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《ISPN学习》总第636期
日期：2020-06-07 15:19:22
《ISPN学习》2020年05月29日总第636期
Saunders 8th 中英对照
★ ISPN Review ★
Epilepsy 癫痫
Epilepsy, the most prevalent of the neurological disorders, is not a single disease but a collection of different syndromes characterized by the same feature: Sudden discharge of excessive electrical energy from nerve cells located within the brain, which leads to a seizure. In some cases, this release stimulates motor nerves, resulting in convulsions, with tonic–clonic muscle contractions that have the potential to cause injury, tics, or spasms. Other discharges may stimulate autonomic or sensory nerves and cause very different effects, such as a barely perceptible, temporary lapse in consciousness or a sympathetic reaction. Because epilepsy involves a loss of control, it can be very frightening to patients when they are first diagnosed.
癫痫是最普遍的神经性障碍，癫痫并不是单一疾病，而是具有相同特性的多种综合征的一个合称：大脑神经细胞大量电能的突然释放，从而导致癫痫发作。在有些病例中，这种释放刺激运动神经，导致惊厥，伴强直-阵挛性肌肉收缩，有可能引起损伤、抽搐或痉挛。其他放电可能刺激自主或感觉神经，引起极为不同的效应，如几乎察觉不到的短暂的意识流逝或交感反应。因为癫痫涉及失去控制，首次诊断时，对患者来说是极其恐怖的。
The treatment of epilepsy varies widely, depending on the exact problem and its manifestations. The drugs that are used to manage epilepsy are called antiepileptics, or antiseizure agents, and are sometimes referred to as anticonvulsants; however, because not all types of epilepsy involve convulsions, this term is not generally applicable. The drug of choice for any given situation depends on the type of epilepsy, patient age, specific patient characteristics such as cultural variations, and patient tolerance for associated adverse effects. Drugs can be used to treat more than one type of seizure.
癫痫治疗多有不同，取决于具体的问题和表现。用于管理癫痫的药物叫抗癫痫药或抗癫痫制剂，有时也被称为抗惊厥药。不过，由于并不是所有类型的癫痫都会涉及惊厥，这一术语一般不用。任何已经情况的首选药物取决于癫痫的类型、患者年龄、患者的具体特征如文化多样性和患者对相关不良效应的耐受性。药物可用于治疗一种以上的癫痫发作类型。
Because of differences in liver enzyme functioning among Arab Americans and Asian Americans, patients in these ethnic groups may not metabolize antiseizure agents in the same way as patients in other ethnic groups. They may require not only lower doses to achieve the same therapeutic effects but also frequent dose adjustment.
由于阿拉伯裔美国人和亚洲裔美国人肝酶功能的差异，这些族群患者的抗癫痫制剂代谢可能不同于其他族群患者。他们可以不仅需要减少剂量以达到相同的治疗效应，而且可能需要经常调整剂量。
Nurses need to be aware that the therapeutic range for patients in these ethnic groups may differ from standard norms and that these patients may be more apt to show adverse or toxic reactions to antiepileptic drugs at lower doses. As with all medications the lowest possible dose should be used. Serum drug levels should be closely monitored and titrated carefully and slowly to achieve the maximum benefits with the fewest adverse effects.
护士必须认识到，这些族群患者的有效药物浓度范围可能不同于标准规范，这些患者可能更容易在小剂量时就出现抗癫痫药的不良或毒性反应。因此，所有药物均应使用尽可能小的剂量。应密切监测血清的药物浓度，仔细、慢慢滴定，以最小的不良效应达到最大的好处。
★ Vocabulary for Today ★
epilepsy – n. 癫痫
prevalent – a. 流行的，普遍的
electrical energy – 电能
nerve cell – 神经细胞
seizure – n. 癫痫发作
convulsion – n. 惊厥，抽搐
tonic – a. 强直的，紧张的
clonic – a. 阵挛性的，间隙性抽搐的
contraction – n. 收缩
potential – n. a. 潜力，电位，潜能
tic – n. 抽筋，局部抽筋
spasm – n. 痉挛，抽筋
discharge – n. 放电，释放
perceptible – a. 可感知的，可察觉的
temporary – a. 暂时的，瞬时的
lapse – n. 流逝，记错
antiepileptic – a. n. 抗癫痫的（药）
antiseizure – a. 抗癫痫发作的
anticonvulsant – a. n. 抗惊厥的（药）
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★ Video ★
Seizure Disorder
★ Test ★
1. A client is who is receiving edrophonium chloride suddenly is complaining of abdominal cramps and the nurse observes the client is experiencing increased perspiration and salivation. The nurse makes sure the availability of which of the following?
A. Levodopa.
B. Methylphenidate hydrochloride (Ritalin).
C. Atropine sulfate.
D. Carbamazepine (Tegretol).
2. A client is prescribed with Carbamazepine (Tegretol) for the treatment of bipolar disorder. Which of the following laboratory results indicates that the client is experiencing a side effect of this medication?
A. Neutrophil count of 1,200/mm3.
B. Platelet count of 160,000/mm3.
C. Uric acid level of 4mg/dl.
D. SGPT (ALT) level 50 units per liter of serum.
答案
Answers
1. C. Atropine sulfate.
Rationale:
The client is experiencing signs of cholinergic crisis. When administering edrophonium chloride, have emergency resuscitation equipment on hand and atropine sulfate available. Option A is used alone or in combination with carbidopa to treat Parkinson’s disease. Option B is a central nervous system stimulant used to treat ADHD and narcolepsy Option D is used to prevent and control seizures.
2. A. Neutrophil count of 1,200/mm3.
Rationale:
Carbamazepine is used to treat seizures and nerve pain such as trigeminal neuralgia and diabetic neuropathy. It causes a decreased level of platelet count, white blood cells, and neutrophil count. The normal range for neutrophil is 1,500 to 8,000/mm3). Options B, C, and D all have a normal value.
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