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Stack #152429
pharm ch 13, kilgore lvl1
| Question | Answer |
|---|---|
| epilepsy | broad syndrome of CNS dysfunction that can manifest as momentary sensory disturbances to convulsive seizures -chronic, recurrent pattern of seizures |
| seizure | brief episode of abnormal electrical activity in the nerve cells of brain |
| convulsion | involuntary spasmodic contractions of any or all voluntary muscles thru-out body, including skeletal and facial muscles |
| Primary (idiopathic) epilepsy | -undetermined cause -over 50% of epilepsy cases |
| Secondary epilepsy | distinct cause can be identified -trauma, infection, cerebrovascular disorder like stroke |
| partial seizures | -simple seizures: no impaired consciousness -complex seizures: impaired consciousness |
| Generalized seizures | mainly seen in children, affect most parts of body |
| unclassified seizures | seizure that do not clearly fit into other categories |
| status epilepticus | common seizure disorder characterized by series of tonic(stiffening) and clonic (rapid synchronized jerking) muscular contractions |
| antiepiliptic drugs | anticonvulsants |
| Goals of epilepsy med therapy | -control or prevent seizures & maintain a reasonable quality of life -minimize AEs and drug-induced toxicity -Usually lifelong -single drug 1st, then 2 drug or multiple drug therapy is tried |
| AED therapy must | -prevent generation and spread of excessive electrial discharge from abnomally functioning nerve cells -protect surrounding normal cells |
| Affect of AED therapy | thought to alter Na, K and Ca movements across neurons in brain causing: -reduction of nerve's ability to be stimulated -suppression of transmission of impulses -decreasion in speed of nerve impulse conduction w/in a neuron |
| overall affect of AED therapy | -neurons are stabilized -neuron hyperexcitability is decreased -spread of excessive nerve impulses is decreased |
| AEs of antieleptical drugs | numerous adverse effects that vary by drug usually cause the need to change choice of medication |
| Types of drugs w/ antiepileptic effects | Barbiturates (phenobarbitol/Ssofoton) carbamazepine (Tegretol) valproic acid (Depakote) felbamate (felbatol) Hydantoins (pheytoin/Dilantin)4status elept. Succinimides (ethosuximide/Zarontin) benzodiazepine (clonazepam & clorazepate) others |
| necessary info needed b4 administration | -current medications & health history -drug allergies -liver function studies, CBC -baseline vital signs |
| Client education opportunities | -med alert tag/ID s/b worn by client -AEDs should NOT be discontinued abruptly -understanding therapy is longterm/lifelong and not a cure |
| carbamazapine (Tegretol) | -1st line for simple partial, complex partial and generalized tonic-clonic seizures -related to tricylic antidepressants -undergoes autoinduction (drug increases it own metabolism over time) |
| gabapentin (Neurontin) | -add-om drug for treatment of parial seizures & partial seizures w/ 2ndary generalization in adults -also used to treat neuropathic pain -related to GABA -abrupt discontinuatio can lead to withdrawal seizures |
| phenobarbital (Solfoton) | -anticonvuslant barbiturate (primidone metabolizes into phenobarb & phenylethblahblah in liver) -1stline for status epilepticus -effectinve prophylactic drug for febrile seizures |
| phenytoin (Dilantin) | -indicated for tonic-clonic and partial seizures -fosphenytoin-Cerebyx created as alternative b/c of physical shortcommings (pH of 12 for injections, etc..) need to give at a conversion of 1.5 of fosphenytoin to 1 of phenytoin |
| valproic acid (Depakene, Depakote, Depacon) | -For generalized seizures & partial seizures -hepatotxicity and pancreatitis are SERIOUS AEs |
| carbamazapine (Tegretol) | -1st line for simple partial, complex partial and generalized tonic-clonic seizures -related to tricylic antidepressants -undergoes autoinduction (drug increases it own metabolism over time) |
| gabapentin (Neurontin) | -add-om drug for treatment of parial seizures & partial seizures w/ 2ndary generalization in adults -also used to treat neuropathic pain -related to GABA -abrupt discontinuatio can lead to withdrawal seizures |
| phenobarbital (Solfoton) | -anticonvuslant barbiturate (primidone metabolizes into phenobarb & phenylethblahblah in liver) -1stline for status epilepticus -effectinve prophylactic drug for febrile seizures |
| phenytoin (Dilantin) | -indicated for tonic-clonic and partial seizures -fosphenytoin-Cerebyx created as alternative b/c of physical shortcommings (pH of 12 for injections, etc..) need to give at a conversion of 1.5 of fosphenytoin to 1 of phenytoin |
| valproic acid (Depakene, Depakote, Depacon) | -For generalized seizures & partial seizures -hepatotxicity and pancreatitis are SERIOUS AEs |
| Partial seizures | -short alterations in consciousness -repetitive unusual movements -phychological changes and confusion |
| Simple seizures | -consciousness, possible hallucinations -motor symptoms -ANS responses -Personality changes |
| Complex Seizures | -impaired consciousness & memory -behavioral effects -purposeless or bizarre behaviors -aura & tonic, clonic, or tonic-clonic sezuires |
| generalized sizures | -staring off in space/daydreaming -temporary lapse in consciousness -nysthymia (dizzy-eyes) -both hemispheres involved head drop or falling-down symptoms |
| unclassified seizures | do not fit into the other categories |
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gfcfnina
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