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 injury Head trauma Extreme fever Heat exhaustion Brain tumor Infections Stroke
Lowered blood glucose High protein levels Mood disorder, antipsychotic, and local anesthetic med’s Drug abuse—cocaine 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Because seizures are likely to occur with abrupt withdrawal, antiseizure medications is withdrawn over a period of 6 to 12 weeks.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.