Pharm 3

Question 1

epilepsy =

Answer 1

Chronic neurological disorder characterized by recurrent seizures

Question 2

seizures =

Answer 2

Episodes of sudden, transient disturbances in cerebral excitation

Question 3

neurons: epilepsy

Answer 3

hyperexcitable, “irritable” neurons

Question 4

neurons: seizures

Answer 4

Neurons firing in rapidly synchronized bursts

Question 5

Causes of epilepsy/seizures

Answer 5

VARIES WIDELY

• unknown
• congenital
• birth trauma
• anoxia
• genetic
• infection
• hypoglycemic
• injury

Question 6

How much of the US population have epilepsy?

Answer 6

about 3%

Question 7

Effectiveness of meds for seizures (%)

Answer 7

50% - meds effective
25% - meds have substantial control
25% - meds have inadequate control

Question 8

What are the classifications of seizures?

Answer 8

• generalized
• partial or focal seizures
• unknown

Question 9

Which seizure type was formerly called “grand mal” and “petit mal”?

Answer 9

generalized

Question 10

What types of seizures are included in the “generalized” category?

Answer 10

• tonic-clonic

- absence

Question 11

How much of the brain is involved with generalized seizures?

Answer 11

involves whole brain

Question 12

Partial or focal seizures: brain involvement

Answer 12

• only involve a part of the brain

- can become generalized

Question 13

What are unknown seizures?

Answer 13

Anything that doesn’t fit into the categories of generalized or focal/partial

Question 14

What is status epilepticus?

Answer 14

Continuous seizure for 30 minutes or more

OR

successive seizures without regaining consciousness

Question 15

What can status epilepticus be brought on by?

Answer 15

• Sudden withdrawal from anti-seizure meds
• cerebral infarct
• drug/alcohol withdrawal
• infection

Question 16

What does status epilepticus require (immediate)

Answer 16

requires emergency tx

• maintain airway/O2
• Monitor BP/HR
• Assessing for injury, blood gases, toxicology, IV medications

Question 17

What are the first drugs used for status epilepticus?

Answer 17

typically benzodiazepines

Question 18

first drugs for status epilepticus: benzos are _____ acting

Answer 18

short

Question 19

first drugs for status epilepticus: benzos may be used concurrently with or followed by _______ (2)

Answer 19

• phenytoin (Dilantin)

- fosphenytoin (Cerebyx)

Question 20

If status epilepticus is not resolved after first tx method, what is the next course of action?

Answer 20

• phenobarbital (Solfoton)

- valproic acid (Depakene)

Question 21

If status epilepticus is still not resolved after first and second tx attempt, wht must be done?

Answer 21

If still not resolved, general anesthetics given, then slow tapering over 12 hours

• midazolam (Versed)
• phenobarbital (Nembutal)
• propofol (Diprivan)

Question 22

rationale for drug tx even though seizures are usually self-limiting

Answer 22

Uncontrolled recurrent seizures may cause further damage to injured neurons

Question 23

How can seizures be potentially harmful to other healthy cells?

Answer 23

• Cascade of other harmful proteins and oxidative stress
• Structural and functional changes in neuronal pathways
• Impaired cerebral activity
• Susceptibility to other seizures

Question 24

When can seizures be fatal?

Answer 24

if cardiac irregularities result in cardiac arrest