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322 Exam 2
322 Anticonvulsants, Parkinson's, Alzheimer, MS, MG
Term | Definition |
---|---|
prodromal phase seizure | sensation days before, anxiety, headache |
early ictal seizure | prepare oneself for what is about to occur, differs based on seizure; may alter taste, numbness |
ictal phase seizure | seizure itself, vision loss, tremors |
postictal phase seizure | drowsiness, nausea, malaise; put in side position to prevent tongue from closing over trachea |
anticonvulsants | antiseizure drugs, have a narrow therapeutic index |
hydantoins, phenytoin | stabilizes nerve cells to keep them from getting overexcited; interfere with vitamin K metabolism; purple glove syndrome |
side effects of hydantoins | gingival hyperplasia, nystagmus, slurred speech, anorexia, urine discoloration, hyperglycemia |
iminostilbene side effects | possible interaction with grapefruit juice; hematologic toxicity, dizziness, GI distress |
succinimides | treat absence seizures; suppress abnormal electric activity, decrease calcium influx |
succinimides adverse reactions | blood dycrasias, steven johnson rash, lupus, suicidal ideation |
valproic acid | increases GABA activity, can cause thrombocytopenia and liver toxicity is deadly |
status epilepticus | ongoing seizure, medical emergency treated with diazepam or lorazepam followed by phenytoin; slow IV to avoid depression |
myasthenia gravis | antibodies attach ACh receptors and decrease attachment to receptors at neuromuscular junction and prevents normal muscular contraction |
myasthenia gravis signs | weakness and fatigue of muscles; affects eye muscles, chewing, facial muscles and respiratory muscles |
treatment of myasthenia gravis | acetylcholinesterase inhibitors; neostigmine, pyridostigmine, edrophonium |
if ACE inhibitors do not work | prednisone for myasthenia gravis, immunosuppressive drug |
myasthenia crisis | underdosing acetylcholinesterase inhibitors ; generalized muscle weakness involves diaphragm and intercostal muscles leading to respiratory failure |
cholinergic crisis | overdosing acetylcholinesterase inhibitors causes possible respiratory depression and arrest; use atropine as antidote |
multiple sclerosis | autoimmune disorder that attacks myelin sheath of nerve fibers creating lesions and plaques |
multiple sclerosis treatment | immunomodulators, immunosuppressants, skeletal muscle relaxants |
immunomodulators | modify body's immune response so body doesn't attack itself, inhibits function of cytokines |
immunosuppressants | suppress the immune system |
skeletal muscle relaxants | depress neuron activity in the spinal cord and enhance neuronal inhibition of skeletal muscles |
peripherally acting skeletal muscle relaxants | treat muscle spasticity |
centrally acting skeletal muscle relaxants | treat muscle spasms |
spascticity | muscular hyperactivity that causes contraction of the muscles resulting in pain and limited mobility |
spasms | associated with traumatic injury |
parkinson's | chronic progressive neurologic disorder; imbalance of acetylcholine and dopamine; lack of dopamine |
parkinson's hallmark signs | tremors, muscle rigidity, bradykinesia, postural instability, flat affect |
dopaminergics | convert dopamine and increase mobility; carbidopa levodopa |
dopamine agonists | promotes release of dopamine from receptors, blocks dopamine reuptake |
MAO B inhibitors | inhibit MAO B from breaking down dopamine; prolongs action of levodopa |
COMT inhbitors | inhibit COMT from inactivating dopamine, increase amount of levodopa in the brain |
carbidopa levodopa considerations | dry mouth and fatigue, orthostatic hypotension, dyskinesia, hallucinations and nightmares, sweat and urine discoloration |
alzheimer's | memory loss, impaired judgment, sundowning |
treatment for alzheimer's | donepezil, galantamine, rivastigmine; acetylcholinesterase inhibitors prevent the breakdown of acetylcholine and help slow the progression |
adverse effect for acetylcholinesterase inhibitors | orthostatic hypotension |
hydantoin range | 10 -20 |
iminmostilbene range | 4 -12 |
succinimide range | 40 - 100 |