chapter 32 anticonvulsants. copyright 2007 thomson delmar learning, a division of thomson learning...

Chapter 32Anticonvulsants

Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

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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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Symptoms of Epilepsy Abnormal motor function Loss of consciousness Altered sensory awareness Psychic changes

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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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Anticonvulsants

Treatment Start with one drug and add others as

needed Check serum drug concentrations as

required

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Goal of Anticonvulsants

Prevent the generation and spread of excessive discharges in the brain

Protect the normal cells

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Anticonvulsants: Therapeutic Effects

Stabilize nerve cells and prevent hyperexcitability

Prevent the generation of hyperactive neurons

Prevent abnormal impulses from spreading

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Anticonvulsants: Side Effects

Carbamazepine (Tegretol) Blood dyscrasias

Phenytoin (Dilantin) Gum hyperplasia

Diazepam (Valium) Respiratory depression and drowsiness

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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