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Chapter 32 Anticonvulsants
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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 32 - 2 Epilepsy An electrical disorder of the brain that sometimes leads to seizures Definitions Seizure: a brief episode of abnormal electrical activity in the nerve cells Convulsion: spasmodic contractions of involuntary muscles
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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 32 - 3 Symptoms of Epilepsy Abnormal motor function Loss of consciousness Altered sensory awareness Psychic changes
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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 32 - 4 Drug Agents Used to Prevent Seizures Barbiturates Hydantoins Succinimides Benzodiazepines Other agents Valproic acid Carbamazepine (Tegretol) Clients often on these medications for life
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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 32 - 5 Anticonvulsants Treatment Start with one drug and add others as needed Check serum drug concentrations as required
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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 32 - 6 Goal of Anticonvulsants Prevent the generation and spread of excessive discharges in the brain Protect the normal cells
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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 32 - 7 Anticonvulsants: Therapeutic Effects Stabilize nerve cells and prevent hyperexcitability Prevent the generation of hyperactive neurons Prevent abnormal impulses from spreading
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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 32 - 8 Anticonvulsants: Side Effects Carbamazepine (Tegretol) Blood dyscrasias Phenytoin (Dilantin) Gum hyperplasia Diazepam (Valium) Respiratory depression and drowsiness
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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 32 - 9 Pediatric Considerations Barbiturates require lower dosages Excessive sedation, confusion, lethargy, or decreased movement Paradoxical reactions Valproic acid: do not give with milk Wear a MedicAlert® bracelet
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