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seizures_od

drug-induced seizures

see also seizures, toxicology, neurology, anticonvulsants

NB. AVOID phenytoin in drug-induced seizures.

mechanisms of seizures

Domoic acid (from mussels)

  • ⇒ decreased GLU reuptake ⇒ GIT effects, confusion, seizures

isoniazid

  • ⇒ inhibits pyridoxyl phosphate ⇒ impairs glutamic acid decarboxylase ⇒ impaired production of GABA ⇒ seizures
  • Rx of OD: pyridoxine - see isoniazid overdose
  • NB. barbiturates/benzodiazepines no help as need GABA to work although GA dose of barbiturates open GABA-A without GABA

ethanol withdrawal seizures:

  • ⇒ early seizures via GABA-A down-regulation & lack of ethanol as agonist
  • ⇒ late seizures due to up regulation of NMDA receptor
    • ⇒ less easily treated & thus higher mortality
    • ? try Mg as:
      • alcoholics tend to be Mg deficient
      • Mg inhibits NMDA
      • Mg assists with thiamine metabolism

theophylline:

  • ⇒ antagonist at adenosine A1 & A2 receptors
  • ⇒ seizures with loss of post-ictal period ⇒ continuous seizures ⇒ increased CNS oxygen demand ⇒ vasoconstriction ⇒ unable to increase oxygen supply ⇒ poorer prognosis than with other seizures

lathyrism:

  • Due to ingesting XS chick peas (eg. WWII POW camps)
  • ⇒ BOAA is agonist of AMPA receptors
  • ⇒ degeneration of corticospinal tracts (ant. horn cells)

tricyclic antidepressants:

seizures_od.txt · Last modified: 2014/04/10 02:59 by gary1