470.Antiseizure Drugs. M. Burnham (2007)

470.Antiseizure Drugs. M. Burnham (2007) - 4 Other other...

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CHAPTER 18: ANTISEIZURE DRUGS 1. DEFINITIONS Epilepsy Seizure Low seizure threshold Seizure, electrographic seizure, clinical seizure, convulsion 2. CAUSES OF EPILEPSY Symptomatic epilepsy Idiopathic epilepsy Biochemical hypotheses: GABA glutamate channelopathies
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3. SEIZURE TYPES Generalized: absence (petit mal) tonic-clonic (grand mal) Partial (Focal): simple partial (cortical focal) complex partial (psychomotor, temporal lobe) 4. THERAPY FOR EPILEPSY Need for treatment Drug versus non-drug therapy Definitions: anticonvulsant, antiepileptic drug (AED), antiseizure Drug
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5. CHARACTERICS OF ANTISEIZURE DRUGS They don’t cure epilepsy. They may cause rare, life-threatening ADR’s. They frequently cause other ADR’s. 6. MECHANISMS OF ACTION 1. Bind to voltage-dependent sodium channels 2. Enhance GABA-A inhibition 3. Bind to T-Type calcium channels
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Unformatted text preview: 4. Other: other calcium channels, AMPA receptors 7. PRINCIPLES OF DRUG THERAPY 1. Whom to treat 2. Choice of drug 3. Monotherapy, not polypharmacy 4. Drug interactions 5. Use of blood levels 6. Compliance 7. Withdrawal of drugs 8. Drug therapy during pregnancy 8. SPECIFIC DRUGS 1. Traditional drugs used primarily for absence seizures ethosuximide 2. Traditional drugs used primarily for tonic-clonic and partial seizures phenytoin carbamazepine phenobarbital primidone 3. Traditional broad-spectrum drugs valproate clonazepam clobazam 4. Drugs introduced since 1990 vigabatrin gabapentin lamotrigine levitiracetam oxcarbazepine topiramate zonisamide *********** felbamate pregabalin 5. Drugs for status epilepticus benzodiazepines – diazepam, lorazepam others 9. PROGNOSIS FOR DRUG CONTROL...
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