Term
| Through clinical case scenarios, recognize classic symptoms of seizure activity. |
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Definition
Last 30 sec. to 2 min
-Change in alertness
-Mood changes
-Changes in sensation
-Vision changes (flashing lights)
-Falling, loss of muscle control
-Muscle twitching
-Muscle tension or tightness
-Shaking of entire body
-Tasting a bitter or metallic flavor |
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Term
| Discuss appropriate first aid management of a seizure. |
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Definition
1) Protect the person from injury, prevent falls, lay person on the ground, clear objects
2) Cushion the person's head
3) Loosen tight clothing, especially around the neck
4) Turn the person on his/her side-prevent vomit being inhaled
5) Look for a medical ID bracelet
6) Stay with the person until he/she recovers
-Do not restrain the person
-Do not place anything b/w the person's teeth
-Do not move the person unless he/she is in danger
-Do not try to make the person stop convulsing
-Do not give the perosn anything by mouth |
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Term
| Recognize when to call 911. |
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Definition
-Seizure lasts more than 2 to 5 min.
-Person does not awaken or have normal behavior after a seizure
-Another seizure starts soon after a seizure ends
-First time the person has had a seizure
-Person had a seizure in water
-Person is pregnant, injured, or has diabetes
-Person does not have a medical ID bracelet
-Anything different about this seizure as compared to their usual seizures |
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Term
| List the neurotransmitters involved in seizure activity. |
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Definition
Glutamate-excitatory
-Opens sodium and calcium channels
When it is released, it travels across the synapse and binds with receptors on the postsynaptic neuron. The binding opens membrane channels to allow sodium or calcium to flow into neuron, transmitting the excitatory signal.
Some AEDs either block the release of glutamate or block the opening of the sodium and/or calcium channels.
GABA-Inhibitory
-causes influx of chloride
Attaches to neuronal membranes and opens chloride channels. Chloride flows into neuron, it becomes hyperpolarized and less excitable |
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Term
| Discuss general therapeutic goals for management of epilepsy. |
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Definition
-Decrease seizue frequency to an acceptable level for the patient
-Balance benefits vs. drug toxicities and ADRs
-Non-compliance (50% of therapy failures)
-Quality of life goes beyond balancing seizures and ADRs (driving, future, etc.) |
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Term
| Describe the adverse effects common to all the anti-epileptic drugs. You do not need to know the ADRs listed for individual AEDs as "other ADRs". |
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Definition
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Term
| Discuss preventive management of the osteoporosis risk associated with the AEDs. |
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Definition
Similar to the risk seen with corticosteroid use.
Patients should take supplemental calcium+vitamin D if taking carbamazepine, phenytoin, phenobarbital, oxcarbazepine, or valproate |
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Term
| Recognize the potential severity of AED-induced rash and appropriate referral. |
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Definition
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Term
| List ADRs for gabapentin and pregabalin incl. weight gain, peripheral edema, paradoxical response, and mild euphoria. |
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Definition
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Term
List the other therapeutic uses for the AEDs incl. management of pain, neuromuscular disorders, and psychiatric indications. You do not need to memorize which AEDs are more commonly used to treat these indications except you should know:
a. diabetic neuropathy pain, shingles pain, HIV-neuropathy, and fibromyalgia: pregabalin
b. essential tremor: primidone, propranolol |
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Definition
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Term
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Definition
Older
-Phenobarbital
-Primidone
-Phenytoin (Dilantin)
-Valproic Acid
-Carbamazepine
Newer
-Oxcarbazepine
-Gabapentin (Neuronitn)-increase appetite, weight gain
-(Lyrica)-Drug of Choice
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