ANTI EPILEPTIC DRUGS ::
Anti epileptic drugs may produce their effects by the following mechanism ::
(a) Normalization of seizure foci
(b) Prevention of the origin of seizures from the foci
(c) Prevention PTP
(d) Elevation of excitatory synaptic threshold
(e) Potentiation of pre-or post-synaptic inhibition
(f) Prolongation of the refractive period
At molecular level anti epileptics may increase GABA action produce inhibition of sodium or calcium channel opening or inhibit NMDA activity :
Accordingly anti -epileptic drugs may be classified as follows :
1.Drugs inhibiting Na+ channels ::
(a) Phenytoin Fosphenytoin Ethotoin Mephenytoin
(b) Lamotrigine Topiramate
(c) Carbamezepine
2.Drugs affecting Ca++ channels
(a) Flunarizine
(b) Ethosuccimide phensuccimide Methsuccimide
3.Drugs affecting GABA
(a) Barbiturates like phenobarbitone Mephobarbitone Primidone
(b) Sodium valproate Vigabetrine (inhibitors of GABA transaminase)
(c) Tigabine (Inhibits GABA reuptake )
(d) Progabaline (GABA receptor stimulator)
(e) Gabapentene (GABA releases)
4.Drugs that bind to Benzodiazepine receptors clonazepam Diazepam Oxazepam Midazolam
5.NMDA receptor antagonists Phencyclidine
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