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Antiepileptics approximately 8 minutes

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A seizure is a brief episode of abnormal electrical activity in the nerve cells of the brain which may or may not lead to a convulsion a convulsion is a more severe seizure characterized by involuntary spasmodic contractions of any or all voluntary muscles throughout the body including skeletal facial and ocular muscles anti-epileptic drugs are called anticonvulsants

Anti-epileptic drugs is a more appropriate term because many of these medications are indicated for the management of all types of epilepsy not necessarily just convulsions anticonvulsants are medications that are used to prevent the convulsive seizure to be associated with epilepsy the goal of antiepileptic drug therapy is to control or prevent seizures while

Maintaining a reasonable quality of life many anti-epileptic drugs have adverse effects and achieving seizure control while avoiding adverse effects is often a difficult balancing act in most cases the therapeutic goal is not to eliminate seizure activity but rather to maximum ly reduce the incidence of seizures while minimizing drug induced toxicity many patients

Must take these drugs for their entire lives treatment may eventually be stopped in some but others will experience repeated seizures if constant levels of antiepileptic drugs are not maintained in the blood abrupt discontinuation of these drugs can result in withdrawal seizures a number of antiepileptic drugs are available sometimes a combination of drugs must

Be given to control the disorder nonetheless most seizure disorders can be controlled to optimize drug selection for each patient neurologists consider the known efficacy of a given drug for a certain type of seizure the adverse effects the likelihood of drug interactions the cost and the ease of use generally single drug therapy must fail before two drug or multi

Drug therapy is attempted patients are normally started on a single antiepileptic drug and dosage is slowly increased until the seizures are controlled or until clinical toxicity occurs if the first antiepileptic drug is not effective the drug should be tapered slowly while a second drug is introduced anti-epileptic drugs should never be stopped abruptly unless the

Severe adverse effects occur it is sometimes difficult to control a patient seizures using a single drug but mono therapy is most likely to result in higher serum drug concentrations fewer side effects and better control therapeutic drug monitoring of a serum drug concentration provides a useful guide line in assessing the effectiveness of therapy maintaining serum

Drug levels within therapeutic ranges have helps not only to control seizures but also to reduce adverse effects each patient should be monitored individually and the dosages adjusted based on the individual case in many patients maintenance is successful at levels below or above the usual therapeutic range the goal should be to slowly drive straight to the lowest

Effective serum drug level that controls seizure disorders this reduces the risk of adverse drug effects and drug interactions successful control with seizure disorders hinges on the selection of appropriate class as with many classes of drugs the exact mechanism of action of the antiepileptic drugs is not known with certainty however strong evidence indicates that

They alter the movement of sodium potassium calcium and magnesium ions the changes in the movement of these ions induced by anti epileptics results in more stabilized and less excitable cell membranes the major pharmacologic effects of anti epileptics are threefold first they increase the threshold of activity in the brain called the motor cortex in other words they

Make it more difficult for a nerve to be excited or they reduce the nerves responds to incoming electrical or chemical stimulation second they act to limit the spread of a seizure discharged from its origin they do this by suppressing the transmission of impulses from one nerve to the next third they can decrease the spread of nerve impulse conduction within a given

Neuron regardless of the mechanism the overall effect is that anti epileptics stabilize neurons and keep them from becoming hyper excited and generating excessive nerve impulses to adjacent neurons some work by enhancing the effects of the inhibitory neurotransmitter gamma amino butyric acid better known as gamma the major therapeutic use of antiepileptic drugs is

A prevention or control of seizure activity anti epileptics are chiefly used for the long-term maintenance of epilepsy however they are useful for the acute treatment of convulsions and status epilepticus in these cases that therapy is typically diazepam which is considered by many to be the drug of choice once status epilepticus kiss is controlled long-term drug

Therapy has begun with drugs from the prevention of future seizures patients who undergo brain surgery or who have experienced severe head injuries may receive prophylactic anti epileptic therapy these patients are at high risk for acquiring a seizure disorder and often severe complications will arise if seizures are not controlled anti-epileptic drugs are plagued

By many adverse effects which often limit their usefulness drugs must be withdrawn for many patients because of some of these effects in december 2008 the us food and drug administration required black box warnings on all anti-epileptic drugs regarding the risk for suicidal thoughts and behavior patients being treated with anti-epileptic drugs for any indication

Should be monitored for the emergence or worsening of depression suicidal thoughts or behavior or any unusual changes in mood or behavior this slide lists the major classifications of antiepileptic drugs with examples of drugs in each category

Transcribed from video
Antiepileptics approximately 8 minutes By Mary Bryniarski