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NURS 2514 > Week 8 - Seizures & Antiepileptics > Flashcards

Week 8 - Seizures & Antiepileptics Flashcards

1
Q

what is a seizure

A
  • temporary disturbance in cerebral function caused by abnormal, excessive, and synchronous electrical discharge of cortical neurons
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2
Q

define epilepsy

A
  • group of disorders characterized by recurrent seizures
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3
Q

what is the cause of seizures (2)

A
  • 75% idiopathic

- other are secondary to brain injury

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4
Q

list examples of brain injuries that cause seizures

A
  • stroke
  • trauma
  • infection
  • tumor
  • hemorrhage
  • renal failure
  • hypoglycemia
  • eclampsia
  • electrolyte disturbance
  • drug induced
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5
Q

what are febrile seizures

A
  • seziures induced by a fever
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6
Q

who do febrile seizures commonly occur in? who are they dangeous to>?

A
  • common = children

- more dangerous to adults

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7
Q

what are 2 current theories regarding the pathogenesis of seizures

A
  1. disruption of GABA-secreting or adenosine secreting inhibitory neurons
  2. elevated extracellular K+
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8
Q

how do most anticonvulsant drugs work

A
  • inhibiting voltage-gated sodium or calcium channels (which typically excite the brain)
  • increasing the amount of GABA at inhibitory synaptic junctions
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9
Q

what is a common cause of seizures in a minority of clients

A
  • certain stimuli triggering a seziures
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10
Q

what types of stimuli may induce a seizure (6)

A
  • loud noises
  • bright lights
  • stress
  • excessive fluid retention
  • hypoglycemia
  • hyperventilation-induced alkalosis
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11
Q

what are the 2 categories of seizures

A
  1. generalized

2. focal

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12
Q

what are generalized seizures

A
  • involve uncontrolled electrical activity of the entire brain
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13
Q

what is the focus of generalized seizures

A
  • deep within the cerebrum or brainstem
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14
Q

what do generalized seizures result in

A
  • loss of consciousness
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15
Q

what causes generalized seizures (2)

A
  1. spontaneous

2. secondary to focal seizures

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16
Q

what does a tonic seizure involve (6)

A
  • sudden stiffening of the muscles
  • generalized muscle contraction
  • rigid body
  • extended limbs
  • jaw clenched
  • resp stops
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17
Q

what does a clonic seizure involve

A

involve:

  • rhythmic twitching of the muscles due to muscles contract & relaxing
  • increased salivation
  • incontinence is frequent
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18
Q

what is the most common seizure associated w epilepsy

A
  • tonic-clonic seizures
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19
Q

what is a tonic clonic seizure

A
  • seizure consisting of a clonic & tonic phase
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20
Q

what can a tonic-clonic seizure cause (2)

A
  • hypoxia –> due to stopped resp

- hypoglycemia –> due to increased muscle activity

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21
Q

what is status epilectus

A
  • recurrent & continuous seizures without return of consciousness between
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22
Q

what can status epilepticus cause (4)? what does this mean?

A

can cause:

  • hypoxia
  • hypoglycemia
  • acidosis
  • potential brain damage

= life-threatening

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23
Q

what is an absence seizure? what characteristics are seen (3)?

A
  • brief loss of consciousness resulting in “starring into space”, twitching of the eyelids, and lipsmacking
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24
Q

who do absence seizures commonly occur in

A
  • young children
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25
Q

how long do absence seizures last? how often do they occur?

A
  • 5-10 sec

- several times throughut the day

26
Q

what occurs following an absence seizure

A
  • normal activity is resumes

- no memory of the event

27
Q

is an absence seizure a general or focal seizure

A
  • generalized
28
Q

what is a focal seizure

A
  • seizures that arise from specific areas & localized damage/dysfunction in the brain
29
Q

what are 4 types of focal seizures

A
  • motor
  • sensory
  • autonomic
  • psychic
30
Q

what do motor seizures manifest as

A
  • repeated motor activity due to damage to the motor cortex

- occurs in the extremity depending on where damge is

31
Q

what do sensory seizures manifest as

A
  • tingling sensation
  • auditory or visual sensations
    ex. ringing ears, see things
32
Q

what is a progressive seizure

A
  • motor seizure involving clonic contractions that begin in one region of the body but spread progressively to other areas (often the face)
33
Q

what is an example of a type of progressive seizure

A
  • Jacksonian’s seizure
34
Q

how are focal seizures classified? what are they based on?

A
  • aware
  • impaired awareness

based on memory of the seizure

35
Q

what is an aura

A
  • an unusual sensory sensation prior to the seizure
36
Q

what other signs may occur before seizures?

A
  • nausea

- muscle twitching

37
Q

what are meds for seizures called

A
  • antiepileptic (AED) or

- anticonvulsants

38
Q

what is the goal of drug therapy for seizures

A
  • control or prevent seizures while maintaining a reasonable quality of life
  • minimize side effects & drug induced toxicity
39
Q

how long do pts with seizure disorders typically have to be on AEDs

A
  • typically lifelong
40
Q

what type hydantoin drug is used for seizures?

A

phenytoin (dilantin)

41
Q

what is the MOA of phenytoin

A
  • blocks voltage-gated sodium channels
42
Q

describe the therapeutic index of phenytoin

A
  • very narrow
43
Q

what type of seizure can phenytoin not be used for

A
  • absence
44
Q

what are 2 types of benzodiazipines that can be used for seizures?

A
  • clonazepam & lorazepam
45
Q

what is the MOA of benzos

A
  • activate GABA receptors
46
Q

what is GABA

A
  • major inhibitory nt

= reduces the activity lvl of neurons & less likely to produce action potentials

47
Q

what can benzos be used for

A
  • absence seizures
48
Q

what type of barbiturate is used for seizures

A
  • phenobarbital
49
Q

what is the MOA of barbiturate

A
  • activates GABA receptors

- can mimic GABA

50
Q

which is more potent, benzos and barbs

A
  • barbs

- since they can also mimic GABA, they have a higher change of causing CNS & resp depression

51
Q

list 3 other AEDS

A
  • valproic acid
  • carbamazepine
  • gabapentin
52
Q

what is the MOA of valproic acid

A
  • blocks voltage gated Na channels

- increases GABA

53
Q

what type of seizure can valproic acid be used for

A
  • absence
54
Q

what is the MOA of carbamazepine

A
  • stabilizes voltage gated Na channels

- GABA agonists

55
Q

what can carbamazepine be used for

A
  • neurpathic pain
56
Q

what is the MOA of gabapentin

A
  • GABA analog that also increases GABA production

- may stabilize calcium channels

57
Q

what can gabapentin be used for

A
  • neuropathic pain

- restless leg syndrome

58
Q

what is the drug of choice for status epilepticus ? why?

A

lorazepam –> have very quick onset

59
Q

describe the adverse effects of AEDs

A
  • numerous & vary per drug
  • often result in need to change meds
  • narrow therapeutic index
60
Q

what do many AEDs require the monitoring of

A
  • plasma lvls

NURS 2514 (75 decks)

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