerve pain?
gabapentin
What is important to remember about pregnancy and many anti seizure drugs?
many are pregnancy class C or D
Carbamazepine has interactions with which drugs?
erythromycin grapefruit juice protease inhibitors allopurinol oral contraceptives warfarin
Name some serious adverse effects with carbamazepine
blood dycrasias:
aplastic anemia
agranulocytosis
define agranulocytosis
severe and dangerous leukopenia (low white blood cell counts)
serious adverse effects of valproic acid
pancreatitis
hepatitis
adverse effects of valproic acid
N/V anorexia weight gain sedation, stupor tremor thrombocytopenia
what kind of seizures can valproic acid treat?
absence
generalized
parital
febrile
how long does it take to reach a steady state with phenobarbital?
3-4 weeks
what antiseizure drugs require a loading dose?
phenytoin
phenobarbital
name a black box warning for lamotrigine
SJS
toxic epidermal necrosis
adverse effects of lamotrigine
somnolence diplopia headache dizziness nausea
what anti seizure medication is also used to treat migraines
topiramate
what is the nickname for topiramate and why?
“dopamax”
due to adverse effects
what are the adverse effects of topiramate?
slowed thinking and speech confusion difficulty concentrating word-finding difficulties headache fatigue weight loss
generic name of Keppra
levetiracetam
Keppra must be adjusted for which kind of patients?
those with renal impairment
with what other seizure drugs does Keppra interact?
none
adverse effects of levetiracetam
dizziness
somnolence
behavior disturbances
Name some serious adverse effects of oxcarbazepine
SJS
toxic epidermal necrosis
multi-organ hypersensitivity
What anti seizure drugs require adjustments for renal issues?
levetiracetam
oxcarbazepine
What anti seizure drugs list SJS and toxic epidermal necroses as adverse effects?
oxcarbazepine
lamotrigine
What allergy can zonisamide cause?
sulfa allergy
list the adverse effects of zonisamide
sedation dizziness cognitive impairment Nausea weight loss sulfa allergy
how does gabapentin work?
alters amino acid metabolism
increases GABA
decreases glutamate
adverse effects of gabapentin
dizziness
somnolence
weight gain
behavioral changes in children
name a last line agent
felbamate
