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Clinical Pharmacology And Therapeutics Of Antiepileptic Drugs For Treatment Of Epilepsy And Seizure Disorders Discussion
Seizure Disorders in Women: Epilepsy
Common Symptoms
A seizure is referred to as an abrupt, uncontrolled electrical disruption in the brain. They are characterized by abnormal, excessive, and hypersynchronous electrical discharge of neurons in the brain. Seizures can lead to changes in levels of consciousness, movements, behavior, or feelings. Epilepsy is typically defined as having two or more seizures that are unprovoked and occur at least 24 hours apart (Reddy et al., 2021). A chronic neurological condition called epilepsy is marked by recurrent, frequently crippling convulsions that can harm the brain, cause severe physical harm, and even cause death. There are two types of epileptic seizures namely partial (focal onset) and generalized (generalized onset) types (Reddy, 2020)Clinical Pharmacology And Therapeutics Of Antiepileptic Drugs For Treatment Of Epilepsy And Seizure Disorders Discussion.
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Recommended Diagnostic Tests
A painless examination called an electroencephalogram (EEG) is frequently used to diagnose seizure disorders (Thijs et al., 2019). Electrodes are affixed to a patient’s scalp during an electroencephalogram procedure using a paste-like substance or cap. The brain’s electrical signals are detected by the tiny sensors that are affixed to the scalp. On an EEG recording, the sensors’ captured electrical activity in the brain appears as wavy lines. Since many persons with epilepsy have abnormal EEGs, changes in the normal brain wave pattern can signal seizure symptoms. Another diagnostic technique is functional magnetic resonance imaging (fMRI). Functional magnetic resonance imaging is used in mapping neural and cognitive functions in various regions of the brain such as labeling areas associated with visual perception, language, or memory. The technique identifies brain activity by monitoring changes in both the blood’s oxygen content and blood flow through a measurement process referred to as blood-oxygen-level-dependent activity, this measurement (BOLD activity) (Thijs et al., 2019).
Although they cannot provide a conclusive diagnosis, laboratory tests such as creatinine, electrolytes, CK, renal, and liver function can help identify the etiology and toxic encephalopathy of epileptic episodes (Nass et al., 2017). Prolactin testing has a high specificity and a moderate sensitivity, which helps distinguish between epileptic seizures and psychogenic non-epileptic seizures in adults and adolescents. After generalized tonic-clonic seizures, elevated creatine kinase (CK) levels are typical and exhibit high specificity and intermediate sensitivity. Blood tests performed after an ictal episode may be able to diagnose metabolic indicators like ammonia and lactate (Nass et al., 2017).
Common Treatments
There is currently no cure for epilepsy. Antiepileptic drugs (AEDs), however, are used to treat the illness and stop or reduce resistant seizures. AEDs work by lowering focal seizure discharges or stopping the spread of excitement to specifically alter the aberrant excitability of neurons (Reddy, 2020). AEDs work by reducing glutamate excitation, potentiating GABA inhibition, and blocking voltage-gated sodium and voltage-activated calcium channels to prevent seizures. The first-line treatments for partial onset seizures and generalized onset seizures are carbamazepine, phenytoin, and valproate (Reddy, 2020). However, AEDs such as carbamazepine, phenobarbital, phenytoin, and valproate are associated with birth defects such as congenital heart and urinary tract defects, skeletal abnormalities, neural tube defects, and cleft palate. This makes them not safe for use by women of childbearing age (Kim et al., 2019). Levetiracetam and Lamotrigine are therefore recommended for use in women of childbearing age (Kim et al., 2019).
Special Implications to be Considered in this Particular Population
Special implications to be considered in this particular population, women, are the adverse events caused by AEDs in women of childbearing age. For the treatment of seizure disorders, valproate and its formulations are effective and have been approved. However, the most teratogenic medication in neuropsychiatric pharmacopeia, according to studies, is valproate, which is considered much more teratogenic than several other antiepileptic medications (AEDs) (Andrade, 2018). According to the findings of the research, valproate exposure during pregnancy is linked to higher chances of cognitive, language, and psychomotor delays in young children as well as higher risks of autism (Andrade, 2018).
Some health issues, including heart disease, depression, and autoimmune disease, present more frequently in women than in men. Others, including ovarian cancer and pregnancy issues, are obviously exclusive to the female population. Nurse practitioners focused on women’s healthcare become well-versed in these health issues and apply their expertise to helping to screen for and offer care for patients with these conditions.
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For this Discussion, you will select a specific women’s health issue. You will research this issue, and share common symptoms, recommended diagnostic tests, and common treatments.
To prepare:
Review the Learning Resources for this week and consider the different types of women’s health issues.
Choose one of the women’s health issue from the following list and once you have selected an issue, search the Walden Library and/or the Internet regarding the health issue symptoms, diagnostic tests, and common treatments:
Osteoporosis
Bladder Issues
Pre-diabetes
Thyroid
Hypertension
Seizure Disorders
Psychiatric Disorders
Part 1: By Day 3Clinical Pharmacology And Therapeutics Of Antiepileptic Drugs For Treatment Of Epilepsy And Seizure Disorders Discussion
Based on the issue you chose, post a description and explanation of common symptoms, recommended diagnostic tests, and common treatments. Be specific and provide examples. Use the evidence from your search of the literature to support your explanation of the woman’s health issue you chose.
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Part 2: By Day 5
Next, based off the one women’s health issue you picked listed below, post your responses to the following questions that corresponds to your women’s health issue.
Osteoporosis – What are your options for primary prevention? How would you educate someone on the treatment?
Bladder Issues – What exactly are the symptoms? What about Interstitial cystitis (IC) and pelvic pain?
Thyroid – What symptoms occur in women? What can you discern from that? What about infertility?
Pre-diabetes – Are there menstrual irregularities? What types of medication are they taking? What about pregnancy plans?
Hypertension – What medications are appropriate for a woman of reproductive age? Should you counsel the woman on appropriate dieting?
Seizure Disorders – What special implications do you need to consider in this particular population?
Psychiatric Disorders – Specify the types of disorders i.e., anxiety/depression/substance abuse/eating disordersReferences
Andrade, C. (2018). Valproate in pregnancy: Recent research and regulatory responses. The Journal of Clinical Psychiatry, 79(3). https://doi.org/10.4088/jcp.18f12351
Kim, H., Faught, E., Thurman, D. J., Fishman, J., & Kalilani, L. (2019). Antiepileptic drug treatment patterns in women of childbearing age with epilepsy. JAMA Neurology, 76(7), 783. https://doi.org/10.1001/jamaneurol.2019.0447
Nass, R. D., Sassen, R., Elger, C. E., & Surges, R. (2017). The role of postictal laboratory blood analyses in the diagnosis and prognosis of seizures. Seizure, 47, 51-65. https://doi.org/10.1016/j.seizure.2017.02.013
Reddy, D. S. (2020). Clinical pharmacology and therapeutics of antiepileptic drugs for treatment of epilepsy and seizure disorders. International Journal of Pharmaceutical Sciences and Nanotechnology, 13(6), 5165-5180. https://doi.org/10.37285/ijpsn.2020.13.6.1
Reddy, D. S., Thompson, W., & Calderara, G. (2021). Molecular mechanisms of sex differences in epilepsy and seizure susceptibility in chemical, genetic and acquired epileptogenesis. Neuroscience Letters, 750, 135753. https://doi.org/10.1016/j.neulet.2021.135753
Thijs, R. D., Surges, R., O’Brien, T. J., & Sander, J. W. (2019). Epilepsy in adults. The Lancet, 393(10172), 689-701. https://doi.org/10.1016/S0140-6736(18)32596-0Clinical Pharmacology And Therapeutics Of Antiepileptic Drugs For Treatment Of Epilepsy And Seizure Disorders Discussion
