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Seizures therapy

Thus, in the millennia extending from antiquity to the mid-nineteenth century, epilepsy remained a medical condition surrounded by mystique— permitting charlatanism, superstition, and quackery to prosper. In general, the therapies of this time were without merit, as demonstrated by the detailed but disturbing description of King Charles IPs death, which provides a comprehensive summary of the complexity and futility of seizure therapy during the pre-modern era. [Pg.109]

Common side effects of theophylline therapy include headache, dyspepsia, and nausea. More serious side effects such as lethal seizures or cardiac arrythmias can occur if blood levels are too high. Many derivatives of theophylline have been prepared in an effort to discover an analogue without these limitations (60,61). However, the most universal solution has resulted from the development of reHable sustained release formulations. This technology limits the peaks and valleys in semm blood levels that occur with frequent dosing of immediate release formulations. ControUed release addresses the problems inherent in a dmg which is rapidly metabolized but which is toxic at levels ( >20 7g/mL) that are only slightly higher than the therapeutically efficacious ones (10—20 p.g/mL). Furthermore, such once-a-day formulations taken just before bedtime have proven especially beneficial in the control of nocturnal asthma (27,50,62). [Pg.440]

Generally, anticonvulsants reduce the excitability of the neurons (nerve cells) of the brain. When neuron excitability is decreased, seizures are theoretically reduced in intensity and frequency of occurrence or, in some instances, are virtually eliminated. For some patients, only partial control of the seizure disorder may be obtained with anticonvulsant drug therapy. [Pg.254]

The most common adverse reaction associated with phenobarbital is sedation, which can range from mild sleepiness or drowsiness to somnolence. These dru > may also cause nausea, vomiting, constipation, bradycardia, hypoventilation, skin rash, headache fever, and diarrhea Agitation, rather than sedation, may occur in some patients. Some of these adverse effects may be reduced or eliminated as therapy continues. Occasionally, a slight dosage reduction, without reducing the ability of the drug to control the seizures, will reduce or eliminate some of these adverse reactions. [Pg.254]

Additional patient information should include a family history of seizures (if any) and recent drug therapy (all drag s currently being used). Depending on die type of seizure disorder, other information may be needed, such as a history of ahead injury or a thorough medical history. [Pg.259]

The nurse obtains the vital signs at die time of the initial assessment to provide baseline data. The primary healtii care provider may order many laboratory and diagnostic tests, such as an electroencephalogram, computed tomographic scan, complete blood count, and hepatic and renal function tests to confirm the diagnosis and identify a possible cause of the seizure disorder, as well as to provide a baseline during therapy with anticonvulsants. [Pg.259]

Promoting an Optimal Response to Therapy When administering an anticonvulsant, the nurse must not omit or miss a dose (except by order of the primary health care provider). An abrupt interruption in ther-apy by omitting a dose may result in a recurrence of the seizures. In some instances, abrupt withdrawal of an anticonvulsant can result in status epilepticus. [Pg.259]

Some patients, once their seizures are under control (eg, stop occurring or occur less frequendy), may have a tendency to stop the drug abrupdy or begin to omit a dose occasionally. The drug must never be abrupdy discontinued or doses omitted. If the patient experiences drowsiness during initial therapy, a family member should be responsible for administration of the drug. [Pg.262]

If a carbonic anhydrase inhibitor is being given for absence or nonlocalized epileptic seizures, the nurse assesses the patient at frequent intervals for the occurrence of seizures, especially early in therapy and in patients known to experience seizures at frequent intervals. If a seizure does occur, the nurse records a description of the seizure in the patient s chart, including time of onset and duration. Accurate descriptions of the pattern and the number of seizures occurring each day helps the primary health care provider plan future therapy and adjust drug dosages as needed. [Pg.451]

Magnesium plays an important role in the transmission of nerve impulses. It is also important in the activity of many enzyme reactions, for example carbohydrate metabolism. Magnesium sulfate is used as replacement therapy in hypomagnesemia Magnesium sulfate (MgS04) is used in die prevention and control of seizures in obstetric patients with pregnancy-induced hypertension (PIH, also referred to as eclampsia and preeclampsia). It may also be added to TPN mixtures. [Pg.640]

INR > 1.7 (PT > 15 if no INR available) with or without chronic oral anticoagulant use Seizure at onset of stroke (This relative contraindication is intended to prevent treatment of patients with a deficit due to postictal Todd s paralysis or with seizure due to some other CNS lesion that precludes thrombolytic therapy. If rapid diagnosis of vascular occlusion can be made, treatment may be given.)... [Pg.72]

Phenobarbitone was the first AED and was introduced in 1912. It was largely replaced in 1932 by phenytoin for the management of tonic-xilonic seizures and partial and secondary epilepsy. Carbamazepine followed, then ethosuximide for absence seizures and valproic acid. These remained, apart from the introduction of the benzodiazepines, the mainstay of therapy until the last decade. They were introduced solely on their ability to control experimentally induced seizures. Their mechanisms of action were unknown and no thought was given to the possibility of NT modification and in fact subsequent research has shown that with the exception of the benzodiazepines none of them work primarily through NT manipulation. They act directly on neuronal excitability. [Pg.342]

Idebenone, an inhibitor of lipid peroxidation, was shown to prolong survival time and delay the onset of ischaemic seizures in a bilateral carotid occlusion model in rats. It is marketed in Japan as a therapy to improve cerebral metabolism and performance after a stroke (Suno and Nagaoka, 1984). Cerebral protective effects after an ischaemic insult in dogs and rabbits have been seen with the hydroxyl radical scavenger, mannitol (Meyer et al., 1987). [Pg.270]

Hyponatremia is very common in hospitalized patients and is defined as a serum sodium concentration below 136 mEq/L (136 mmol/L). Clinical signs and symptoms appear at concentrations below 120 mEq/L (120 mmol/L) and typically consist of agitation, fatigue, headache, muscle cramps, and nausea. With profound hyponatremia (less than 110 mEq/L [110 mmol/L]), confusion, seizures, and coma maybe seen. Because therapy is also influenced by volume status, hyponatremia is further defined as (1) hypertonic hyponatremia (2) hypotonic hyponatremia with an increased ECF volume (3) hypotonic hyponatremia with a normal ECF volume and (4) hypotonic hyponatremia with a decreased ECF volume.16... [Pg.409]

Prior to starting pharmacologic therapy, it is essential to determine the risk of the patient having a subsequent seizure. [Pg.443]

The ultimate outcome goal for any patient with epilepsy is elimination of all seizures without any adverse effects of the treatment. An effective treatment plan would allow the patient to pursue a normal lifestyle with complete control of seizures. Specifically, the treatment should enable the patient to drive, perform well in school, hold a reasonable job, and function effectively in the family and community. However, due to the intractability of the seizures or sensitivity to antiepileptic drugs (AEDs), many patients are not able to achieve these outcomes. In these cases, the goal of therapy is to provide a tolerable balance between reduced seizure severity and/or frequency and medication adverse effects that optimizes the individual s ability to have a lifestyle as nearly normal as possible. [Pg.448]

The goal of therapy is to arrest physical and electroencephalo-graphic evidence of seizures, prevent recurrence of seizures, and minimize adverse drug events. [Pg.461]

Refractory status epilepticus is seizure activity that is not controlled by first-fine and second-line therapies, including benzodiazepines and antiepileptic drugs. [Pg.461]

Diazepam Being extremely lipophilic, diazepam penetrates quickly into the CNS, but can rapidly redistribute into body fat and muscle. This results in a faster decline in CNS levels and early recurrence of seizures. It is dosed at 5 to 10 mg (or 0.15 mg/kg) and infused no faster than 5 mg/minute. Repeated doses can be given every 5 minutes until seizure activity stops or toxicities are seen (e.g., respiratory depression). Diazepam can also be administered as a rectal suppository, making it possible for non-medical personnel to provide rapid therapy for seizures that develop at home or in public areas.11 The adult dose is 10 mg given rectally and this dose may be repeated once if necessary. Diazepam is erratically absorbed via the intramuscular route therefore, IM administration is not recommended. [Pg.465]

Once the first dose of benzodiazepine is given, an antiepileptic drug must be started to prevent further seizures from occurring. AEDs must not be given as first-line therapy since they must be infused relatively slowly to avoid adverse effects, delaying their onset of action. [Pg.465]

Pentobarbital is commonly loaded at a dose of 10 to 15 mg/kg over 1 to 2 hours, followed by a continuous infusion of 0.5 to 4 mg/kg per hour. Therapy can be tapered off after 12 to 24 hours of seizure control as evident on the EEG.35 One metaanalysis reported a lower incidence of treatment failure with pentobarbital (3%) when compared to midazolam (21%) or propofol (20%), although the risk of hypotension requiring vasopressor therapy was higher when pentobarbital was used.36 This relative efficacy for pentobarbital must be considered... [Pg.469]

Continue to evaluate the patient for seizure activity and adjust therapy as needed to control seizures and optimize quality of life. [Pg.470]


See other pages where Seizures therapy is mentioned: [Pg.248]    [Pg.249]    [Pg.248]    [Pg.249]    [Pg.461]    [Pg.129]    [Pg.129]    [Pg.129]    [Pg.254]    [Pg.259]    [Pg.268]    [Pg.295]    [Pg.187]    [Pg.273]    [Pg.325]    [Pg.329]    [Pg.349]    [Pg.349]    [Pg.238]    [Pg.445]    [Pg.448]    [Pg.452]    [Pg.461]    [Pg.463]    [Pg.464]    [Pg.465]    [Pg.466]    [Pg.468]    [Pg.470]    [Pg.578]   
See also in sourсe #XX -- [ Pg.379 ]




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