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第16章 抗癫痫药 和抗惊厥药

第16章 抗癫痫药 和抗惊厥药. Antiepileptics & anticonvulsive drugs. §1 antiepileptic drugs. introduction. ㈠ Epilepsy 癫痫 1、 chronic CNS disorders； 1） cerebral focus nerve cell 2） sudden 、 abnormity 、 rapid high frequency local discharge

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第16章 抗癫痫药 和抗惊厥药

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  1. 第16章 抗癫痫药和抗惊厥药 Antiepileptics & anticonvulsive drugs

  2. §1 antiepileptic drugs introduction ㈠ Epilepsy 癫痫 1、 chronic CNS disorders； 1） cerebralfocus nerve cell 2）sudden 、 abnormity 、rapid high frequencylocal discharge 3）arounddiffuse 4） cerebralfunctiondisorders 。

  3. Causes of epilepsy • Damage to the brain： 1）tumours、 2） head injury 、 3）infection、 4） cerebrovascular accident；

  4. 2、Character of paroxysm 1) abrupt onset ① staring （目瞪） ② cessation of ongoing activities ③ lasting less than 30 sec 2）transient、 3）repeat ；

  5. Classification of epileptic 1、Partial seizures： 1）、simple partial— key feature：preservation of consciousness； 2）、complex partial— impaired consciousness lasting 30sc—2min。

  6. 2、generalized seizures： 1）absence seizures（peptit-mal）： 2）myoclonic seizures： a brief shock like contraction of muscle ； 3）tonic –clonic seizures： （grand-mal epilepsy）

  7. §1 antiepileptic drugs 一、manner of action ： 1、 ㈠ local discharge 2、arounddiffuse. 二、mechanism of action 1 、 function of GABA 2、interfereNa+、K+、Ca2+ channel

  8. usual drugs • phenytoin sodium （苯妥英钠、大仑丁，dilantin） [ pharmacokinetics ] 1、PO.—absorption somewhat slow ， F—difference obvious ； 2、stimulation，not suitable IM 3、extensively bound to serum protein ；

  9. 3、eliminationvelocitywith blood concentration correlation  10g/ml:first-order elimination kinetics ，t½ 6-24 h  10g/ml: zero-order elimination kinetics ，t½ 20-60 h

  10. [actions and uses] • epilepsy 1) Generalized tonic –clonic; partial seizure (first choice ) 2) absence seizures inefficacy ; 2.trigeminal and related neuralgias 3. arrhythmia (related to digitalis intoxication)

  11. [ adverse reactions ] 1.local stimulation (PH 2.chronic toxico ⑴ overgrown of gum collagen (in children and young) ⑵ CNS depression ; ⑶ a variety of endocrine ;

  12. 3. other 1) hypersensitivity reaction ; 2) cardiac toxicity: iv-excessive rate; 3) fatal hepatic necrosis; 4) blood system : reduce immunoglobulin neutropenial folacin

  13. carbamazepine 卡马西平(酰胺咪嗪) [characteristics ] 1、㈠Na+channel，㈠focusdischarge； 2、generalized tonic clonic and simple --- first choice neuralgia > phenytoin sodium；

  14. 3、po-- absorb slowly， induce hepaticenzyme ， 4、adverse reaction 1）acute intoxication：stupor、 coma hyperirritability 、convulsion respiratory depression 2）serious intoxication： ㈠ marrow ， hepatic damage 。

  15. other usual drugs 药 名character 苯巴比妥 ㈠dischargeanddiffuses ， Phenobarbital use： epilepsy absence seizures efficacy 乙琥胺 Ethosuximide 丙戊酸钠widely antiepilepsy Sodium valproate ㈠Na+channel， GABA of CNS

  16. Clinicchoice drugs principles 1、types of epilepsy ； 2、 long term administration； 3、 individual of dose； 4、not suddenstop ； 3、note：adverse reaction anddrug interration

  17. §2 anticonvulsants magnesium sulfate （硫酸镁） 1、Mg2+-Ca2+competitive， 2、use：PO-catharsis im-anticonvulsion ； iv--BP 3、adverse reaction： ㈠CNS、㈠ respiratory、 administrationslowly overdose ： iv.Ca2+。

  18. question • 1、 describe the choice agents of epilepsy ？ • ２、which drugs prossessaction anticonvulsion ？

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