1. Chapter 32 Anticonvulsants

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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