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what is a convulsion?
sudden, involuntary contraction of the muscles of the body, often accompanied by loss of consciousness.
What is a seizure?
periodic disturbances of the brain's electrical activity.
Classified as partial (focal) or generalized
What is epilepsy?
a permanent, recurrent seizure disorder.
Path/eti= brain injury @ birth, head injuries, and inborn errors of metabolism.
What are partial seizures?
- the most common type of epileptic seizure
- arise from localized area in the brain
- Can spread 2 the entire brain & cause a generalized seizure
- Examples - simple(just stare), Jacksonian (stiffining), Psychomotor(jerking)
What are motor seizures?
with uncontrolled stiffening or jerking in one part of the body such as the finger, mouth, hand, or foot that may progress 2 the entire limb.
What is a somatosensory seizure?
a chang in taste or speech
What are generalized seizures?
- Include absence, mycolonic, & tonic (contraction) and clonic (relaxation) of muscles
- Loss of consciousness
What is myoclonic seizures?
involve sudden, forceful contractions of single or multiple groups of muscles.
What is status epilecticus?
- An emergency
- characterized by continual seizure activity w/ no interruption
- May result from abrupt discontinuation of medication
- Diazepam most often inital treatment
What is the general action of an anticonvulsant?
reduce the excitability of brain neurons
What are the uses?
- Prophylactically (head trauma, tumor in brain)
- Seizures of all types
- Neuropathic pain
- Bipolar disorders
- Anxiety disorders
- Status Epilepticus
What are adverse reactions?
- Drowsiness, weakness, dizziness
- Headache, somnolence
- Nystagmus (crossed eyes)
- Slurred speech
- Nausea, vomiting, anorexia, constipation, diarrhea
- Gingival hyperplasia (stomatitis)
- Pancytopenia (blood levels decreased anemia)
What are barbiturates?
Remember! This is a sedative/hypnotic
- Example -----phenobarbital
- Used for status epilpticus, focal seizure,& tonic-clonic seizures
- A/R = bradycardia, hypoventilation, skin rash
What is Benzodiazepines?
- Examples---clonazepam, diazepam, lorazepam
- A/R =---sedation, anorexia, constipation, diarrhea, dry mouth, visual disturbances, aplastic anemia
- SHORTER ACTING
What are Hydatoins?
MONITOR DILANTIN TOXICITY
- Examples---phenytoin (DILANTIN)
- Most commonly prescribed anticonvulsant
- A/R =
- nystagmus, ataxia, slurred speech, mental changes, rashes, nausea, vomiting, gingival hyperplasia, hematologic changes, hepatoxicity
What are s/s of Dilantin toxicity
- S/S include:
- Rapid eye movement
- Slurred speech or difficulty speaking
- Problems w/ coordination or balance
- Unusual body movements or shakiness
- Teach client monitor Dilantin levels monthly & CBC
- Normal levels 10-20mcg per mL
- Above 20mcg = NYSTAGMUS (crossed eyes) CALL DR
- Above 30mcg= Mental changes, Ataxia (gait off)
What are Oxaolidmediones?
Given 4 Epilepsy. Example- Trimethadione
- personality changes
- increased irritability
- nausea / vomiting
- VISUAL CHANGES
NURSE= TELL DON'T DRIVE WHEN TAKING AND WEAR SUNSCREEN OR PROTECTIVE CLOTHING
What are Succinimides?
- GASTROINTESTINAL DISTURBANCES
- urinary frequency
- weight loss
- hematologic changes
- SKIN RASH
NURSE= TELL CLIENTS 2 TAKE WITH FOOD 2 PREVENT GI UPSET
What are Carboxylic Acid Derivatives?
Used 4 Epilepsy, Mania, Migraines
Irritates anything it touches
- Stephen Johnson syndrome
NURSE= TELL CLIENT DONT CHEW SWALLOW WHOLE MIX W/ PUDDING. MAIN GOAL PREVENT MOUTH SORES
What are Misc. Anticonvulsants?
- UNRELATED 2 OTHER ANTICONVULSANTS
What is a general assessment of seizure activity?
- Description of seizure (motor and psych activity)
- Frequency of the seizures (how many per day)
- Average length of time of a seizure
- Description of aura
- Description of degree of impairment of conciousness
- Description of what, if anything appears 2 bring on seizure
Nurse duties on anticonvulsants
- DON'T STICK ANYTHING IN CLIENT'S MOUTH WHILE HAVING SEIZURE
- TAKE V/S RIGHT AFTER SEIZURES
- DON'T STOP TAKING ANTICONVULSANTS ABRUPTLY OR SKIP MEDS
- DON'T DRINK ALCOHOL
- WEAR MEDICAL BRACELET
- DON'T SKIP APPTS. 2 MONITOR TOX LEVELS
When taking anticonvulsants and a dose is skipped what might happen?
recurrence of seizures so make sure u teach them 2 not skip doses!!