Chapter 53. Epilepsy
Select the treatable cause(s) of seizures. Select all that apply.
Answers a, b and c are correct. Hypoglycemia, altered electrolytes, and infections are treatable causes of seizures. A seizure produced by treatable causes does not represent epilepsy. Note: medications that cause hypoglycemia and altered electrolytes could indirectly precipitate a seizure.
Answer d is incorrect. Genetic defects do not represent a treatable cause as they are not something modifiable.
Note: The underlying etiology of epilepsy is unknown in 80% of patients. The most common recognized causes of epilepsy are head trauma and stroke. Central nervous system tumors, infections, metabolic disturbances (hyponatremia and hypoglycemia), neurodegenerative diseases, and medications represent other causes.
WW is a 56-year-old hospitalized patient taking the following medications: cefepime, metoprolol succinate, levothyroxine, and acetaminophen. The patient developed seizures. Select the possible drug-induced cause(s) of seizures.
Answer c is correct. Cefepime has been linked to seizures and nonconvulsive status epilepticus, a risk that is increased in patients with renal impairment and in patients with a history of a seizure disorder. Dosage adjustments are necessary. Other medications associated with development of seizures include tramadol, bupropion, theophylline, some antidepressants, some antipsychotics, amphetamines, cocaine, imipenem, lithium, excessive doses of penicillins or cephalosporins, sympathomimetics, and stimulants.
Answers a, b and d are incorrect. None of these agents are associated with causing seizures.
JW is a 29-year-old woman presenting to the pharmacy with a new prescription for phenytoin. She is currently not taking any other medications. What should this patient be counseled about in relation to her new drug therapy? Select all that apply.
a. Avoid alcohol while taking this medication.
b. Use appropriate barrier methods of contraception.
c. Wear sunscreen. This medication is associated with increased photosensitivity.
d. Take this medication with food at the same time every day.
Answers a and b are correct. Alcohol should be avoided because it can inhibit the metabolism of phenytoin and increase central nervous system (CNS) depression. Phenytoin can also interact with oral contraceptives and decrease their effect, so barrier methods of contraception are recommended. In general, all ...