NURS Exam 3 Prep - The Nervous System Pathophysiology and Drugs for Seizures

What are meninges?

protect and surround the CNS

What is bleeding due to?

injury or damage to an intercranial/intervertebral blood vessel

What is inflammation due to?

disease process but is usually related to an infection

What are tumors?

lesions/cysts; may be benign or malignant 

What does blood, inflammatory debris and swelling, and tumors/growths take up?

limited space in the CNS and cause pressure which damages nervous tissue

What does bleeding, inflammation, and tumor cuase?

mass effect (space occupying lesions)

What is often a presenting symptom of bleeding, inflammation, and tumors?

seizure activity

Where may mass effect occur?

within the spine due to degenerative changes (arthritis) 

Where is spinal degeneration common?

middle-aged and older adults

What is a seizure?

sudden uncontrolled electrical disturbance in the brain that can affect consciousness, motor activity, or sensation

What is unique of seizures?

a single occurrence, not all have the same manifestations 

What is epilepsy?

two or more recurring seizures

What are convulsions?

involuntary spasmodic motor activity that occurs with some (but by no means all) seizures

What are most seizures considered?

idiopathic (make up 50% of seizures)

What are known causes of seizure?

fever, infection, metabolic disorders, cancer, trauma/toxin, exposure, vascular disease

What are febrile seizures?

common to kids, related to fevers

What are metabolic disorders?

fluid/electrolyte disturbances, hypoglycemia 

What is cancer>

a primary brain tumor or metastatic disease

What is a vascular disease?

respiratory hypoxia, stroke, shock

What are the classifications of seizures?

focal, genralized, unknown

What are partial (focal) seizures?

may be simple or complex 

What are simple seizures?

associated with sensation, emotion, twitching

What are complex seizures?

associated with aura, unrespoinsive, fumbling, postictal

What are generalized seizures?

absence (petit mal), atonic, tonic-clonic

What are special types of seizures?

febrile, myoclonic status epilepticus 

Wahat are myoclonic seizures?

involves a major muscle group

Who is epilepsy more common to?

children and young adults, hispanics, hereditary component

Who outgrows children?

50% of children

What do antiepileptic drugs (AEDs) increase activity of?

GABA through chloride ions

What do antiepileptic drugs (AEDs) inhibit?

the amount of sodium & calcium entering neurons 

What do antiepileptic drugs (AEDs) correct?

an imbalance of neurotransmitters

What do antiepileptic drugs (AEDs) block?

glutamate receptors

What is glutamate?

excitatory stimulant in the brain

What GABA medication are used to manage seizures?

benzodiazepines, barbiturates/phenobarbital, gabapentin, topiramate

What are benzodiazepines?

diazepam, lorazepam

What are barbiturates?

phenobarbital

What do phenytoin block?

sodium/calcium channels 

What is associated with carbamazepine?

sodium channels

What is associated with lamotrigine?

sodium channels/gultamate antagonist

What is associated with oxcarbazepine?

sodium channels

What is associated with valproic acid?

GABA/glutamte-NMDA 

What is associated with zonisamide?

sodium/calcium channels

What is associated with ethosuxiimide?

a succinimide drug (not included as a hydantoin_

What are side effects of benzodiazepines?

drowsiness, sedation, ataxia (CNS depression)

What are side effects of barbiturates?

somnolence, dizziness, confusion (CNS depression, Stevens-Johnson Syndrome (SJS) agranulocytosis) 

What are side effects of dilantin?

somnolence, dizziness, nystagmus, gingival hyperplasia (agranulocystosis, SJS)

What are side effects of phenytoin-like AEDs?

dizziness, ataxia, headache, visual disturbances, GI upset (agranulocytosis, SJS, liver failure, pancreatitis, heart block, suicidal behavior)

What is important regarding AEDs?

safety first

What neurotransmitters are involved in seizures?

↓GABA inhibition, ↑glutamate excitation

What sodium/calcium channel agents are used for seizure management?

phenytoin, carbamazpeine

What glutamate medication are used for seizure management?

valproic acid, ethosuximide