Drugs for Seizures by liaoqinmei

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									DRUGS FOR SEIZURES




       Chapter 11
INTRODUCTION
 Epilepsy is a common
 disorder of the CNS
 characterized by
 symptoms of
 blackout, fainting
 spells, apparent
 clumsiness,
 temporary loss of
 memory, and/or
 irregular seizure
 activity.
INTRODUCTION
 Over two million
 Americans have
 epilepsy, and except
 for when these
 symptoms are
 expressed, most of
 the time it appears
 that their health is
 not challenged.
SEIZURES & CONVULSIONS ARE SYMPTOMS
OF EPILEPSY

 Seizures—abnormal or
  uncontrollable
  neuronal discharges
  within the brain.
 May cause a blank
  stare, a loss of
  consciousness, jerking
  body movements, or a
  period of general
  confusion for the client.
SEIZURES & CONVULSIONS
 The  terms
  convulsion and
  seizure are not the
  same.
 Convulsions
  specifically refer to
  involuntary, violent
  spasms of the large
  skeletal muscles of
  the face, neck,
  arms, and legs.
SEIZURES & CONVULSIONS
 All convulsions are
  seizures, but not all
  seizures are
  convulsions.
 Although some types of
  seizures do indeed
  involve convulsions,
  other seizures do not.
 Thus antiseizure meds
  rather than
  anticonvulsants.
CAUSES
    Neuronal damage or    Lowered blood glucose
     injury
                           High protein levels
    Head trauma
                           Mood disorder, anti-
    Extreme fever
                            psychotic, and local
    Heat exhaustion
                            anesthetic med’s
    Brain tumor
                           Drug abuse—cocaine
    Infections
    Stroke                Alcohol withdrawal

                           Withdrawal from
                            sedative-hypnotics
TYPES OF SEIZURES
 Partial   seizures
     Simple
     Complex
 Generalized   seizures
   Absence (petit mal)
   Atonic seizure (drop
    attacks)
   Myoclonic seizure
   Tonic-clonic (grand
    mal)
STATUS EPILEPTICUS
 Status epilepticus is
  a medical
  emergency brought
  on by repeated
  generalized seizures
  and convulsions.
 Muscle spasms may
  block the airway,
  depriving the brain
  of oxygen.
SEIZURE MANAGEMENT
 Effective seizure
  management involves
  strict adherence to
  drug therapy.
 Choice of drug depends
  on the type of seizures,
  medical history,
  diagnostic studies, and
  the pathological
  processes causing the
  seizures.
SEIZURE MANAGEMENT
 Because seizures are
  likely to occur with
  abrupt withdrawal,
  antiseizure
  medications is
  withdrawn over a
  period of 6 to 12 weeks.
 In most cases, a single
  drug effectively
  manages seizures.
 Once seizures are
  controlled, patients are
  continued indefinitely
  on the antiseizure drug
SEIZURE MANAGEMENT
 Withdrawal   should
 only be attempted
 after at least 3
 years of being
 seizure free, and
 only under the close
 observation and
 direction of the
 healthcare team.
SEIZURE MANAGEMENT
 Goal of antiseizure
 drug therapy is to
 suppress neuronal
 activity just enough
 to prevent abnormal
 or repetitive firing.
DRUGS WITH GABA ACTION
 Drugs   with GABA
  action are drugs with
  the ability to mimic
  effects of the inhibitory
  neurotransmitter
  GABA.
 Ex. Benzodiazepines,
  barbiturates, and
  miscellaneous drugs
 DP-phenobarbital
  (luminal) pg. 182.
PHENYTOIN AND PHEYTOIN-LIKE DRUGS
(HYDANTOINS)
 Delay influx of sodium ions
  across neuronal membrane.
 Ex.—hydantoins,
  carbamazepine (Tegretol),
  divalproex (Depakote),
  valoproic acid (Depakene)
 DP for phenytoin—Dilantin
  pg. 185
 DP for valoproic acid
  (Depakene) pg. 185
SUCCINIMIDES
 Succinimides   delay
  entry of calcium
  ions into neuron—
  increases electrical
  threshold; no
  impulse
  transmitted
 DP—ethosuximide
  (Zarontin) pg. 186.
SOME CONTROLLED BY A PREFERRED
GROUP OF DRUGS
 Drugs  do not cure
  epilepsy; just
  reduce number of
  seizures.
 Same seizures do
  not respond to same
  drug.

								
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