神经系统药理—魏尔清抗癫痫药课件.pptx

1、Ineffective for petit mal(absence seizures)(3)AntiarrhythmiaNecessary to monitor plasma concentrations(1)Grand mal/Partial：Broad spectrum of antiepilepsyIneffective for petit mal(absence seizures)Phenytoin,Carbamazepine,PhenobarbitalAdverse effects：Antiepileptic drugsHepatic toxicityGrand mal,status

2、 epilepticus;Mephenytoin 美芬妥英,Ethotoin 乙苯妥英：analogues of phenytoinInduction of hepatic drug-metabolizing enzymes(3)Antiarrhythmia(3)AntiarrhythmiaAntiepileptic drugsPsychomotor seizuresLamotrigine 拉莫三嗪Primidone,Valproate sodiumPrincipals of antiepileptic drug usesCONNHC6H5C6H5NaO Effective for psych

3、omotor seizures,and grand malEpilepsy is not a single entity;it is a family of different recurrent seizure disorders that have in common the sudden,excessive and disorderly discharge of central neurons.(2)Trigeminal and related neuralgiaPhenytoin,Carbamazepine,PhenobarbitalThis results in abnormal m

4、ovement or perceptions that are of short duration but that tend to recur.Other anticovulsant drugsParticularly in the cerebellum and vestibular systems:nystagmus(眼球震颤),ataxia(共济失调),etc.Adverse effectsPartial（部分发作）：Primidone,Valproate sodiumDrug interactionsPartial seizures(simple and complex);Phenyt

5、oin,Carbamazepine,PhenobarbitalInhibiting spread of dischargesCHCOOHPrincipals of antiepileptic drug usesPetit mal（小发作）：Classification of epilepsyPrincipals of antiepileptic drug usesvasodilatation,BP;(1)AntiepilepsyC2H5CONHNHCOCOCC6H5NCONH2CH3CH2CH2 CHCOOHCH3CH2CH2(1)AntiepilepsyPrimidone,Valproate

6、 sodiumplasma concentration monitoring if necessaryClassification of epilepsy(older)CHCOOHParticularly in the cerebellum and vestibular systems:nystagmus(眼球震颤),ataxia(共济失调),etc.Antiepileptic drugsInduction of hepatic drug-metabolizing enzymes),Phenobrbital(i.Effective for psychomotor seizures,and gr

7、and malClassification of epilepsy(older)Partial seizures(simple and complex);Other anticovulsant drugs(2)Peptit mal:Ethosuximide(2)CNS reactions(3)Phenytoin enhances the metabolism of corticosteroids and vitamin DChoice of drugs(1)Increases plasma concentrations of drugs by displacement of plasma pr

8、otein binding(salicylates)and inhibition of inactivation(isoniazid,chloramphenicol)hypertension crisis),Phenobrbital(i.Mechanisms of antiepileptic drugsvasodilatation,BP;small larger doses;hypertension crisistonic-clonic seizures（强直阵挛）Primidone,Valproate sodiumClinical uses(2)Peptit mal:Ethosuximide

9、relaxing skeletal musclesCHCOOHInhibiting both formation and spread of dischargesCHCOOHStereotypical complex partial seizures(2)CNS reactionsSpecial drugsAntiepileptic drugsNecessary to monitor plasma concentrationsOther anticovulsant drugsMechanisms of antiepileptic drugsIneffective for petit mal(a

10、bsence seizures)temporal lobe seizures（颞叶癫痫）dose individualization;CH3CH2CH2 CHCOOHCH3CH2CH2tonic-clonic seizures（强直阵挛）Primidone,Valproate sodiumPsychomotor seizuresPrincipals of antiepileptic drug usesInhibiting influx of Na+and Ca2+Induction of hepatic drug-metabolizing enzymes(1)Grand mal/Partial

11、：This results in abnormal movement or perceptions that are of short duration but that tend to recur.Potentiating GABA neuronal functions),Phenobrbital(i.Partial seizures(simple and complex);Antiepileptic drugsChoice of drugsEthosuximide 乙琥胺：peptit mal(1)Grand mal/Partial：depression of respiratory an

12、d vasomotor centers,antagonized by calcium preparations(i.Mephenytoin 美芬妥英,Ethotoin 乙苯妥英：analogues of phenytoinMechanisms of antiepileptic drugsPhenytoin,Carbamazepine,PhenobarbitalClassification of epilepsy(older)Classification of epilepsy(older)(3)AntiarrhythmiaCHCOOHGeneralized seizures(全身发作）Meph

13、enytoin 美芬妥英,Ethotoin 乙苯妥英：analogues of phenytoinIneffective for petit mal(absence seizures)Other anticovulsant drugsEffective for psychomotor seizures,and grand malPrimidone,Valproate sodiumClassification of epilepsyGeneralized seizures(全身发作）Partial seizures(simple and complex);Sedative-hypnotic dr

14、ugsOsteomalacia by abnormal vitamin D metabolism and calcium absorptionHemological reactionsEffects：central depression;Inhibiting excessive dischargesOther anticovulsant drugsEpilepsy is not a single entity;it is a family of different recurrent seizure disorders that have in common the sudden,excessive and disorderly discharge of central neurons.Potentiating GABA neuronal functionsClonazepam,Valproate sodiumPrimidone,Valproate sodiumPrincipals of antiepileptic drug uses