1. SEIZURES Ch. 15
J. Arzaga, MSN, RN

2. Epilepsy Disorder characterized by recurrent seizures.
Clinical, detectable sign
J. Arzaga, MSN, RN

3. Seizures
Abnormal or uncontrolled neuronal discharges in brain, which may affect consciousness, motor activity, and sensation
Partial (focal)
Generalized (absence, tonic clonic)
Special epileptic syndromes (myoclonic)
J. Arzaga, MSN, RN

4. Convulsions
Involuntary, violent spasms of the large skeletal muscles of the face, neck, arms, and legs.
All convulsions are seizures, not all seizures are convulsions
J. Arzaga, MSN, RN

5. Drug Compliance
Seizure medications are gradually increased from smallest initial dose possible
Additional medications added if necessary
Serum drug levels necessary to determine therapeutic levels
J. Arzaga, MSN, RN

6. Drug Compliance
If seizure free x 3 years while on antiseizure medications, prescriber may attempt to withdraw medication under close supervision
Withdrawn slowly, over several months. If seizure recurrent, resume medication
“Rebound seizures”
J. Arzaga, MSN, RN

7. Nurse’s Role Assessment: past medical history diagnostic studies
pathologic process causing seizures because
type of medication prescribed depends on type of seizure experiencing
J. Arzaga, MSN, RN

8. Nurse’s Role Common side effects: Drowsiness Dizziness
Postural hypotension
Respiratory depression
J. Arzaga, MSN, RN

9. Nurse’s Role = Patient Teaching
Reliable contraception
Immediate notification if pregnancy occurs
Report signs of excessive bleeding
Report severe drowsiness
Report sever bone pain
Avoid alcohol and ginko biloba
Teaching about disease and drug
J. Arzaga, MSN, RN

10. Nurse’s Role = Patient Teaching
Avoid alcohol and nicotine
OTC drugs and herbal medications
Avoid driving, hazardous activity
Take with food
“Rebound seizures”
J. Arzaga, MSN, RN

11. Mechanism of action: Stimulating influx Chloride ions
Delaying influx on sodium
Delaying influx on calcium
Glutamate helps to restore balance
J. Arzaga, MSN, RN

12. Prototype Drugs Phenobarbital(Luminal) Diazepam(Valium)
Phenytoin(Dilantin)
Valporic Acid(Depakote)
Ethossuximide (Zarontin)
J. Arzaga, MSN, RN

13.
J. Arzaga, MSN, RN