NU641 Week 11 Quiz 2023-solved

Generalized seizure types (6) - Answer- -Tonic clonic (grand mal) -Absence (petit mal) -Clonic -Myoclonic -Tonic -Atonic Status epilepticus (2) - Answer- -Two or more seizures without full consciousness between seizure episodes -Requires immediate treatment Absence seizures - Answer- -Impaired consciousness for short period of time -Typically seen in children 4 to 12 -EEG typically shows generalized 3 Hz waves Focal seizure types (2) - Answer- -Simple partial -Complex partial Antiepileptic drugs mechanism of action (4) - Answer- -Reducing sodium and/or calcium influx into brain cells -Causes increase in inhibitory gamma-amino butyric acid (GABA) activity -Enhances influx of chloride -Interferes with excitatory glutamate transmission Antiepileptic agents that reduce efficacy of oral contraceptives (3) - Answer- -Phenytoin -Phenobarbital -Carbamazepine Seizure medications and pregnancy - Answer- -None are safe -Use only if benefit outweighs risk and patient realizes potential of birth defects Phenytoin (Dilantin) (2) - Answer- -Highly plasma protein bound -Serum levels 10 to 20 mcg/ml should be interpreted according to patient's serum albumin level Fosphenytoin (2) - Answer- -Prodrug that is converted to phenytoin -Can be given IM Hypersensitivity syndrome and phenytoin - Answer- -Can occur about 3 to 8 weeks after starting therapy Gabapentin (4) - Answer- -GABA analog -Does not increase GABA brain levels -Does not act at GABAnergic receptors -Few drug interactions Primidone metabolism - Answer- Metabolized to phenobarbital Phenobarbital - Answer- -Usually used in status epilepticus Levetiracetam (Keppra) (3) - Answer- -Chemically different than other AEDs -Should not be stopped abruptly because of increased risk of withdrawal seizures -Can cause dizziness somnolence Benzodiazepines MOA (3) - Answer- -Bind to GABA receptors -Allows influx of chloride through central ion channels -Reduces neurotransmission Hypnotic agents that bind to benzodiazepine receptors (subtype BZ) (3) - Answer- -Zlpidem -Zaleplon (Sonata) -Eszopiclone (Lunesta) Benzodiazepines use (4 - Answer- -Anxiety -Sedative/hypnotics -Anterograde amnesia in procedures -Muscle relaxants Benzodiazepine antagonist - Answer- Flumazenil, a GABA receptor antagonist Most common types of headaches (3) - Answer- -Tension -Migraine -Cluster Migraine characteristics (5) - Answer- -Family hx -Females 3x more than males -Pulsating or throbbing type of pain -Duration of 2 to 72 hours -Associated with visual auras, light and sound sensitivity, pale facial complexion, N/V Migraine therapy goals (4) - Answer- -Relieving headaches -Avoiding overuse of medications -Diminishing impact of migraines on patient's quality of life -Reduction of 50% occurrence realistic goal