NU 578 Controlled Substances Chapters 21-22, 24, 29-35
Study online at https://quizlet.com/_i9hynb
1. simple partial seizure: no loss of consciousness
Patient may experience discrete motor symptoms (i.e., twitching of thumb), sensory symptoms (e.g., local numbness;
auditory, visual, or olfactory hallucinations), autonomic symptoms (nausea, flushing, salivation, urinary incontinence),
or psychoillusory symptoms (feelings of unreality, fear, or depression).
Sz persist for 20 to 90 seconds
2. complex partial seizure: Sz is characterized by impaired consciousness and lack of responsiveness.
At Sz onset, pt becomes motionless and stares with a fixed gaze. This state is followed by a period of automatism,
in which the pt performs repetitive, purposeless movements, such as lip smaking or hand wringing. Sz last 45 to 90
seconds
3. Secondarily generalized seizures: simple or complex partial seizures evolving to a generalized
seizure
4. Generalized seizures: May be convulsive or nonconvulsive. As a rule, they produce immediate loss of
consciousness.
5. tonic-clonic seizure: Neuronal discharge spread throughout both hemispheres.
Sz manifest as major convulsions, characterized by a period of muscle rigidity (tonic phase) followed by synchronous
muscle jerks (clonic phase).
Are accompanied by marked impairment of consciousness and are followed by a period of CNS depression, referred
to as the postictal state. The sz itself typically lasts 90 seconds or less.
6. Absence seizures (petit mal): 10 to 30 sec loss of consciousness with eyelid fluttering, abruptly stop
activity
Pt may experience hundreds of absence attacks a day.
Occur primarily in children and usually cease during the early teen years.
7. Atonic seizure (drop attack): generalized seizure characterized by sudden loss of muscle tone and
strength; may cause the head to drop suddenly, objects to fall from the hands, or the legs to lose strength, with falling
and potential injury
1/7
, NU 578 Controlled Substances Chapters 21-22, 24, 29-35
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typically seen in children
8. myoclonic seizure: sudden jerk of the body or extremities lasts for just 1 second
9. status epilepticus: a seizure that persists for 15-30 minutes or longer or a series of recurrent seizures during
which the pt does not regain consciousness.
10. febrile seizures: Seizures that result from sudden high fevers, particularly in children 6 months to 5 years.
11. How antiseizure drugs work: 5 Basic mechanisms: Suppression of sodium influx, Suppression of
Calcium influx, promotion of potassium efflux, blockade of receptors for glutamate, and potentiation or increase of
gamma-aminobutyric acid (GABA)
12. suppression of sodium influx: Dilantin (Phenytoin), Carbamazepine, Lamotrigine
These drugs reversibly bind to sodium channels while they are in the inactivated state and thereby prolong channel
inactivation. By delaying return to the active state, these drugs decrease the ability of neurons to fire at high frequency.
As a result, sz that depend on high-frequency discharge are suppressed.
other drugs: exlicarbazepine, oxcarbazepine, lacosamide, rufinamide, zonisamide, topiramate
13. suppression of calcium influx: Ethosuximide (Zarontin)
In axon terminals, influx of calcium through voltage-gated calcium channels promotes transmitter release. Hence drugs
that block these calcium channels can suppress transmission.
14. Promotion of potassium efflux: Ezogabine
During an action potential, influx of sodium causes neurons to depolarize, and then efflux of potassium causes neurons
to repolarize.
Ezogabine acts on voltage-gated potassium channels to facilitate potassium efflux. This action is believed to underlie
the drug's ability to slow repetitive neuronal firing and thereby provide seizure control.
15. Antagonism of Glutamate: Felbamate and Topiramate (both block the actions of glutamate at NMDA
receptors and thereby suppress neuronal excitation)
Glutamic acid is the primary excitatory transmitter in the CNS. The compound works through 2 receptors: 1)
N-methyl-d-aspartate (NMDA), 2) alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA).
2/7
Study online at https://quizlet.com/_i9hynb
1. simple partial seizure: no loss of consciousness
Patient may experience discrete motor symptoms (i.e., twitching of thumb), sensory symptoms (e.g., local numbness;
auditory, visual, or olfactory hallucinations), autonomic symptoms (nausea, flushing, salivation, urinary incontinence),
or psychoillusory symptoms (feelings of unreality, fear, or depression).
Sz persist for 20 to 90 seconds
2. complex partial seizure: Sz is characterized by impaired consciousness and lack of responsiveness.
At Sz onset, pt becomes motionless and stares with a fixed gaze. This state is followed by a period of automatism,
in which the pt performs repetitive, purposeless movements, such as lip smaking or hand wringing. Sz last 45 to 90
seconds
3. Secondarily generalized seizures: simple or complex partial seizures evolving to a generalized
seizure
4. Generalized seizures: May be convulsive or nonconvulsive. As a rule, they produce immediate loss of
consciousness.
5. tonic-clonic seizure: Neuronal discharge spread throughout both hemispheres.
Sz manifest as major convulsions, characterized by a period of muscle rigidity (tonic phase) followed by synchronous
muscle jerks (clonic phase).
Are accompanied by marked impairment of consciousness and are followed by a period of CNS depression, referred
to as the postictal state. The sz itself typically lasts 90 seconds or less.
6. Absence seizures (petit mal): 10 to 30 sec loss of consciousness with eyelid fluttering, abruptly stop
activity
Pt may experience hundreds of absence attacks a day.
Occur primarily in children and usually cease during the early teen years.
7. Atonic seizure (drop attack): generalized seizure characterized by sudden loss of muscle tone and
strength; may cause the head to drop suddenly, objects to fall from the hands, or the legs to lose strength, with falling
and potential injury
1/7
, NU 578 Controlled Substances Chapters 21-22, 24, 29-35
Study online at https://quizlet.com/_i9hynb
typically seen in children
8. myoclonic seizure: sudden jerk of the body or extremities lasts for just 1 second
9. status epilepticus: a seizure that persists for 15-30 minutes or longer or a series of recurrent seizures during
which the pt does not regain consciousness.
10. febrile seizures: Seizures that result from sudden high fevers, particularly in children 6 months to 5 years.
11. How antiseizure drugs work: 5 Basic mechanisms: Suppression of sodium influx, Suppression of
Calcium influx, promotion of potassium efflux, blockade of receptors for glutamate, and potentiation or increase of
gamma-aminobutyric acid (GABA)
12. suppression of sodium influx: Dilantin (Phenytoin), Carbamazepine, Lamotrigine
These drugs reversibly bind to sodium channels while they are in the inactivated state and thereby prolong channel
inactivation. By delaying return to the active state, these drugs decrease the ability of neurons to fire at high frequency.
As a result, sz that depend on high-frequency discharge are suppressed.
other drugs: exlicarbazepine, oxcarbazepine, lacosamide, rufinamide, zonisamide, topiramate
13. suppression of calcium influx: Ethosuximide (Zarontin)
In axon terminals, influx of calcium through voltage-gated calcium channels promotes transmitter release. Hence drugs
that block these calcium channels can suppress transmission.
14. Promotion of potassium efflux: Ezogabine
During an action potential, influx of sodium causes neurons to depolarize, and then efflux of potassium causes neurons
to repolarize.
Ezogabine acts on voltage-gated potassium channels to facilitate potassium efflux. This action is believed to underlie
the drug's ability to slow repetitive neuronal firing and thereby provide seizure control.
15. Antagonism of Glutamate: Felbamate and Topiramate (both block the actions of glutamate at NMDA
receptors and thereby suppress neuronal excitation)
Glutamic acid is the primary excitatory transmitter in the CNS. The compound works through 2 receptors: 1)
N-methyl-d-aspartate (NMDA), 2) alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA).
2/7
