Gerontologic Considerations Drug Therapy for Seizure Disorders Seizure

Gerontologic considerations drug therapy for seizure

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Gerontologic Considerations Drug Therapy for Seizure Disorders Seizure disorders are high among older adults because the liver metabolizes phenytoin, its use can be a problem for older patients with compromised liver function Age-related changes in liver enzymes decrease the liver's ability to metabolize drugs Created 7/2016
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Phenobarbital, carbamazepine, and primidone have potential effects on cognitive function, so their use may be less desirable for the older adult Surgical Therapy The most common surgical intervention is an anterior temporal lobe resection Surgical candidates must meet three requirements: o a confirmed diagnosis of epilepsy o an adequate trial with drug therapy without satisfactory results o a defined electroclinical syndrome (type of seizure disorder) Other Therapies Vagal nerve stimulation is used as an adjunct to medications when surgery is not feasible A surgically implanted electrode in the neck is programmed to deliver the electrical impulse to the vagus nerve The patient can activate it with a magnet when he or she senses a seizure is imminent Vagal nerve stimulation can cause adverse effects such as coughing, hoarseness, dyspnea, and tingling in the neck Battery replacement is required via surgery about every 5 years The ketogenic diet is a special high-fat, low-carbohydrate diet that has been used to control seizures in some people with epilepsy When a person is on this diet, ketones are produced and pass into the brain and replace glucose as an energy source The diet may be effective for some patients with drug-resistant epilepsy Biofeedback to control seizures is aimed at teaching the patient to maintain a certain brain wave frequency that is refractory to seizure activity Safety Alert During a seizure, you should do the following: Maintain a patent airway for the patient. Protect the patient's head, turn the patient to the side, loosen constrictive clothing, ease patient to the floor (if seated). Do not restrain the patient. Do not place any objects in the patient's mouth. Restless Leg Syndrome Etiology and Pathophysiology Also called Willis-Ekbom disease, is a relatively common condition characterized by unpleasant sensory (paresthesia’s) and motor abnormalities of one or both legs It is more common in older adults More common in women There are two distinct types of RLS: primary (idiopathic) and secondary The majority of cases are primary, and many patients with this type of RLS report a positive family history Created 7/2016
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Secondary RLS can occur with metabolic abnormalities associated with iron deficiency, renal failure, hypertension, diabetes mellitus, or rheumatoid arthritis Conditions such as anemia, pregnancy, and certain medications can cause or worsen symptoms It is believed that RLS is related to a dysfunction in the brain’s basal ganglia circuits that use the neurotransmitter dopamine, which controls movement
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