Describe the general mechanism of anticonvulsant drugs.
Anticonvulsant drugs inhibit neural activity (↓ neural excitation, ↑ neural inhibition) and increase the seizure threshold by interacting with specific receptors and ion channels
What is the difference between first- and second generation anticonvulsants?
Compared to second-generation anticonvulsants, first-generation anticonvulsants have a narrower therapeutic range, more severe side effects, and a wider range of drug interactions.
List the importatn (EDU) first-generation anticonvulsants.
Valproate
Carbamazepine
Ethosuximide
Phenytoin
List the importatn (EDU) second-generation anticonvulsants.
Lamotrigine
Gabapentin
What is an additional consideration concerning anticonvulsants?
Monotherapy should always be the first-line treatment: increase the dosage of the drug to the therapeutic range before initiating combination therapy —> However, approx. one-third of epilepsy patients do not become seizure-free with monotherapy.
Combination therapy: drugs from different classes and/or with different pharmacologic modes of action for refractory seizures —> Combining two or three of the standard antiepileptic drugs is usually safe. 20–30% of epilepsy patients do not become seizure‑free even with combination therapy, although it may decrease seizure frequency and increase the quality of life in such patients. In such cases, nonpharmacological therapy should be considered.
Last changed2 years ago