第16章 抗癫痫抗惊厥药.ppt

第16章抗癫痫药和抗惊厥药
Antiepileptics & anticonvulsive drugs
§1 antiepileptic drugs
㈠ Epilepsy 癫痫
1、 S disorders;
1) cerebral focus nerve cell
2)sudden 、 abnormity 、rapid
high frequency local discharge
3)around diffuse
4) cerebral function disorders 。
introduction
Causes of epilepsy
Damage to the brain:
1)tumours、
2) head injury 、
3)infection、
4) cerebrovascular accident;
2、Character of paroxysm
1) abrupt onset
① staring (目瞪)
② cessation of ongoing activities
③ lasting less than 30 sec
2)transient、
3)repeat ;
Classification of epileptic
1、Partial seizures:
1)、simple partial—
key feature:preservation of
consciousness;
2)、complex partial—
impaired consciousness
lasting 30sc—2min。
2、generalized seizures:
1)absence seizures(peptit-mal):
2)myoclonic seizures:
a brief shock like contraction
of muscle ;
3)tonic –clonic seizures:
(grand-mal epilepsy)
§1 antiepileptic drugs
一、manner of action :
1、㈠ local discharge
2、around diffuse.
二、mechanism of action
1 、 function of GABA
2、interfere Na+、K+、Ca2+
channel
usual drugs
phenytoin sodium
(苯妥英钠、大仑丁,dilantin)
[ ics ]
1、PO.—absorption somewhat slow ,
F—difference obvious ;
2、stimulation,not suitable IM
3、extensively bound to serum
protein ;
3、 elimination velocity with blood concentration correlation
 10g/ml: first-order elimination
ics ,t½ 6-24 h
 10g/ml: zero-order elimination
ics , t½ 20-60 h
[actions and uses]
epilepsy
1) Generalized tonic –clonic;
partial seizure (first choice )
2) absence seizures inefficacy ;
and related neuralgias
3. arrhythmia
(related to digitalis intoxication)