Anti-epileptic drugs and anticonvulsant

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?16? ????????? Anti-epileptic drugs and
anticonvulsant
??(epilepsy)
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??(epilepsy)????????????????????,????????????????
????????? ?????????????,??????? ???? 30-40?????
,?????????????? GABA?? (1)?? GABA?????????
??GABA???????? (2)VB6?GABA??????,?GABA?,??
???VB6????? ??????, GABA??????? GABA????????
?
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???? ?.?????(?????????) 1.
???(???????)??????,???????
??,CNS????,????? 2. ?????? ????????,????.
3. ???(????)?????,??????? ,??30s
?,?????? 4. ?????? ?.?????(?????) 1.
???????(?????) ?????????,?????????
??????????? 2. ???????(???????)
??????,???????,???????,30s-2min?
???????? 3. ????3-9???,??????
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• ??? ???????
• ????(phenytoin sodium,???)
• ????
• ???,????,PO???????,6-10????????(10-20ug/ml),??????
  ????.
• i.v??????(??????)
• ???(??,????)
• 2. ???????85-90,????,10ug/ml???????????

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????? 1. ???????????????
???????? ?????????
?????(?????)? 2.  ???????????? gt?????. 3. 
???????????????????
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???? ?????????,???????????, ??????????? 1.
???????????? 2. ????????????Na?Ca
??,??????,Na?Ca ???,????????,???????,
?????? (1)??????????(L??N?) (2)?????????? (3)?????
?????
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???? ????, 20ug/ml???????? 1. ????,???,????. 2.
 CNS????,????????????? ?? ???,?????40ug/ml??,??
???? 3.???? (1)????,?????,??????,???? (2)
????? (3)???????????,???????? (4)???????????,VitD?
?? (5) ????????????????,???
??????? 4.????,?????????????? 5.?????????????
??????????? 6.????
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????(carbamazepine,????)
????? 1.?????Na??,??????????? ?  
??????????(2/3??) ?  
?????????????? 2. ???????
????????????????? 3.???????????????? gt
???? ???? 1.??????????????,????(????)2.??????
??(????????????)????
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? ? ? ?(phenobarbital,???,luminal) 1.
?????????????(????GABA
??Cl-??,????,?????)?
??Ca2????????? 2. ???????????????(????)
????????(??,???????
?)
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???(primidone,?????????) 1. ??????????????????,??
????? 2. ??? ??????,???????????? ?????????
lt???? ???? 3. ????CNS??????? 4.
?dilantin?carbamazepine??????
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???(ethosuximide) 1.
????4-6d??????? 2. ??T?Ca2????3Hz????
3. ?????????,????????,
?????,?????,????????? 4. ????
??????????(?????????????) ?????????????
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????(sodium valproate) 1. ??????,????????
????? gt ???,?????? ?????? lt ????
??? lt ?????????
???????????????? ??????????? 2.
???????????,??????? (1)??Na??,??????
(2)??GABA??,????,GABA??? 3. ????
???????,????(40),????(??)?
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????? ????????? ???(????)???????????,
????????
????(????)????,??????
???????????????
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????(flunarizine) 1. ????? ??????????,????Na?T
??L?Ca2?? (1)???? (2)??????,?????????????? 2.
??????,????
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????????????? ?????????????????????
??,??????????????????? ?????????????????????
?????????
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???   ????





Mg2???????,????5,?Mg2 ?,
?????????(??)? ???(magnesium dulfate) 1.
PO???,???????? 2. ????CNS???????( Mg2??Ca2
, ??Ach?????????Ca2
???????????) ??? ?????????????
? ???????? 3. ??,???????????????
???????????????
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Summary
1. Phenytoin is one of the most effective drugs
against partial seizures and generalized
tonic-clonic seizures. 2. Phenobarbital is
useful in the treatment of partial seizures and
generalized tonic-clonic seizures. 3.
Carbamazepine was initially marketed for the
treatment of trigeminal neuralgia but has proved
useful for epilepsy as well. Carbamazepine is
also useful in some patients with mania (bipolar
disorder).
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