Oral Hygiene and Dental Care for Patients with Seizure Medications

Importance of Oral Hygiene and Dental Examinations

• Gum overgrowth is a common issue in patients with seizure disorders, especially those taking medications like phenytoin and ethotoin.
• Frequent rushing and proper dental care during pregnancy are crucial; consult an obstetrician as needed.
• Patients should carry an identification card or wear a medical alert tag to inform healthcare providers of their seizure medications.

Patient Education and Adherence

• Recognize the importance of patient acceptance and understanding in achieving strict adherence to medication regimens.
• Provide patients with essential information, including medication monographs, to increase their understanding of the medication.
• Enlist the patient's help in maintaining a written record of medication and monitoring parameters.

Benzodiazepines for Seizure Disorders

• Mechanisms of action for benzodiazepines involve stimulating BDZ2 receptors to inhibit neurotransmission by enhancing GABA effects in the postsynaptic clefts.
• Increased GABA levels open the chloride channel, resulting in a hyper-polarized cell membrane that prevents further cell excitation.
• Benzodiazepines are used to prevent propagation of seizure activity.

Uses of Benzodiazepines

• Four benzodiazepines are approved for use as anti-epileptic therapy: diazepam, lorazepam, clonazepam, and clorazepate.
• Clonazepam is used to treat absence, akinetic, and myoclonic seizures in children.
• Diazepam and lorazepam are used to control seizures and are the drugs of choice for treating status epilepticus.
• Clorazepate is used with other antiepileptic agents to control partial seizures.
• Diazepam can be administered as a rectal gel or nasal spray to treat seizure clusters at home.

Therapeutic Outcomes

• The primary therapeutic outcomes expected from benzodiazepines include reduced frequency of seizures and improved seizure control.