chap 12

• okay let's talk about the drugs for epilepsy this is chapter 12 but i don't think it's chapter 12 zakat zone maybe sally pink but it's chapter 12
• okay let's talk about epilepsy class what do you know about epilepsy what do you know or have you seen a person having epilepsy what have you observed president obama
• alcohol i have i have seen that also yeah i guess i have i know shared that's a new hackathon pharmacy but i think that was here 20 2014 if i'm not mistaken so it's it was on my class a farm chem one the first day of class nagano next seizure
• let's differentiate let's differentiate epilepsy from seizure or conditions nah associated with this one
• Epilepsy


  A neurologic disorder, the second most common neurologic disorder after cerebral vascular disease and Alzheimer's disease, characterized by recurrent seizures
• Epilepsy is a symptom, a heterogeneous symptom complex
• Epilepsy


  • Requires recurrent seizures
  • Cause is unknown
• Increase in temperature can trigger seizures, especially in children
• Do not place hard objects in the mouth of someone having a seizure, but do protect them from harm
• Seizure


  A dysfunction of the brain where there is abnormal, repetitive firing of neurons
• Seizure


  • Can cause loss of consciousness
  • Abnormal movements
  • Atypical behaviors
  • Distorted perceptions
• Causes of seizures


  • Infection
  • Neoplasm (brain tumour)
  • Head injury
  • Electrolyte imbalance
  • Drug abuse
  • Alcohol withdrawal
• Convulsion


  Rapid, uncontrollable muscle contractions and relaxations, a result of a seizure
• Epilepsy, seizure, and convulsion are interconnected but different
• Types of seizures


  • Simple partial
  • Complex partial
  • Partial seizures secondarily generalized
  • Generalized tonic-clonic (grand mal)
  • Absence (petit mal)
  • Tonic
  • Atonic
  • Myoclonic
  • Infantile spasms
• Simple partial seizure


  • Least complicated
  • Abnormal firing in specific part of brain
  • Patient remains conscious
  • Sudden onset of jerking in extremities
• Complex partial seizure


  • Involves the limbic system
  • Altered consciousness
  • Automatisms (repetitive movements)
  • Can last for hours after attack
• Generalized seizures have no localized onset, most common type
• Impairment of consciousness


  1. Auditory hallucinations

  2. Visual hallucinations

  3. Olfactory hallucinations

  4. Seizure

  5. Psychomotor phenomena (abnormal movements, chewing, lip smacking)
• Abnormal firing causes repetitive sharp waves over the left
• Simple partial seizure


  Localized onset, no loss of consciousness
• Complex partial seizure


  Localized onset, impaired consciousness
• Secondarily generalized seizure


  Localized onset, then spreads to whole brain
• Generalized seizure


  No localized onset, whole brain involved
• Generalized tonic-clonic seizure is the most dramatic type of seizure
• Epileptic status (seizure lasting >5 minutes) is a medical emergency
• Absence seizure


  Brief loss of consciousness, may occur 100 times per day
• Myoclonic jerk


  Brief, sudden muscle contraction (e.g. hiccups)
• Atonic seizure


  Sudden loss of muscle tone, no jerking
• Infantile spasm


  Epileptic syndrome with sudden flexion or extension of body/limbs in infants
• Causes of seizures include head injury, infection, hypoglycemia, brain tumors, and metabolic disorders
• Action potential


  Nerve impulse, involves movement of sodium and potassium ions
• Resting potential


  Negative charge inside neuron compared to outside
• Abnormal neuronal firing causes the signs and symptoms of seizures
• Anti-seizure drugs


  • Enhance GABA (inhibitory neurotransmitter)
  • Decrease glutamate (excitatory neurotransmitter)
  • Modify ion channels and action potential
• Phenytoin


  Oldest and most commonly used anti-seizure drug, modifies ion channels and neurotransmitters
• Phenytoin has a narrow therapeutic index, requiring close monitoring
• Ethosuximide, phensuximide, and methsuximide are drugs used for the treatment of both partial seizures and generalized tonic-clonic seizures
• Ethosuximide


  Brand name: Zarontin, drug of choice for absence seizures
• Ethosuximide


  • Targets the calcium channel, leading to decreased release of neurotransmitters
  • Effective for absence seizures due to its effect on the low-threshold calcium current