Epilepsy is a heterogeneous symptom complex. Epilepsy is chronic cerebral disorder characterized by recurrent seizures. The seizures are classified as partial seizure and generalized seizure. Seizures result in bone fracture, hypoxia, acidosis and electrolyte disturbance.
The local neuron’s abnormal high frequency electrical discharge and extension to peripheral tissue is the main reason. A lot of drugs are use for treating epilepsy. Different drugs play important role however the mechanism of all anti-epileptic drugs is to inhibit the electrical discharge and extension by enhancing the GABA effect and interfering the Na+, K+ and Ca 2+.
1) phenytoin sodium. It has great pharmacological effect. It is the first choice for simple local seizure and is given intravenous for the status of epilepticus. However it is not commonly used in clinic because of adverse reaction and causes trifacial neuralgia, glossopharyngeal neuralgia. Toxic reactions related with dose are dizziness, defective coordination, and ocular tremor by affecting cerebellum-vestibule. Large dose can induce mental confusion, hypnody and coma. The drug also induces seizure after sudden withdrawal.
2) Carbamazepine; It is a broad spectrum, and first choice for simple local seizure, neuralgia. It also works as anti depressant. Its mechanism is to block Sodium ions channels and enhance GABA effect. The adverse reactions include dizziness, bone marrow inhibition if used for a long time.
3) Phenobarbital; The clinical uses are grand mal, status of epilepticus, simple local seizure and complexiy seizure. It is used specially for children of high fever. Its mechanism is to enhance GABA effect and block Na+ Ca2+ channels. Its metabolite is primaclone.
4) Ethosuximide. Use only for absence seizure
5) Sodium valproate; This drug is also a broad spectrum and is the first choice for treatment of grand mal and absence seizure.
6) Benzodiazepine. This is further sub categorized into three drugs;
diazepam: is given intravenously for status epilepticus. Need more attention to patient having respiratory depression
nitrazepam: for treating absence seizure.
clonazepam: for treating absence seizure
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