Pharmaceutical and Non-Pharmaceutical Care in the Treatment of Epilepsy

Epilepsy is a chronic neuropathy described by repetitive or inexplicable seizures caused by anomalous electrical discharges in the brain. It affects individuals of all ages and manifests itself in different ways, as convulsions, disturbances of the senses, or unconsciousness. Diagnosis is performed with a deep look at the medical history, neurological assessment, use of the electroencephalogram (EEG), and image scans, either MRI or CT, to screen for any structural basis. Still, Woo and Robinson (2020) designate two unprovoked epileptic seizures separated by over 24 hours as a minimum to define epilepsy: Pharmaceutical and Non-Pharmaceutical Care in the Treatment of Epilepsy.

Condition Defined

Epilepsy is a disorder of the brain which is due to a disorder of neuronal activity, leading to certain periods of impaired behavior or awareness. The focal or generalized nature of the seizures will depend on the area of the brain involved. The symptoms include mild confusion and staring spells to convulsions.

EEG is used as a diagnostic tool to monitor abnormal brain waves, MRI or CT to locate damage, and lab tests to exclude a metabolic source. The aim is proper classification to lead to proper treatment.

Lifestyle Modifications

Managing epilepsy involves essential lifestyle changes to reduce seizure frequency and improve safety. First, medication adherence is critical, as missed doses often lead to breakthrough seizures. Second, patients should maintain consistent sleep routines, since sleep deprivation can be a seizure trigger.

Third, stress management through mindfulness, relaxation, or therapy is beneficial. Fourth, avoiding known triggers like flashing lights, alcohol, and extreme fatigue is necessary. Lastly, individuals should adopt safety measures, such as not swimming or cooking alone, to reduce the risk of injury during seizures.

Pharmaceutical Therapeutics

One major drug class used in epilepsy management is sodium channel blockers. Phenytoin (Dilantin) works by inhibiting neuronal sodium influx and is usually prescribed at 100 mg three times daily or 300 mg once daily in extended-release form. It requires long-term use and monitoring of serum levels (10–20 mcg/mL) and liver function.

Common side effects include gingival hyperplasia, dizziness, and rash. Carbamazepine (Tegretol) also reduces synaptic transmission, dosed at 200 mg twice daily (Epocrates, n.d.-c). Monitoring includes CBC and liver enzymes due to risks such as aplastic anemia and hyponatremia.

The second class includes GABA enhancers. Valproic acid (Depakote) increases GABA levels and inhibits sodium and calcium channels (Epocrates, n.d.-a). A typical dose is 250–500 mg twice daily. It requires monitoring of liver enzymes and blood levels (50–100 mcg/mL).

Adverse effects include weight gain, hepatotoxicity, and teratogenicity. Clonazepam (Klonopin), another GABA agent, is dosed at 0.5–1 mg three times daily and carries sedation and dependence risks (Epocrates, n.d.-b).

For non-prescription options, magnesium (400–600 mg/day) supports nerve stability through NMDA receptor modulation. Vitamin B6 (pyridoxine), taken at 50–100 mg/day, aids neurotransmitter production and is critical in pyridoxine-dependent epilepsy. Alternative modalities include the ketogenic diet, which reduces seizures by inducing ketosis, especially in pediatric cases, and cannabidiol (CBD, Epidiolex), used at 2.5 mg/kg twice daily for Lennox-Gastaut and Dravet syndromes.

Across the Lifespan

In children, dosing is weight-based and parental education is key. For teens and young adults, issues such as independence, driving restrictions, and medication compliance arise. Women of reproductive age require careful counseling due to AED teratogenic risks. Moreover, older adults are vulnerable to drug accumulation and interactions, making low-dose monotherapy preferred with close monitoring.

Summary

Epilepsy treatment is multifaceted, combining medications, lifestyle changes, and alternative therapies to manage and reduce seizure activity. Antiepileptic drugs (AEDs) remain the cornerstone of treatment, tailored to the type of seizures and individual patient needs. In cases where medications are ineffective, options such as ketogenic diets, vagus nerve stimulation, or surgical interventions may be considered.

Lifestyle modifications, including adequate sleep, stress management, and avoiding seizure triggers, play a crucial role in maintaining seizure control. Personalized care and patient education across all age groups are essential, as they empower individuals to understand their condition, adhere to treatment plans, and improve their overall quality of life.

References

Epocrates. (n.d.-a). Depakote: Dosing, contraindications, side effects, and pill pictures. https://www.epocrates.com/online/drugs/612/depakote

Epocrates. (n.d.-b). Klonopin: Dosing, contraindications, side effects, and pill pictures. https://www.epocrates.com/online/drugs/845/klonopin

Epocrates. (n.d.-c). Tegretol: Dosing, contraindications, side effects, and pill pictures. https://www.epocrates.com/online/drugs/1284/tegretol

Woo, T. M., & Robinson, M. V. (2020). Pharmacotherapeutics for advanced practice nurse prescribers (5th ed.). F.A. Davis.

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For this assignment you will develop an essay in Word as an overview on pharmaceutical and non-pharmaceutical care in the treatment of a rheumatoid arthritis OR epilepsy. The Unit 9 learning activity as a review will help you to apply those principles.

Levels of headings within the paper to include:

• First a brief introduction (should not be a heading)
• Condition Defined
  • Briefly define the condition. Include content related to anatomy, symptoms and diagnostic techniques.
• Lifestyle modifications
  • Include lifestyle management with 4-5 general points of patient education for lifestyle modification.
• Pharmaceutical Therapeutics
  • Include 2 different drug classes, prescription medication modalities. 2 examples of medication per class. Drug names, class, mechanism of action as well as dose, frequency and length of therapy examples. 5-6 points of content per medication
    

    Pharmaceutical and Non-Pharmaceutical Care in the Treatment of Epilepsy

  • Include 2 non- prescription, over the counter, alternative modalities. 1 example of medication per class. Drug names, class, mechanism of action as well as dose, frequency and length of therapy examples.
  • Include 2 alternative modalities or naturopathic options and discuss each with dose and frequency as applicable.
• Across the LifeSpan
  • Include aspects to manage and key points to consider across the lifespan regarding the management of this condition. Include aspects to manage and key points to consider across the lifespan regarding the management of this condition. Address three (3) age group populations such as: child, teen, young adult, middle adult, older adult.
• Summary
  • Provide a summary / conclusion

Format

• Follow APA 7th edition
• All essays required an introduction and conclusion.
• Standard essay format with a title page.
• 2 pages of content are required
• use Epocrates drug references.
• 4 references are required