WEEK 5_NEUROPSYCH 2_STUDENT.ppt - Chapter 23 Antiseizure Agents Copyright \u00a9 2013 Wolters Kluwer Health | Lippincott Williams Wilkins Epilepsy \u2022 Most

WEEK 5_NEUROPSYCH 2_STUDENT.ppt - Chapter 23 Antiseizure...

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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 23: Antiseizure Agents Chapter 23: Antiseizure Agents
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Epilepsy Epilepsy Most prevalent of the neurological disorders Collection of different syndromes Seizures A loss of control Frightening to patients
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Classification of Seizures Classification of Seizures Seizure type is very important Formerly categorized as: Grand mal (tonic-clonic seizures) Petit mal (absence seizures) Current classifications different
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Copyright © 2017 Wolters Kluwer • All Rights Reserved International Classification of Seizures International Classification of Seizures
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Drugs for Treating Generalized Seizures Drugs for Treating Generalized Seizures Drugs typically used to treat generalized seizures stabilize the nerve membranes by blocking channels in the cell membrane or altering receptor sites. Because they work generally on the central nervous system (CNS), sedation and other CNS effects often result Absence seizures may require drugs that are different Used in both children and adults
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Hydantoins Hydantoins Ethotoin (Peganone) Fosphenytoin (Cerebyx) Phenytoin (Dilantin) Generally less sedating May be the drugs of choice for patients unable to tolerate sedation and drowsiness
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Hydantoins (cont.) Hydantoins (cont.) Therapeutic Actions and Indications – Stabilize nerve membranes throughout the CNS directly by influencing ionic channels in the cell membrane, thereby decreasing excitability and hyperexcitability to stimulation Pharmacokinetics- Well absorbed from the gastrointestinal (GI) tract, metabolized in the liver, and excreted in the urine
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Hydantoins cont. Hydantoins cont. Therapeutic serum phenytoin levels range from 10 to 20 mcg/mL. The therapeutic serum levels of ethotoin are from 15 to 50 mcg/mL. Fosphenytoin is given intramuscularly or intravenously.
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Hydantoins cont. Hydantoins cont. Contraindications and Cautions- Known allergies Pregnancy and lactation Caution should be used with elderly or debilitated patients Impaired renal or liver function Depression, or psychoses
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Copyright © 2017 Wolters Kluwer • All Rights Reserved Hydantoins cont. Hydantoins cont. Adverse Effects- Relate mostly to CNS depression- Depression, confusion, drowsiness, lethargy, fatigue, constipation, dry mouth, anorexia, cardiac arrhythmias and changes in blood pressure, urinary retention, and loss of libido.
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